Clinical trial of specific imaging of infections.
OBJECTIVE
For several decades Ga citrate, technetium-99m ((99m)Tc) or (111)In-labelled leukocytes have been used for imaging the inflammatory process. Unfortunately, these radiopharmaceuticals are not infection-specific markers. In preclinical settings, radiolabelled antimicrobial peptides (AMPs), such as UBI 29-41 seem to be highly infection-specific and even high doses of these peptides have shown neither toxicity nor side effects in animals.


METHODS
In this study we present data of a recent clinical trial carried out with the (99m)Tc labelled antimicrobial peptide UBI 29-41 ((99m)Tc-UBI 29-41) regarding its sensitivity, specificity, and accuracy in detecting various types of infections in 148 patients. The outcome of the trial with (99m)Tc-UBI 29-41 is compared with that of five other trials.


RESULTS
Preparation of (99m)Tc-UBI 29-41 as a kit formulation is an easy, rapid, and reproducible process, and the tracer is very well tolerated by patients. The radiopharmaceutical has proven to be very stable and after injection into patients the biodistribution (renal clearance) and dosimetry seem to be favourable over other infection imaging radiopharmaceuticals. In this preliminary human study, patients with fever of unknown origin, osteomyelitis, diabetic foot, prosthesis infection, septic arthritis, or bacteraemia were successfully imaged with (99m)Tc-UBI 29-41 scintigraphy.


CONCLUSIONS
(99m)Tc-UBI 29-41 is a promising agent for the specific detection of infections in humans because of its high sensitivity (96.3%), specificity (94.1%), and accuracy (95.3%) with high positive predictive (95.1%) and negative predictive values (95.5%).
Arteaga de Murphy
Consuelo
C
Departamento de Medicina Nuclear, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga, Delegación Tlalpan, Mexico.
Gemmel
Filip
F
Balter
Jenny
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010446:Peptide Fragments; D011786:Quality Control; D011874:Radiometry; D055815:Young Adult
D015609:Organotechnetium Compounds; D010446:Peptide Fragments; C485080:technetium 99m ubiquicidin(29-41)