University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen, Netherlands.
University of Pretoria, Steve Biko Academic Hospital, Department of Nuclear Medicine, Pretoria, South Africa.
Curr Pharm Des. 2018;24(12):1287-1303. doi: 10.2174/1381612824666180227094454.
Diabetic Foot Infections (DFIs) are associated with increased morbidity, an economic burden on patients, their families and healthcare systems and increased mortality. Early diagnosis with prompt, appropriate and adequate treatment of the infected diabetic foot is crucial. The determination of DFIs, however, may be quite perplexing and invasive. Imaging is useful in the evaluation of certain cases of DFIs, especially in suspected instances with no overt clinical features, or in the diagnosis of osteomyelitis. Nuclear medicine imaging is currently used in the evaluation of DFIs; however, like all the imaging techniques now available, it has its limitations. Several radiopharmaceuticals presently available play useful roles in the management of DFIs, while new ones are being evaluated. Optical imaging techniques have recently demonstrated promising results in the evaluation of many infections including DFIs. Using the same molecule, a tracer can be labeled with a radioisotope or an optical imaging dye. This enables infections to be evaluated both pre- and intra-operatively when surgery is required in their management. In some cases, tracers have been simultaneously labeled with both a radioisotope and an optical imaging dye to produce a hybrid tracer. These new tracers potentially provide powerful and new opportunities in the management of DFIs. In this review, we briefly examine tracers that have been used in the evaluation of the infected diabetic foot. We then explore the potential of new imaging tracers currently under development for infection that may be useful in the management of DFIs.
糖尿病足感染（DFI）与发病率增加、患者及其家庭和医疗保健系统的经济负担以及死亡率增加有关。早期诊断和及时、适当、充分的治疗感染性糖尿病足至关重要。然而，DFI 的确定可能相当复杂和具有侵入性。影像学在某些 DFI 病例的评估中很有用，尤其是在没有明显临床特征的疑似病例中，或在骨髓炎的诊断中。核医学成像目前用于 DFI 的评估；然而，与目前所有可用的成像技术一样，它也有其局限性。目前有几种放射性药物在 DFI 的治疗中发挥了有用的作用，而新的放射性药物正在评估中。光学成像技术最近在评估许多感染方面显示出了有希望的结果，包括 DFI。使用相同的分子，可以用放射性同位素或光学成像染料对示踪剂进行标记。这使得在需要手术治疗时可以在术前和术中对感染进行评估。在某些情况下，示踪剂同时用放射性同位素和光学成像染料进行标记，以产生混合示踪剂。这些新的示踪剂在 DFI 的治疗中提供了强大的新机会。在这篇综述中，我们简要地检查了用于评估感染性糖尿病足的示踪剂。然后，我们探讨了目前正在开发的用于感染的新型成像示踪剂的潜力，这些示踪剂可能对 DFI 的治疗有用。
