Tc-UBI 29-41 Scintigraphy Imaging in Preferentially Detection Infection from Sterile Inflammation among Diabetic Patients with Suspected Foot Infection

Ubiquicidin 29-41 (UBI 29-41) is an antimicrobial peptide with six positively charged residues which preferentially binds to the negatively charged groups present on the microbial membrane by electrostatic interaction at the foci of infection. For this reason UBI 29-41 has been suggested to label by 99m Tc ( 99m Tc-UBI 2941)directly or by using coligand reagents like 6-hydrazinopyridine 3-carboxylic acid(HYNIC)and tricine[ 99m Tc/Tricine/HYNIC]UBI 29-41 indirectly. The purpose of this study was to investigate the clinical efficacy of [ 99m Tc/Tricine/HYNIC] UBI 29-41 scintigraphy imaging in combination with 99m Tc-methylene diphosphonate ( 99m TcMDP) three phase bone scanning among diabetic patients with suspected foot infection. Ten diabetic patients 6 man and 4 women (mean age 62.45, range 57 -67 years) with suspected foot infection before antibiotic therapy for the present complication have been participated in this study. Every patient underwent 99m Tc-MDP three phase bone scan and 99m Tc-UBI 29-41 scintigraphy imaging. All subjects had positive cultures. None of the patients reported any adverse reaction after the (740-920 MBq) 99m Tc-MDP and the (555-740 MBq) 99m Tc-UBI 29-41 injections. The visualized site of infection with 99m Tc-UBI 2941 scintigraphy imagines were consistent with 99m Tc-MDP three phase bone scanning. 99m Tc-UBI 29-41 scintigraphy image demonstrated rapid distribution at the suspected region to infection. This matter can provide scan interpretation of suspected infection as early as 5 min after injection. Not only there was no major improvement in scan contrast was observed up to 120 min after injection, but also there was no any appreciable distribution difference between soft tissue and bone at the site of infection. For preferentially discrimination diagnosis of infection from sterile inflammation lesions among diabetic patients with diabetic foot problem, 99m Tc-UBI 29-41 scintigraphy imaging may be considered after the 99m Tc-MDP three phase bone scan of the patient is positive. It is suggested to preferentially diagnose infection from sterile inflammation lesion among patients with suspicious foot infection two scintigraphy imaging 99m Tc-MDP and 99m Tc-UBI 29-41 can be considered.