Usefulness of 18F-FDG PET-CT for the management of invasive fungal infections: A retrospective cohort from a tertiary university hospital

被引：1

作者：

Gutierrez-Martin, Isabel ^{[1
]}

Garcia-Prieto, Sonia ^{[1
]}

Velasquez, Karina ^{[2
]}

Gutierrez-Abreu, Edith Vanessa ^{[1
]}

Diego-Yaguee, Itziar ^{[1
]}

Calderon-Parra, Jorge ^{[3
]}

Gutierrez-Villanueva, Andrea ^{[3
]}

Ramos-Martinez, Antonio ^{[3
]}

Munez-Rubio, Elena ^{[3
]}

Callejas-Diaz, Alejandro ^{[3
]}

Moral, Sara De la Fuente ^{[1
,3
]}

de Santiago, Alberto Diaz ^{[1
,3
]}

Romero, Isabel Sanchez ^{[4
]}

Alfonso, Begona Rodriguez ^{[2
]}

Fernandez-Cruz, Ana ^{[3
]}

机构：

[1] Hosp Univ Puerta Hierro Majadahonda, Internal Med Dept, Inst Invest Sanitaria Puerta Hierro Segovia de Ara, Madrid, Spain

[2] Hosp Univ Puerta Hierro Majadahonda, Inst Invest Sanitaria Puerta Hierro Segovia de Ara, Inst Invest Sanitaria Puerta Hierro Segovia Arana, Madrid, Spain

[3] Hosp Univ Puerta Hierro Majadahonda, Inst Invest Sanitaria Puerta Hierro Segovia de Ara, Infect Dis Unit, Inst Invest Sanitaria Puerta Hierro Segovia Arana, C. Joaquin Rodrigo 2, Madrid 28222, Spain

[4] Hosp Univ Puerta Hierro Majadahonda, Microbiol Dept, Madrid, Spain

来源：

MYCOSES | 2024年 / 67卷 / 02期

关键词：

F-18-FDG PET-CT; fungal infections; invasive; radiology; POSITRON-EMISSION-TOMOGRAPHY; FDG PET/CT; DIAGNOSIS; INFLAMMATION;

D O I：

10.1111/myc.13701

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

Background F-18-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 F-18-FDG PET-CT for IFI management. Patients/MethodsRetrospective cohort of IFI episodes in a university hospital from 2018 to 2023 with a(18)F-FDG PET-CT performed during the episode. We analysed its impact on IFI management compared to conventional imaging. ResultsThirty-five patients diagnosed with 36 episodes of IFI (52.8% moulds, 44.4% yeasts and 2.8% Pneumocystis) underwent 55 F-18-FDG PET-CT. 74.3% were immunocompromised, including 45.7% solid organ transplant recipients. Indications for F-18-FDG PET-CT were diagnostic (10.9%), staging (47.3%) and follow-up (41.8%). Altogether F-18-FDG PET-CT added value to IFI management in 50.9% episodes. In 26 patients who had both staging F-18-FDG PET-CT and conventional imaging, sites of IFI dissemination were detected in 53.8% and 19.2%, respectively. Staging F-18-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 F-18-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 F-18-FDG PET-CT and CT follow-up in 40% cases. Results Thirty-five patients diagnosed with 36 episodes of IFI (52.8% moulds, 44.4% yeasts and 2.8% Pneumocystis) underwent 55 F-18-FDG PET-CT. 74.3% were immunocompromised, including 45.7% solid organ transplant recipients. Indications for F-18-FDG PET-CT were diagnostic (10.9%), staging (47.3%) and follow-up (41.8%). Altogether F-18-FDG PET-CT added value to IFI management in 50.9% episodes. In 26 patients who had both staging F-18-FDG PET-CT and conventional imaging, sites of IFI dissemination were detected in 53.8% and 19.2%, respectively. Staging F-18-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 F-18-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 F-18-FDG PET-CT and CT follow-up in 40% cases. Conclusions Overall, F-18-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 F-18-FDG PET-CT helped adjust the treatment duration and deserves further study.

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页数：14