Diabetic foot infections: how to investigate more efficiently? A retrospective study in a quaternary university center

Insights into Imaging

Table 3 Comparison between the hospital imaging related fees for the pre- and post-intervention cohorts

	Patient (#)	Fees ($CAD)⁴	Total ($CAD)
Pre-intervention cohort
Foot MRI¹	98	335.00	32,830.00
Foot scintigraphy²	108	429.80	46,418.40
Foot radiograph³	186	27.27	5072.22
Total hospital fees	223	–	84,320.62
Average hospital fee per patient	–	–	378.12
Post-intervention cohort
Foot MRI¹	37	335.00	12,395.00
Foot scintigraphy²	17	429.80	7306.60
Foot radiograph³	65	27.27	1772.55
Total hospital fees	73	–	21,474.15
Average hospital fee per patient	–	–	294.17

¹Foot MRI; our standard MRI protocols are usually performed on a 3 T imaging system with a dedicated foot and ankle coil and include: coronal and axial fat-saturated FSE T2-weighted images (Echo time (TE) 80–100, repetition time (TR) 2800–8000, echo train length (ETL) 11–13), coronal and sagittal FSE T1-weighted (TE 10–30, TR 450–750, ETL 3–5) and if creatinine clearance allows it, coronal and sagittal fat-saturated T1-weighted imaging following IV gadolinium administration
²Foot scintigraphy; our local protocol always includes a tri-phasic planar bone scan, with the addition of SPECT-CT acquisition when pertinent. This is then followed by planar ± SPECT-CT Gallium scintigraphy, when pertinent. This results in a total fee that can range from 214$CAD to 614$CAD, with an average fee of 429,80$CAD
³Foot radiograph; includes a standard AP, lateral and oblique views of the foot
⁴The fees are mandated by Québec’s Health and Social services Ministry and can be found on the ministry website. These fees are related to manpower and equipment related to imaging in the hospital setting, they do not include the radiologist or nuclear medicine specialist professional fee [20]