Microdose 14C urea breath test for the diagnosis of Helicobacter pylori: a survey in Iranian population

The carbon -14 urea breath test (UBT)is a non-invasive and simple method for the diagnosis of Helicobacter pylori infection. Attempts have been made to use lower doses of 14C-urea in the UBT in order to reduce the radiation risk of the test. The aim of this study was to assess the accuracy of a microdose (1 μCi [37 KBq]) 14C-UBT in Iranian population for validation of its diagnostic accuracy against gold standard methods. Eighty and two patients were subjected to upper gastrointestinal endoscopy as well as 14C-UBT in one week. Rapid urease test and histological examinations were used as gold standard. Breath samples were collected 10, 20 and 30 minute after ingestion of 1 μCi of 14C- urea solution and their activities were measured using a scintillation counter and expressed as counts per minute (cpm) and disintegration per minute (dpm). Good agreement was observed between the 14C-UBT and gold standard for samples which were collected 20 minutes after 14C-urea administration. The 14CUBT showed 100% sensitivity, 95% specificity, 95.45% positive predictive value, 100% negative predictive value and 97.50% accuracy. The results of this study showed good concordance between the 14C-UBT and invasive methods.