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Updated: Apr 11, 2026
A Novel Application of Musculoskeletal Ultrasound Imaging
Published on: September 17, 2013
Diagnostic Efficacy of UBI Scan in Musculoskeletal Infections
Ali Akbar Esmailiejah1, Mohammadreza Abbasian2, Salman Azarsina1
1Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Background:
Limited recent studies have demonstrated that 99mTc-UBI scan can be a helpful method in precise diagnosis of infection. In the current study, we aimed to investigate the diagnostic efficacy of 99mTc-UBI scan in detection of musculoskeletal infections.
Methods:
Fifty patients with suspected musculoskeletal infections (painful THA, TKA, implant and nonunion) were enrolled in this study. After injection of 99mTc-Ubiquicidin 29-41, up to 30 minutes, dynamic imaging was performed every 1 minute. Whole body anterior and posterior images were acquired at 60 and 120 min (5 min/frame). A polygonal region of interest (ROI) was drawn manually around the area of increased accumulation of tracer (lesion) and anatomically similar area on the contralateral side (background) and the lesion to background ratio (LBR) was calculated. Then, patients underwent surgical procedures to assess infection by tissue sampling and histopathologic studies as gold standard. The receiver operating characteristics (ROC) analysis was performed to find a cut-off value for LBR and determining the diagnostic efficacy of UBI scan in musculoskeletal infections.
Results:
Histopathologic studies revealed infection in 38 patients. The mean LBR was significantly higher in infected patients (2.05 ± 0.41 vs. 1.52 ± 0.22; P < 0.001). ROC analysis showed that a cut-off point of 1.74 for LBR will have 94.7% sensitivity, 83.3% specificity and 92% accuracy for diagnosis of musculoskeletal infections.
Conclusion:
UBI scan is a useful diagnostic tool for evaluation of patients with suspected musculoskeletal infection. However, UBI imaging has some limitations which result in some incorrect diagnoses. It is important to interpret the results of the scan with regard to the clinical findings.
Insights
The 99mTc-UBI scan effectively detects musculoskeletal infections, showing high accuracy. This imaging technique aids in diagnosing infections in patients with suspected conditions like painful joint replacements.
Area of Science:
- Nuclear Medicine
- Diagnostic Imaging
- Infectious Disease
Background:
- Limited studies show 99mTc-UBI scan's utility in infection diagnosis.
- Musculoskeletal infections require precise diagnostic methods.
Purpose of the Study:
- To evaluate the diagnostic efficacy of 99mTc-UBI scan for musculoskeletal infections.
- To determine the accuracy of 99mTc-UBI scan in identifying infected joint implants and nonunions.
Main Methods:
- Fifty patients with suspected musculoskeletal infections were enrolled.
- 99mTc-Ubiquicidin 29-41 was injected, followed by dynamic and whole-body imaging.
- Lesion-to-background ratio (LBR) was calculated, and results were compared to histopathology.
Main Results:
- Histopathology confirmed infection in 38 patients.
- Mean LBR was significantly higher in infected patients (2.05 vs. 1.52, P < 0.001).
- ROC analysis indicated a cut-off LBR of 1.74 with 94.7% sensitivity, 83.3% specificity, and 92% accuracy.
Conclusions:
- 99mTc-UBI scan is a valuable tool for diagnosing musculoskeletal infections.
- The scan demonstrates high sensitivity and accuracy in detecting these infections.
- Clinical correlation is essential for interpreting UBI scan results due to potential limitations.
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