Therapeutic impact of [(18)F]fluoride positron-emission tomography/computed tomography on patients with unclear foot pain.
OBJECTIVE
To evaluate the therapeutic impact of [(18)F]fluoride positron-emission tomography/computed tomography ([(18)F]fluoride PET/CT) imaging on patients with unclear foot pain.


METHODS
Twenty-eight patients were prospectively included in this study. Therapeutic management was defined by two experienced dedicated foot surgeons before and after [(18)F]fluoride PET/CT imaging. Twenty-six patients underwent cross-sectional imaging [CT, magnetic resonance (MR)] prior to PET/CT. A retrospective analysis of the magnetic resonance imaging (MRI) diagnoses was performed when a therapy change occurred after PET/CT imaging.


RESULTS
In 13/28 (46%) patients therapeutic management was changed due to PET/CT results. Management changes occurred in patients with the following diagnoses: os trigonum syndrome; sinus tarsi syndrome; os tibiale externum syndrome; osteoarthritis of several joints; non-consolidated fragments; calcaneo-navicular coalition; plantar fasciitis; insertional tendinopathy; suggestion of periostitis; neoarticulations between metatarsal bones. Os trigonum, os tibiale externum, subtalar osteoarthritis and plantar fasciitis were only seen to be active on PET/CT images but not on MR images.


CONCLUSIONS
[(18)F]fluoride PET/CT has a substantial therapeutic impact on management in patients with unclear foot pain.
Fischer
Dorothee Rita
DR
Department of Nuclear Medicine, University Hospital of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland. dorothee.fischer@usz.ch
Maquieira
Gerardo J
GJ
Espinosa
Norman
N
Zanetti
Marco
M
Hesselmann
Rolf
R
Johayem
Anass
A
Hany
Thomas F
TF
von Schulthess
Gustav K
GK
Strobel
Klaus
K
D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D005528:Foot / Q000000981:diagnostic imaging; D005534:Foot Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010146:Pain / Q000209:etiology; D059408:Pain Management; D049268:Positron-Emission Tomography / Q000379:methods; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed / Q000379:methods*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18