Author/Authors :
Malek، Hadi نويسنده Assistant Professor, Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular, Medical and Research Center , , Alvandi، Maryam نويسنده Resident of Nuclear Medicine, Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular, Medical and Research Center , , Yaghoobi، Nahid نويسنده Associate Professor, Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular, Medical and Research Center , , Ghavidel، Alireza نويسنده Associate Professor, Department of Cardiac Surgery, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences , , Bitarafan Rajabi، Ahmad نويسنده Assistant Professor, Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular, Medical and Research Center , , Amouzadeh، Hedieh نويسنده Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular, Medical and Research Center , , Firoozabadi، Hassan نويسنده Associate Professor, Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular, Medical and Research Center ,
Abstract :
Aims- Previous studies have demonstrated that 99mTc-labeled Ubiquicidin 29-41 (99mTc-UBI) can
be used for the detection of bacterial infections as an accurate method.1 This study was
conducted to evaluate the clinical use of 99mTc-UBI for the evaluation of sternal wound
infection (SWI) after cardiac surgery.
Materials and Methods - Twenty-one patients with suspected SWI after median sternotomy were
included. Qualitative and quantitative voxel-based analyses of 99mTc-UBI images were
performed by two experienced nuclear physicians and the images were reported as negative,
positive for superficial, or positive for deep SWI on the basis of the uptake patterns. SWI was
defined according to the Centres for Disease Control and Classifications’ guideline.
Results- Among the cases, only one subject with a final diagnosis of non-infectious inflammation
was reported as superficial SWI in 99mTc-UBI scintigraphy. The sensitivity, specificity,
positive predictive value (PPV), and negative predictive value (NPV) for distinguishing SWI
from sterile inflammation were equal to 100%, 83.3%, 93.8%, and 100%. After implicating a
threshold of 3.08 for the target-to-background ratio, the specificity and PPV reached 100%.
The sensitivity, specificity, positive, and negative predictive values for the detection of
superficial and deep SWI were 100%, 92.9%, 87.5%, and 100% and 100%, 100%, 100%, and
100%, respectively. There was also a high interobserver agreement with all the kappa values
exceeding 0.8.
Conclusions- The results of the present study suggest that 99mTc-UBI could be of great use as an
accurate method for the evaluation of suspected postoperative SWI and could help in the
selection of appropriate treatment strategies for these patients.
