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.
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.
Authors: Emilio Bouza; Arístides de Alarcón; María Carmen Fariñas; Juan Gálvez; Miguel Ángel Goenaga; Francisco Gutiérrez-Díez; Javier Hortal; José Lasso; Carlos A Mestres; José M Miró; Enrique Navas; Mercedes Nieto; Antonio Parra; Enrique Pérez de la Sota; Hugo Rodríguez-Abella; Marta Rodríguez-Créixems; Jorge Rodríguez-Roda; Gemma Sánchez Espín; Dolores Sousa; Carlos Velasco García de Sierra; Patricia Muñoz; Martha Kestler Journal: J Clin Med Date: 2021-11-26 Impact factor: 4.241