The goal of this study is to explore whether Dual Energy CT (DECT) scanning, using virtual noncalcium color maps, can serve as an alternate imaging modality to MRI for diagnosing osteomyelitis in patients with diabetic foot disease. Due to the speed at which CT scans can be produced and diagnosed, this method, if successful, would drastically reduce diagnosis time and hospital stay, leading to faster treatment and better patient outcomes.

Patients presenting with lesions suspicious for bone edema undergo standard-of-care x-ray and MRI scan for diagnosis. In addition, those who choose to participate in this study only need to undergo corresponding DECT scans of the same lesion. After diagnosis and treatment, scanned images from both modalities are de-identified and DECT images are post-processed using GE's Gemstone Spectral Imaging (GSI) to yield modified series that omit calcium and result in color maps, with hues, representing Hounsfield Units (HUs) of tissue density. Using only the color maps, blinded study radiologists then assess possible bone edema (fluid collection inside bone tissue cavities) across all cases and compare them to their earlier diagnoses to determine inter-modality accuracy and the value of DECT color maps for osteomyelitis diagnoses.