68Ga-DOTA Ubiquicidin PET/CT in an Infected Implant

Iranian journal of pharmaceutical research (IJPR)

Ubiquicidin (UBI) [29][30][31][32][33][34][35][36][37][38][39][40][41] is a synthetic cationic antimicrobial peptide that preferentially binds to bacterial cell membrane at the site of infection. We aimed to assess diagnostic value of 99m Tc-UBI [29-41] as a radiopharmaceutical in differentiation of bacterial infection from sterile inflammation in suspected orthopedic implants. Nine patients suspected for orthopedic implant infection, all males with the mean age of 41.6 ± 20.9 years, were studied. A dose of 10 MBq/Kg (range : 555-740 MBq) 99m Tc-UBI [29-41] was injected intravenously. A dynamic study followed by static whole body imaging at 30, 60 and 120 min post-radiotracer injection was acquired. Periprosthetic tissue culture was considered the closest test to a gold standard for diagnosing infections and scintigraphic scans were categorized as true-or false-positive and true-or false-negative, considering the bacterial culture as the gold standard. No adverse reaction was observed during or after the radiotracer injection days. There were five true positive, four true negative and no false positive and false negative scans. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were all calculated as 100%. We found a high diagnostic accuracy for 99m scintigraphy in differentiation of bacterial infection from sterile inflammation in suspected orthopedic implants. Therefore, 99m Tc-UBI [29-41] scintigraphy might be potentially recommended as a safe and promising imaging modality in these settings. However, further studies on a larger number of patients and different pathologies are still needed.

2013

Ubiquicidin (UBI) [29][30][31][32][33][34][35][36][37][38][39][40][41] is a synthetic cationic antimicrobial peptide that preferentially binds to bacterial cell membrane at the site of infection. We aimed to assess diagnostic value of Tc-UBI [29-41] was injected intravenously. A dynamic study followed by static whole body imaging at 30, 60 and 120 min post-radiotracer injection was acquired. Periprosthetic tissue culture was considered the closest test to a gold standard for diagnosing infections and scintigraphic scans were categorized as true-or false-positive and true-or false-negative, considering the bacterial culture as the gold standard. No adverse reaction was observed during or after the radiotracer injection days. There were five true positive, four true negative and no false positive and false negative scans. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were all calculated as 100%. We found a high diagnostic accuracy for 99...

Nuclear medicine communications, 2017

The aim of this study was to evaluate the utility of Tc-ubiquicidin (Tc-UBI) (29-41) as an adjunct to an methylene diphosphonate (MDP) bone scan in differentiating septic versus aseptic loosening in patients with painful prosthesis posted for revision surgery. A two-vial cold kit of UBI (29-41) was prepared and utilized for the preparation of patient dose of Tc-UBI (29-41). Twenty two patients with painful hip or knee prosthesis and scheduled for revision surgery were included in the study. Overall, 370-555 MBq of Tc-UBI (29-41) was injected intravenously in all the patients. A blood pool image at 20 min after injection was followed by spot views of the suspected region of infection (target) and a corresponding normal area (nontarget) at 60 min. All patients underwent a routine Tc-MDP three-phase whole-body bone scan, followed by single-photon emission computed tomography/computed tomography of the prosthesis within a week of the Tc-UBI (29-41) study. For Tc-UBI scans, a visual scor...

European Journal of Nuclear Medicine and Molecular Imaging, 2012

Prosthetic joint replacement surgery is performed with increasing frequency. Overall the incidence of prosthetic joint infection (PJI) and subsequently prosthesis revision failure is estimated to be between 1 and 3%. Differentiating infection from aseptic mechanical loosening, which is the most common cause of prosthetic failure, is especially important because of different types of therapeutic management. Despite a thorough patient history, physical examination, multiple diagnostic tests and complex algorithms, differentiating PJI from 18 F-fluoride. But unfortunately this superb tomographic technique will only receive full acceptance when specific PET uptake patterns can be successfully developed. The emergence

Hellenic journal of nuclear medicine

A serious complication of joint replacement surgery is infection, which results in prolonged invalidity as well as removal and subsequent re-implantation after lengthy antibiotic therapy. In terms of diagnostic imaging, nuclear medicine has presented several tracers and imaging modalities over the years to be used in prosthetic joint infection. The PubMed/MEDLINE literature database was systematically examined for publications on infection, arthroplasty, joint replacement, prosthetic joint, gallium, labeled leukocytes, sulfur colloid, antimicrobial peptides, Fluorine-18-fluorodeoxyglucose ((18)F-FDG), positron emission tomography/computed tomography (PET-CT), and single-photon emission (SPET-CT). This was determined to be a comprehensive review, not a meta-analysis of prosthetic joint infection and diagnostic imaging in the field of nuclear medicine. Prosthetic joint replacement is more frequently being employed as a way of improving the quality of life in an ever-ageing population....

Nuclear Medicine Communications, 2019

Infection and inflammation are a common occurrence with orthopaedic procedures. Anatomical modalities can show the transformation in the disease process; however, these may occur later when compared with functional imaging modalities that are more likely to identify early disease patterns. Various molecular imaging modalities such as three-phase bone scintigraphy, labelled leucocyte scintigraphy, as well as radiolabelled antibiotics and immunoglobulins have been considered and have played key roles in assisting clinical decision-making. While 18F-flurodeoxyglucose (FDG) PET/computed tomography (CT) has been relatively well established in cancer pathways, it has the potential to contribute to surgical decision making for possible osteomyelitis post-metal implant surgery. In this article, we present a review of recently used tracers, and share our experience with using 18F-FDG PET/CT studies in a few diverse clinical settings related to post-metal implant osteomyelitis. Nucl Med Commun 40:875

EJNMMI Research

Background: Prosthetic joint infections may lead to failures of total joint arthroplasty. Radionuclide imaging can play a diagnostic role in identifying such infections, which require two-stage exchange arthroplasty (instead of simple revision surgery performed in non-infected cases). Although 18 F-FDG PET/CT has emerged as a novel diagnostic tool in this setting, the clinical usefulness of 68 Ga-citrate PET/CT has not been previously investigated. This single-center prospective study was designed to address this issue. Methods: Between January 2016 and October 2017, we examined 34 patients with clinically proven or suspected prosthetic hip/knee joint infections scheduled to undergo surgery. All patients underwent 68 Ga-citrate PET/CT scans and sequential 18 F-FDG PET/CT imaging for comparative purposes. Intraoperative findings and the results of microbiological analyses of surgical specimens served as gold standard. The diagnostic results were examined according to (1) image interpretation based on radiotracer uptake patterns and (2) quantitative analysis using volumes of interest (VOIs) to calculate standard uptake values (SUVs) and metabolic volumes (MVs). Results: A total of 26 (76%) patients were diagnosed as having infections. Based on radiotracer uptake pattern criteria, the sensitivity, specificity, and accuracy of 68 Ga-citrate PET/CT and 18 F-FDG PET/CT were 92%, 88%, and 91% and 100%, 38%, and 85%, respectively. MV was significantly higher in the infected group when 68 Ga-citrate PET/CT was used (422.45 vs. 303.65 cm 3 , p = 0.027), whereas no significant differences were observed on 18 F-FDG PET/CT. According to receiver operating characteristic (ROC) curve analysis, a cutoff value of 370.86 for MV resulted in a sensitivity of 61.5% and a specificity of 87.5% (area under curve: 0.75, 95% confidence interval: 0.57-0.88, p = 0.035). Conclusions: Subject to future confirmation, our data provide preliminary evidence that 68 Ga-citrate PET/CT may have a complimentary role to 18 F-FDG PET/CT in detecting prosthetic joint infections, being characterized by a higher specificity and the possibility to discriminate between an infectious condition and sterile inflammation. Trial registration: This prospective study was registered at clinicaltrials.gov (registration number: NCT02855190).

Web application development presents significant differences from conventional application development. The spectrum varies from technical to organizational differences. Technical means the specific architectures and technologies employed and the impacts involved. Organizational is related to the strategic use of these applications aiming at improving the business. Among other issues, uncertainty, volatility and high competitiveness are innate characteristics which must be carefully addressed. Therefore, the nature of web engineering suggests the need of specialized software processes that cover, in a systematic way, the complete life cycle of hypermedia web applications, in contrast to adopting ad-hoc approaches to comply with the constraints imposed by this application domain. This essay presents an abridge discussion concerned with the impact of these differences on development process for web applications, analyzing some proposals, indentifying the requirements and challenges. This work intends to be an initial step towards the definition of a process suitable to web development, in dimensions such as requirements gathering, user interface, testing and navigation design.

In the early 19th century, a small Black community formed in White Oaks, Williamstown/MA. In 1866, 32 West Africans founded Africatown/AL, one of the first cities established and governed by Black people in the United States. In the face of the impossibility of returning to their native lands, as recounted by the Martinican poet Aimé Cesaire (1913-2008), millions of Africans and their descendants sought to find home in the Diaspora. In so doing, they not only contributed to building cities, nations, and societies. Frequently, and in several episodes alongside Amerindians, the Black population in the Americas also endeavored numerous strategies that challenged the colonial order. Such experiences also occurred in the Caribbean and Latin America and are usually described as maroon societies, cimarrones, or quilombos. However, the literature does not usually address them via an afrodiasporic framework. Drawing from the work of scholars such as Beatriz do Nascimento (Brazil, 1942-1995), students will analyze the bonds of combative solidarity within and across the Black diaspora. Through this approach, the experiences of afrodiasporic communities are not only defined or limited to the forms of territorial organization. Instead, they can be viewed and studied as examples of Black association aligned with the struggles of emancipation — from rural villages to urban neighborhoods and towns. The seminar invites students to investigate and discuss the following questions: What do these communities have in common? What are their main differences in countries such as the USA, Jamaica, Colombia, Suriname, French Guiana, and Brazil? What can we learn from the history of White Oaks and Africatown? How could we use concepts such as quilombismo and marronage to think about the Black experience today? The seminar aims to provide students with an afrodiasporic framework (drawn mainly from Anthropology, Sociology, and History) to investigate different experiences in the Black diaspora in the Americas and the Caribbean.

International Journal of Recent Academic Research, 2020

The events which cannot be explained by our known five senses-hearing, seeing, smelling, touching, and tasting are called paranormal events. These are mysterious events happening frequently across the world and these simply defy logic Paranormal events are, still, a mystery. These events are sporadic in nature and are frequently happening across the globe and have intrigued intelligentsia. With so much work going across the world to understand the paranormal phenomena, we are still wondering whether Paranormality is a myth or reality. In this article, I try to analyze this question keeping the probing totally unbiased and rational. I approach the question with research in favour and also against the question, giving fair weightage to arguments in favour and also against Please read on.