Clinical utility of 99mTc-labeled ubiquicidin 29-41 antimicrobial peptide for the scintigraphic detection of mediastinitis after cardiac surgery.

Abstract:

BACKGROUND:Previous studies demonstrated that (99m)Tc-labeled-ubiquicidin 29-41 ((99m)Tc-UBI 29-41) imaging is an accurate method for detection of bacterial infections. This study was conducted to evaluate the clinical use of (99m)Tc-UBI 29-41 for detection of mediastinitis after cardiac surgery. METHODS:Thirteen patients with suspected mediastinitis after cardiac surgery were included. Qualitative and semiquantitative analyses of (99m)Tc-UBI 29-41 images were performed. Mediastinitis was confirmed by bacterial culture. RESULTS:Qualitative analysis correctly identified the infection in 5/6 patients with mediastinitis. For observer 1, there were five true-positive results, six true-negative results, one false-positive result and one false-negative result (sensitivity: 83%, specificity: 85%, positive predictive value: 83%, negative predictive value: 85%, and overall diagnostic accuracy: 84%). For observer 2, there were five true-positive results, five true-negative results, two false-positive results and one false-negative result (sensitivity: 83%, specificity: 71%, positive predictive value: 71%, negative predictive value: 83%, and overall diagnostic accuracy: 76%). Agreement between observers was 0.847 (SE=0.145, p=0.002). Semiquantitative analysis showed a higher mediastinum uptake of the (99m)Tc-UBI 29-41 in patients with mediastinitis than that derived from patients without mediastinitis. Mean uptake of (99m)Tc-UBI 29-41 was 60.4+/-10.3 counts/pixel and 47.4+/-5.5 counts/pixel, respectively (p=0.01). At the threshold value of > or =57 counts/pixel using ROC analysis, the sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy for detecting patients with mediastinitis were 83, 100, 100, 87, and 92%, respectively (p=0.02; 95% CI: 0.65-1.10%). CONCLUSIONS:(99m)Tc-UBI 29-41 imaging yielded fast and promising first results for patients with suspected mediastinitis after cardiac surgery and, as such, deserves further investigation.

journal_name

Arch Med Res

authors

Vallejo E,Martinez I,Tejero A,Hernandez S,Jimenez L,Bialostozky D,Sanchez G,Ilarraza H,Ferro-Flores G

doi

10.1016/j.arcmed.2008.09.002

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

768-74

issue

8

eissn

0188-4409

issn

1873-5487

pii

S0188-4409(08)00221-X

journal_volume

39

pub_type

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