Usefulness of 18 F-FDG PET-CT for the management of invasive fungal infections: A retrospective cohort from a tertiary university hospital
Background: 18F-FDG PET-CT is a potentially useful technique to help manage invasive fungal infection (IFI), but information on this topic is scarce. Objectives: To describe our experience using 18F-FDG PET-CT for IFI management. Patients/Methods: Retrospective cohort of IFI episodes in a university...
| Autores: | , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Universidad Autónoma de Madrid |
| Repositorio: | Biblos-e Archivo. Repositorio Institucional de la UAM |
| Idioma: | inglés |
| OAI Identifier: | oai:repositorio.uam.es:10486/711278 |
| Acceso en línea: | http://hdl.handle.net/10486/711278 https://dx.doi.org/10.1111/myc.13701 |
| Access Level: | acceso abierto |
| Palabra clave: | 18 F-FDG PET-CT Fungal Infections Invasive Radiology Medicina |
| Sumario: | Background: 18F-FDG PET-CT is a potentially useful technique to help manage invasive fungal infection (IFI), but information on this topic is scarce. Objectives: To describe our experience using 18F-FDG PET-CT for IFI management. Patients/Methods: Retrospective cohort of IFI episodes in a university hospital from 2018 to 2023 with a18F-FDG PET-CT performed during the episode. We analysed its impact on IFI management compared to conventional imaging. Results: Thirty-five patients diagnosed with 36 episodes of IFI (52.8% moulds, 44.4% yeasts and 2.8% Pneumocystis) underwent 55 18F-FDG PET-CT. 74.3% were immunocompromised, including 45.7% solid organ transplant recipients. Indications for 18F-FDG PET-CT were diagnostic (10.9%), staging (47.3%) and follow-up (41.8%). Altogether 18F-FDG PET-CT added value to IFI management in 50.9% episodes. In 26 patients who had both staging 18F-FDG PET-CT and conventional imaging, sites of IFI dissemination were detected in 53.8% and 19.2%, respectively. Staging 18F-FDG PET-CT unveiled occult sites in 34.6%, uncovering unknown dissemination in 19.2%. In the evaluation of endocarditis in patients with fungemia, it contributed in at least 38.5%. Follow-up 18F-FDG PET-CTs had an added value in 47.8% episodes. They were allowed to de-escalate antifungal therapy in 26.1%. There were discordant findings between 18F-FDG PET-CT and CT follow-up in 40% cases. Conclusions: Overall, 18F-FDG PET-CT added value to IFI management in more than 50% of the episodes. It increased the diagnosis of occult sites, unveiled disseminated disease missed out by conventional imaging, and contributed to diagnose or rule out endocarditis in fungemia. Follow-up 18F-FDG PET-CT helped adjust the treatment duration and deserves further study |
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