title: Diagnostic value of 99mTc-ubiquicidin scintigraphy for osteomyelitis and comparisons with 99mTc-methylene diphosphonate scintigraphy and magnetic resonance imaging.
abstract: OBJECTIVE
  The discrimination of bacterial infections from sterile inflammatory processes is of great importance in the management of inflammation. Currently available techniques cannot decisively address this issue. In this respect, antimicrobial peptide Tc-ubiquicidin (UBI) 29-41 scans have been showing interesting results. The aim of this study was to determine the accuracy of Tc-UBI scan in the detection of osteomyelitis and to compare it with Tc-methylene diphosphonate scan and magnetic resonance imaging (MRI).
  
  
  METHODS
  Twenty patients (mean age=48.90 years) with suspected osteomyelitis were included in this study. After evaluation of each patient through history taking, physical examination, appropriate laboratory tests, and other processes including bone probing, wound culture, and plain film radiography, MRIs, Tc-UBI scans, and Tc-methylene diphosphonate scans were performed. For quantitative analysis, the mean count of abnormal-to-normal (A/N) region was calculated for images acquired at 15, 30, 45, 60, 120, and 240 min to obtain the most favorable time for imaging.
  
  
  RESULTS
  In total, osteomyelitis was detected in the Tc-UBI scans of 17 patients, indicating 100% accuracy, compared with an accuracy of 90% for osteomyelitis detected in three-phase bone scans. The maximum mean A/N was observed at 15 min after intravenous injection (median: 1.91; interquartile range: 1.54-2.94). MRI was performed in 12 cases only with 75% accuracy. In addition, the A/N ratios for the Tc-UBI scans were not significantly different between patients with or without Staphylococcus aureus growth on wound cultures.
  
  
  CONCLUSIONS
  For fast imaging with high accuracy, Tc-UBI 29-41 is a suitable choice for the detection of osteomyelitis.
authors.affiliation: The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran. assadipoya@yahoo.com
authors.forename: Majid
authors.initials: M
authors.lastname: Assadi
authors.forename: Katayoun
authors.initials: K
authors.lastname: Vahdat
authors.forename: Iraj
authors.initials: I
authors.lastname: Nabipour
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Sehhat
authors.forename: Fahimeh
authors.initials: F
authors.lastname: Hadavand
authors.forename: Hamid
authors.initials: H
authors.lastname: Javadi
authors.forename: Alireza
authors.initials: A
authors.lastname: Tavakoli
authors.forename: Jamshid
authors.initials: J
authors.lastname: Saberifard
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Kalantarhormozi
authors.forename: Alireza
authors.initials: A
authors.lastname: Zakani
authors.forename: Mohammad
authors.initials: M
authors.lastname: Eftekhari
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010019:Osteomyelitis / Q000000981:diagnostic imaging*; D010446:Peptide Fragments; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013669:Technetium Tc 99m Medronate; D055815:Young Adult
chemical_list: D015609:Organotechnetium Compounds; D010446:Peptide Fragments; C485080:technetium 99m ubiquicidin(29-41); D013669:Technetium Tc 99m Medronate