Abstract
Introduction: Single photon emission computed tomography (SPECT)/CT imaging is a standard approach for assessing myocardial perfusion, but has not been traditionally applied for evaluating peripheral vascular disease (PVD). Due to the prevalence of extremity perfusion abnormalities in PVD patients, SPECT/CT imaging may allow for sensitive physiological evaluation of regional changes in perfusion within the lower extremities following revascularization. Therefore, we assessed regional changes in angiosome foot perfusion following percutaneous revascularization in diabetic patients with critical limb ischemia (CLI) to evaluate the association between treatment-induced perfusion responses and clinical outcomes. Methods: Diabetic patients with CLI and non-healing ulcers (n=24) underwent SPECT/CT perfusion imaging of the feet before and after revascularization (Fig. 1A). CT images were segmented into angiosomes (i.e. vascular territories of the foot), and radiotracer uptake was expressed as standardized uptake values (SUVs). Post-treatment changes in perfusion within ulcerated angiosomes were quantified and limb salvage outcomes were assessed for the following 12 months. Results: Post-revascularization changes in perfusion were significantly higher in patients who experienced limb salvage compared to patients who underwent amputation in the 12-months after treatment (Fig. 1B). When patients were divided into groups (high and low perfusion responders) based on median perfusion response, patients with higher percent change in perfusion demonstrated a significantly higher incidence of amputation free survival (p=0.005; Fig. 1C). Conclusion: SPECT/CT imaging detects regional changes in foot perfusion following revascularization that are associated with limb salvage outcomes. Application of SPECT/CT perfusion imaging in the evaluation of PVD could assist with characterizing treatment success and predicting clinical outcomes.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Arteriosclerosis, Thrombosis, and Vascular Biology
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
