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Osteomyelitis is a risk factor for lower extremity amputation in diabetic people. Antibiotic therapy allows a remission in 60 to 80% of cases. However the optimal duration of antibiotic therapy remains controversy due to the absence of validated marker of osteomyelitis remission. We have previously shown that the negativity of white blood cell SPECT/CT (Single Photon Emission Computed Tomography/Computed Tomography) imaging at the end of treatment allowed to predict remission of osteomyelitis at 1 year in all cases. A positive imaging was associated with recurrence in 70% of cases. The aim of our study was to evaluate prospectively the interest of white blood cell SPECT/CT to set the duration of antibiotic therapy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Diabetic patients with osteomyelitis | Patients with a clinical and radiological diagnosis of osteomyelitis were included in two diabetic centers |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| white blood cell SPECT/CT (Single Photon Emission Computed Tomography/Computed Tomography) imaging | Other |
|
| Measure | Description | Time Frame |
|---|---|---|
| Rate of remission of osteomyelitis at one year after the cessation of antibiotic treatment, evaluated by white blood cell SPECT/CT (Single Photon Emission Computed Tomography/Computed Tomography). | The outcome measure was reviewed by patient examination at least 12 months after completion of antibiotic treatment. A remission was defined by :
| one year after the end of the antibiotic treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of osteomyelitis remission at one year after a 6 weeks antibiotics duration, evaluated by white blood cell SPECT/CT | The outcome measure was reviewed by patient examination at least 12 months after completion of antibiotic treatment. A remission was defined by :
| one year after the end of the antibiotic treatment |
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Inclusion Criteria:
Exclusion Criteria:
- Indication for acute surgical bone resection or amputation
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Patients with a clinical and radiological diagnosis of osteomyelitis were included in two diabetic centers
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Julien Vouillarmet, MD | Contact | (4) 78 86 14 89 | +33 | julien.vouillarmet@chu-lyon.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Service d'Endocrinologie-Diabétologie-Maladies de la nutrition, GH Sud, Hospices Civils de Lyon | Recruiting | Pierre-Bénite | 69495 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33660690 | Derived | Vouillarmet J, Tordo J, Moret M, Michon P, Morelec I. 99mTc-white blood cell SPECT/CT to assess diabetic foot osteomyelitis remission: contribution of semi-quantitative scoring system. Nucl Med Commun. 2021 Jul 1;42(7):713-718. doi: 10.1097/MNM.0000000000001390. | |
| 28866726 | Derived | Vouillarmet J, Moret M, Morelec I, Michon P, Dubreuil J. Application of white blood cell SPECT/CT to predict remission after a 6 or 12 week course of antibiotic treatment for diabetic foot osteomyelitis. Diabetologia. 2017 Dec;60(12):2486-2494. doi: 10.1007/s00125-017-4417-x. Epub 2017 Sep 2. |
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| ID | Term |
|---|---|
| D017719 | Diabetic Foot |
| D010019 | Osteomyelitis |
| ID | Term |
|---|---|
| D003925 | Diabetic Angiopathies |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D016523 | Foot Ulcer |
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| ID | Term |
|---|---|
| D014965 | X-Rays |
| ID | Term |
|---|---|
| D060733 | Electromagnetic Radiation |
| D055590 | Electromagnetic Phenomena |
| D060328 | Magnetic Phenomena |
| D055585 | Physical Phenomena |
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| Sensibility ration of White Blood Cell SPECT/CT performed at the end of antibiotic treatment to predict the remission of osteomyelitis at one year. | Sensibility ratio= number of true positive /number of (true positive+false negative) | one year after the end of the antibiotic treatment |
| Specificity ratio of White Blood Cell SPECT/CT performed at the end of antibiotic treatment to predict the remission of osteomyelitis at one year. | Specificity ratio= number of true negative /number of (true negative+false positive) | one year after the end of the antibiotic treatment |
| Positive predictive value of White Blood Cell SPECT/CT performed at the end of antibiotic treatment to predict the remission of osteomyelitis at one year. | Positive predictive value = number of true positive / number of (true positive+false positive) | one year after the end of the antibiotic treatment |
| Negative predictive value of White Blood Cell SPECT/CT performed at the end of antibiotic treatment to predict the remission of osteomyelitis at one year. | Negative predictive value = number of true negative / number of (true negative+false negative) | one year after the end of the antibiotic treatment |
| D007871 |
| Leg Ulcer |
| D012883 | Skin Ulcer |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D048909 | Diabetes Complications |
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |
| D003929 | Diabetic Neuropathies |
| D001850 | Bone Diseases, Infectious |
| D007239 | Infections |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D011827 | Radiation |
| D011839 | Radiation, Ionizing |