DIAGNOSTIC ACCURACY OF 99 MTC LABELLED UBIQUICIDIN (29-41) SPECT/CT FOR DIAGNOSIS OF OSTEOMYELITIS IN DIABETIC FOOT

Muhammad Atif; Fida Hussain; Zaigham Salim Dar; Jameela Khatoon; Saadia Ajmal; Muhammad Adil

doi:10.51253/pafmj.v71i3.4102

Authors

Muhammad Atif Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Fida Hussain Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Zaigham Salim Dar Armed Forces Institute of Cardiology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Jameela Khatoon Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Saadia Ajmal Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Adil INOR Cancer Hospital, Abbottabad Pakistan

DOI:

https://doi.org/10.51253/pafmj.v71i3.4102

Keywords:

Diabetic foot, Infection imaging, Osteomyelitis, 99mTc-UBI (29-41) SPECT/CT

Abstract

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.