Objective: To determine diagnostic accuracy of 99mTc labelled Ubiquicidin (29-41) SPECT/CT for detection of osteomyelitis in diabetic foot patients by taking bone biopsy as gold standard.
Study Design: Cross-sectional validation study.
Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, from Apr 2017 to Mar 2018.
Methodology: Study assessed 122 patients of both genders, aged between 30-80 years (mean age=55.3 years), presenting with diabetic foot ulcers having suspicion of osteomyelitis, by 99mTc-Ubiquicidin (29-41) SPECT/CT followed by bone biopsy (histopathology and culture) taken as gold standard.
Results: Among 122 patients [94 male (77%) and 28 female (23%)], osteomyelitis was histopathologically confirmed in 113 patients. 107 out of these patients were positive for osteomyelitis on 99mTc-UBI (29-41) SPECT/CT (true positives) while 6 were false negative. Out of 9 patients declared negative for osteomyelitis on histopathology and culture, 8 were negative on 99mTc-UBI (29-41) SPECT/CT as well (true negative) while only 1 case came out to be positive (false positive). Thus, the 99mTc-UBI (29-41) scan showed 94.6% sensitivity, 88.89% specificity, 99% positive predictive value, 57% negative predictive value with overall 94.2% diagnostic accuracy.
Conclusion: 99mTc labelled Ubiquicidin (29-41) SPECT/CT scan can precisely localize infective focus, in diabetic foot osteomyelitis, with simultaneous discrimination between bone and soft tissues.
Objective: To evaluate the diagnostic accuracy of C-14 Urea Breath Test for detection of helicobacter pylori infection in patients with gastritis.
Study Design: Cross-sectional validation study.
Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, from Feb to Aug 2016.
Methodology: After fulfilling inclusion and exclusion criteria, 110 patients of both genders, aged between 18-50 years, were enrolled. Prior written informed consent was obtained from each patient. First, they were assessed by C-14 Urea Breath Test, followed by endoscopic biopsy and histopathology. Results of C-14 Urea Breath Test were compared to histopathology diagnosis which was taken as gold standard.
Results: Patients’ ages ranged from 18-50 years with a mean ± SD of 37.45 ± 10.21 years. Seventy four (67.3%) of them were males and 36 (32.7%) were females. Sixty four (58.2%) patients were suspected of helicobacter pylori on C-14 Urea breath test. However, histopathology of endoscopic biopsy confirmed helicobacter pylori in 66 (60%) patients yielding 64 true positive, 44 true negative and 2 false negative cases. Calculated sensitivity was 96.97%, specificity 100% and accuracy was 98.18% for C-14 Urea Breath Test with negative and positive predictive values of 95.65% and 100% respectively.
Conclusion: C-14 Urea Breath Test is highly accurate, sensitive and specific test for detection of helicobacter pylori infection, irrespective of patient’s age and gender.
Objective: To compare single photon emission computed tomography (SPECT) with planar whole body bone scan (WBBS) in diagnosis of solitary vertebral lesion in non-skeletal malignancies in terms of diagnostic accuracy.
Objective: To validate ‘stress only’ protocol against ‘rest stress protocol in normal and essentially normal cases undergoing Tc99m MIBI gated myocardial perfusion Single Photon Emission Computed Tomography imaging.
Study Design: A retrospective observational study.
Place and Duration of Study: Department of Nuclear Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Disease, Rawalpindi, Pakistan, from Jul to Sep 2019.
Methodology: 136 cases were included. Patients underwent Tc-99m gated Single Photon Emission Computed Tomography MPI using a single day, rest/stress protocol. The rest study was performed first with 8-10 mCi Tc-99m MIBI followed by stress study, 3 hours later with 3 times the rest dose. The most common stress technique was pharmacological stress and bicycle ergometer exercise with 0.14 mg/kg/min adenosine infusion. Few patients underwent physical stress using Bruce protocol, achieving a minimum of 85% of the target heart rate. Mages–stress followed by rest–were evaluated by two experienced nuclear cardiologists (blinded to the MPI reports) and interpreted as ‘normal’ or ‘essentially normal’.
Results: Evaluation of stress-only and rest-stress Single Photon Emission Computed Tomography myocardial images yielded a concordance rate of 84.56% with Cohen’s kappa coefficient of 0.69.
Conclusion: Substantial agreement and good concordance were found in normal and essentially normal ‘stress only’ and ‘rest stress protocols.
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