title: Superiority of non-capsulated 14C-urea breath test over capsule based method for detection of Helicobacter pylori infection - a preliminary report.
abstract: BACKGROUND
  14C-urea breath test (14C-UBT) is employed as a 'gold standard' technique for the detection of active gastric Helicobacter pylori infection and is recommended as the best option for "test-and-treat" strategy in primary health care centers.
  
  
  OBJECTIVE
  To compare the performance of capsulated and non-capsulated 14C-UBT protocols for the detection of H. pylori infection in patients.
  
  
  METHODS
  Fifty eight H. pylori infected patients underwent routine upper GI endoscopy and biopsies were processed for rapid urease test (RUT) and histopathology examination. Capsulated 14C-UBT was done in a novel way by using 74 kBq of 14C-urea along with 6.0 MBq of 99mTc-diethylene triamine penta-acetic acid (99mTc-DTPA) to simultaneously monitor the movement and the fate of ingested capsule after delineating the stomach contour by using 20.0 MBq of 99mTechnetium pertechnetate (99mTcO4-) under dual head gamma camera. Non-capsulated 14C-UBT was performed within 2 days of the previous test and the results of these protocols were compared.
  
  
  RESULTS
  In 3 out of 58 H. pylori positive cases (5.17%), 14C-UBT results were found to be negative by using the capsulated method. Interestingly, on monitoring the real time images of the capsule in these cases it was found that misdiagnosis of H. pylori infection occurred mainly due to either rapid transit of the 14C-urea containing capsule from the upper gastric tract or its incomplete resolution in the stomach during the phase of breath collection.
  
  
  CONCLUSIONS
  Use of non-capsulated '4C-UBT protocol appears to be a superior option than the conventional capsule based technique for the detection of H. pylori infection.
authors.affiliation: Departments of Biophysics, New Delhi, India. chander_pathak@rediffmail.com
authors.forename: Chander M
authors.initials: CM
authors.lastname: Pathak
authors.forename: Balwinder
authors.initials: B
authors.lastname: Kaur
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Bhasin
authors.forename: Bhagwant R
authors.initials: BR
authors.lastname: Mittal
authors.forename: Sarika
authors.initials: S
authors.lastname: Sharma
authors.forename: Krishan L
authors.initials: KL
authors.lastname: Khanduja
authors.forename: Lalit
authors.initials: L
authors.lastname: Aggarwal
authors.forename: Surinder S
authors.initials: SS
authors.lastname: Rana
mesh_terms: D001944:Breath Tests / Q000379:methods; D002214:Capsules; D002250:Carbon Radioisotopes; D005188:False Negative Reactions; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D014508:Urea
chemical_list: D002214:Capsules; D002250:Carbon Radioisotopes; D014508:Urea