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RADIOTRACER IMAGING OF ANGIOSOME FOOT PERFUSION CORRELATES WITH ANKLE-BRACHIAL INDEX AND DIFFERENTIATES CRITICAL LIMB ISCHEMIA PATIENTS FROM HEALTHY SUBJECTS
1518 JACC March 21, 2017 Volume 69, Issue 11
Non Invasive Imaging (Echocardiography, Nuclear, PET, MR and CT) RADIOTRACER IMAGING OF ANGIOSOME FOOT PERFUSION CORRELATES WITH ANKLE-BRACHIAL INDEX AND DIFFERENTIATES CRITICAL LIMB ISCHEMIA PATIENTS FROM HEALTHY SUBJECTS Poster Contributions Poster Hall, Hall C Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m. Session Title: Nuclear Cardiology: Beyond Perfusion Abstract Category: 30. Non Invasive Imaging: Nuclear Presentation Number: 1196-199 Authors: Jessica Buckley, Xenophon Papademetris, Carlos Mena-Hurtado, Peter A. Blume, Bauer Sumpio, Albert Sinusas, Mitchel Stacy, Yale University School of Medicine, New Haven, CT, USA
Background: Disruptions to the microcirculation may contribute to foot ulceration in patients with diabetes mellitus and critical limb ischemia (CLI). Single photon emission computed tomography (SPECT)/CT imaging assesses microvascular perfusion in the foot, but has not been evaluated in foot angiosomes or correlated to standard indices such as the ankle-brachial index (ABI), which assesses large vessel disease.
Methods: Diabetic CLI patients with non-healing ulcers (n=21) and healthy subjects (n=9) underwent resting SPECT/CT perfusion imaging of the feet (Fig. 1A). CT images were segmented into five angiosomes and used for quantifying radiotracer uptake (Fig. 1B), expressed as standardized uptake values (SUVs). SUVs were assessed in the angiosome containing the non-healing ulcer, while average SUVs for the whole foot were evaluated in healthy subjects. ABI was assessed in the limbs of CLI and healthy subjects. Results: SPECT/CT imaging of angiosome perfusion correlated with ABI (r=0.51; P<0.01; Fig. 1C). SPECT/CT imaging of ulcerated foot angiosomes in CLI patients revealed significantly lower perfusion values when compared to average perfusion values in the feet of healthy subjects (P=0.04; Fig. 1D). Conclusions: SPECT/CT imaging correlates with ABI and allows for comparison of angiosome perfusion between CLI patients and healthy subjects. Future application of SPECT/CT imaging may provide insight into local changes in microvascular perfusion after targeted therapeutic interventions.
Non Invasive Imaging (Echocardiography, Nuclear, PET, MR and CT) RADIOTRACER IMAGING OF ANGIOSOME FOOT PERFUSION CORRELATES WITH ANKLE-BRACHIAL INDEX AND DIFFERENTIATES CRITICAL LIMB ISCHEMIA PATIENTS FROM HEALTHY SUBJECTS Poster Contributions Poster Hall, Hall C Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m. Session Title: Nuclear Cardiology: Beyond Perfusion Abstract Category: 30. Non Invasive Imaging: Nuclear Presentation Number: 1196-199 Authors: Jessica Buckley, Xenophon Papademetris, Carlos Mena-Hurtado, Peter A. Blume, Bauer Sumpio, Albert Sinusas, Mitchel Stacy, Yale University School of Medicine, New Haven, CT, USA
Background: Disruptions to the microcirculation may contribute to foot ulceration in patients with diabetes mellitus and critical limb ischemia (CLI). Single photon emission computed tomography (SPECT)/CT imaging assesses microvascular perfusion in the foot, but has not been evaluated in foot angiosomes or correlated to standard indices such as the ankle-brachial index (ABI), which assesses large vessel disease.
Methods: Diabetic CLI patients with non-healing ulcers (n=21) and healthy subjects (n=9) underwent resting SPECT/CT perfusion imaging of the feet (Fig. 1A). CT images were segmented into five angiosomes and used for quantifying radiotracer uptake (Fig. 1B), expressed as standardized uptake values (SUVs). SUVs were assessed in the angiosome containing the non-healing ulcer, while average SUVs for the whole foot were evaluated in healthy subjects. ABI was assessed in the limbs of CLI and healthy subjects. Results: SPECT/CT imaging of angiosome perfusion correlated with ABI (r=0.51; P<0.01; Fig. 1C). SPECT/CT imaging of ulcerated foot angiosomes in CLI patients revealed significantly lower perfusion values when compared to average perfusion values in the feet of healthy subjects (P=0.04; Fig. 1D). Conclusions: SPECT/CT imaging correlates with ABI and allows for comparison of angiosome perfusion between CLI patients and healthy subjects. Future application of SPECT/CT imaging may provide insight into local changes in microvascular perfusion after targeted therapeutic interventions.