18F-FDG PET/CT during diagnosis and follow-up of recurrent hepatic cyst infection in autosomal dominant polycystic kidney disease

Lantinga, Marten A.; Sévaux, R.G.L. de; Drenth, J.P.H.

doi:10.5414/cn108495

Cited by 16 publications

(12 citation statements)

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“…Accumulative evidence supports that 18 FDG-PET/CT may help (i) diagnose CyI, (ii) discriminate CyI from non-cystic disease and (iii) localize pyocysts, thereby facilitating the management[ 17 , 27 – 29 ]. Of note, CyH has not been reported thus far with pathological uptake of 18 FDG, which further help distinguish CyI from CyH[ 11 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Algorithm in the Management of Acute Febrile Abdomen in Patients with Autosomal Dominant Polycystic Kidney Disease

et al. 2016

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BackgroundAcute febrile abdomen represents a diagnostic challenge in patients with autosomal dominant polycystic kidney disease (ADPKD). Although criteria have been proposed for cyst infection (CyI) and hemorrhage (CyH), there is a lack of comparative assessments. Furthermore, distinguishing cystic from non-cystic complications remains problematic.DesignADPKD patients presenting with abdominal pain and/or fever between 01/2005 and 06/2015 were retrospectively identified in a systematic computerized billing database. CyH was defined as spontaneous intracystic density above 50 Hounsfield units on computed tomography (CT). CyI was definite if confirmed by cyst puncture, and probable if 4 criteria were met: 3-day fever, loin/liver tenderness, C-reactive protein (CRP) plasma levels >50mg/L and no CT evidence for CyH. Other episodes were grouped as inflammation of unknown origin (IUO).ResultsAmong a cohort of 173 ADPKD patients, 101 presented with 205 episodes of abdominal pain (n = 172) and/or fever (n = 33). 20 patients experienced 30 CyH, whereas 16 presented 23 episodes of definite (n = 11) or probable (n = 12) CyI. 35 IUO were observed in 31 patients. Clinically, fever was observed in 7% vs. 100% vs. 66% of CyH, CyI and IUO, respectively. Biologically, CRP cut-off at 70 mg/dl showed 92% sensitivity and 81% specificity in CyI diagnosis. Urine or blood cultures remained sterile in >90% of CyH, but were contributive in 53.4% of CyI and IUO, with a 74.2% prevalence for E. coli. Radiologically, ultrasounds, CT and magnetic resonance diagnosed CyI in 2.6%, 20% and 16.7% of cases, respectively. 18F-FDG positron-emission tomography (PET)/CT was done within a median period of 7 days post antibiotics, and significantly changed patient management in 71.4%.ConclusionsThis retrospective single-center series underscores the usefulness of clinical–fever–and biological–CRP–parameters, but emphasizes the limitations of bacteriological and radiological investigations in cases of acute febrile abdomen in ADPKD patients. 18F-FDG-PET/CT imaging may be helpful in such condition.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Algorithm in the Management of Acute Febrile Abdomen in Patients with Autosomal Dominant Polycystic Kidney Disease

et al. 2016

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“…The diagnostic properties of FDG-PET are incomplete, as anecdotal evidence suggests that FDG accumulation only occurs in a late stage of the disease, and that FDG accumulation may disappear despite the presence of a well-established infection. 55 HCI incidence has been estimated at 1% of all patients with hepatic cysts. 56 Most liver cyst infections are thought to arise from translocation of bacteria across the intestinal barrier.…”

Section: Hepatic Cyst Infectionmentioning

confidence: 99%

“…54 FDG-PET can be used in combination with serum C-reactive protein to evaluate treatment effect. 55…”

Section: Hepatic Cyst Infectionmentioning

confidence: 99%

Clinical management of polycystic liver disease

Aerts

Laarschot

Bañales

et al. 2018

Journal of Hepatology

Self Cite

129

209

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In this Grand Rounds article, we present a typical case of a woman with polycystic liver disease. This case prompts questions which both patients and clinicians may face in clinical practice. This article aims to provide guidance to clinicians caring for patients with polycystic liver disease, in relation to key recent developments in the field. We discuss the latest advances in our understanding of pathophysiology, the natural course of disease, complications, as well as existing and potential new treatment options.

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“…In contrast, PET/ CT is now considered as the best imaging technique to identify liver cyst infection in ADPKD patients. PET/CT may be also helpful in the follow-up to evaluate the response to antibiotherapy [5], as illustrated by our patient who inally required cyst drainage.…”

Section: Introductionmentioning

confidence: 93%

Liver cyst infection in kidney transplant patient with autosomal dominant polycystic kidney disease: Interest of PET/CT in diagnosis and treatment

H*¹

2018

J Clini Nephrol

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Liver cyst infection in patients with autosomal dominant polycystic kidney disease (ADPKD) is a rare but life-threatening complication. Diagnosis and treatment remain challenging. We report the case of a 64-year-old kidney transplant patient presenting with fever and abdominal pain. The diagnosis of liver cyst infection was made by positron emission tomography scan (PET/CT). Moreover, the course of our patient illustrates the interest of subsequent PET/CT during follow-up as our patient failed on antibiotherapy and required liver cyst drainage.

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18F-FDG PET/CT during diagnosis and follow-up of recurrent hepatic cyst infection in autosomal dominant polycystic kidney disease

Cited by 16 publications

References 0 publications

Diagnostic Algorithm in the Management of Acute Febrile Abdomen in Patients with Autosomal Dominant Polycystic Kidney Disease

Diagnostic Algorithm in the Management of Acute Febrile Abdomen in Patients with Autosomal Dominant Polycystic Kidney Disease

Clinical management of polycystic liver disease

Liver cyst infection in kidney transplant patient with autosomal dominant polycystic kidney disease: Interest of PET/CT in diagnosis and treatment

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