Is the PY test for H. pylori a contender against laboratory technology?

Objectives The use of the PY test in Nuclear Medicine was analyzed amongst hospitals in Northern California. Ten Nuclear Medicine departments were evaluated on how frequent PY tests are being performed and how valuable these tests are for the diagnosis of Helicobacter pylori infection. Four laboratory tests were also evaluated and compared to the Nuclear Medicine PY Test for H. pylori.The advantages and disadvantages of both PY Test and laboratory tests are differentiated for limitations and ability to test for current infection.

Methods Questionnaires were given to each participating facilities. Questions included how often PY tests were performed since January 2015. If the PY test was performed at the facility, participants were asked how many times since January 2015. Some physicians in the department were also asked to provide their opinion on the accuracy and value of PY testing for diagnosis of H. pylori. Limitations for both laboratory and PY Testing in Nuclear Medicine were evaluated by standard guidelines placed by testing facilities.

Results Out of ten facilities assessed, only five currently perform PY tests for diagnosis of H. pylori infection. All of which stated that the test is performed infrequently, less than five times since January 2015. Reasons included costs, lack in availability of C-14 by nearby pharmacies, and shortage of orders by providers. Out of four laboratory tests, only two can determine current infection of H. pylori. These include fecal examination by immunoassay and biopsy evaluation by rapid urease studies.

Conclusions Although PY Tests are not frequently performed in the Northern California facilities evaluated, it continues to provide a quality method of diagnosis of current infection of H. pylori. Reference ranges include quantitative measurements in counts per minute of C-14 and indicate positive, negative, or inconclusive results. Due to the invasive nature of biopsy collection, focus is placed on fecal examination for comparison to the PY Test for current infection of H. pylori. Tests results include a distinct positive or negative result based on antigens detected. There is no quantitative data given as a result.The Nuclear Medicine PY Test and fecal exam for current infection of H. pylori both hold great value in the medical field. Each has a greater advantage over other methods of H. pylori detection.