Clinical value of Tc-99m MIBI scintigraphy for the level of lower limb amputation in patients with diabetic foot ulcers

Abstract Background There is a positive relationship between mitochondrial damage in the cell and uptake in 99mTc-MIBI scintigraphy. Severe mitochondrial dysfunction with cell death occurs in patients with diabetic foot ulcers. 99mTc-MIBI scintigraphy should be considered in order to decide on the level of amputation. Methods Prospectively twenty-four patients with diabetic foot ulcers (DFUs) were included in the study. As a result of treatment that started with the hospitalization, patients whose DFUs healed and did not need surgical intervention were determined as group 1, and patients whose DFUs did not regress despite surgical and medical treatment and who required further surgical intervention were determined as Group 2. 99mTc-MIBI scintigraphy was obtained before surgery. The 99mTc-MIBI uptake rates of the injured foot relative to the healthy foot were recorded. Deep tissue culture was taken at surgery. ESR, WBC, CRP and albumin values of the patients were measured. Results In this study, 99mTc-MIBI uptake rates of patients with poor prognosis were higher at all times than in patients who did not require revision surgery. A significant difference was found between these values in the 10th- and 30th-second rates. While the CRP level was 86.04 ± 21.87 mg / dL in Group 1, it was measured as 144.43 ± 27.54 mg / dL in Group 2 (p = 0,040). There is a positive correlation between ulcerated foot / healthy foot 99mTc-MIBI involvement rates at 10 and 30 seconds and CRP values, and a negative correlation between albumin values. Conclusion There is a significant relationship between 99mTc-MIBI involvement rates and poor prognosis and reamputation. The correlation between CRP and albumin levels which are among the predictive values, and 99mTc-MIBI uptake confirms this relationship. In diabetic foot ulcers, which are difficult to management and treatment.