18F-fluorodeoxyglucose positron emission tomography for the initial evaluation and monitoring of therapeutic response in bilateral adrenal histoplasmosis

Tsai, Ya Ju; Lin, Yi Hsiang; Hsu, Chih Yang; Yeh, Shauh-Der

doi:10.1016/j.clinimag.2013.02.011

Cited by 16 publications

(7 citation statements)

References 11 publications

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“…FDG-PET has been used to monitor IFI usually correlating with clinical outcome. 83 In 1 case, 18 F-FDG-PET/CT was more accurate than MRI in showing disease progression when MRI findings remained unchanged. 84 In the literature, 18 F-FDG-PET/CT was useful to monitor therapy in different sites including lungs, skeleton, central nervous system, adrenals, and prosthetic heart valves.…”

Section: F-fdg-pet or Pet/ct In Monitoring Antifungal Therapy In Ifismentioning

confidence: 92%

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Monitoring Response to Therapy

Sathekge

Ankrah

Lawal

et al. 2018

Seminars in Nuclear Medicine

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Monitoring response to treatment is a key element in the management of infectious diseases, yet controversies still persist on reliable biomarkers for noninvasive response evaluation. Considering the limitations of invasiveness of most diagnostic procedures and the issue of expression heterogeneity of pathology, molecular imaging is better able to assay in vivo biologic processes noninvasively and quantitatively. The usefulness of F-FDG-PET/CT in assessing treatment response in infectious diseases is more promising than for conventional imaging. However, there are currently no clinical criteria or recommended imaging modalities to objectively evaluate the effectiveness of antimicrobial treatment. Therapeutic effectiveness is currently gauged by the patient's subjective clinical response. In this review, we present the current studies for monitoring treatment response, with a focus on Mycobacterium tuberculosis, as it remains a major worldwide cause of morbidity and mortality. The role of molecular imaging in monitoring other infections including spondylodiscitis, infected prosthetic vascular grafts, invasive fungal infections, and a parasitic disease is highlighted. The role of functional imaging in monitoring lipodystrophy associated with highly active antiretroviral therapy for human immunodeficiency virus is considered. We also discuss the key challenges and emerging data in optimizing noninvasive response evaluation.

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Section: F-fdg-pet or Pet/ct In Monitoring Antifungal Therapy In Ifismentioning

confidence: 92%

“…Demonstrated metabolic response in a bioprosthetic aortic valve Liu et al 94 Clin Nucl Med 2013 Zygomycosis sp. Antifungal therapy was appropriately modified as a result of serial 18 F-FDG-PET/CT studies Tsai et al 83 Clin Imaging 2013 Histoplamosis sp.…”

Section: Metabolic Dysfunction Associated With Antiretroviral Therapymentioning

confidence: 99%

Monitoring Response to Therapy

Sathekge

Ankrah

Lawal

et al. 2018

Seminars in Nuclear Medicine

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“…Bilateral adrenal masses due to histoplasmosis, the most common fungal cause of adrenal infection, were reported to have increased FDG uptake; SUV max of 5.7 and lesion:liver uptake ratio of 3.1 [199]. FDG PET/CT showed a treatment response to antifungals with decreasing SUV to 3.4 on the right and 3.5 on the left.…”

Section: Adrenal Collision Tumorsmentioning

confidence: 95%

“…Alternative PET imaging agents to FDG There are alternative radiopharmaceuticals to FDG for PET imaging, which may be of value for characterization of a Hypermetabolic due to adenomatous and hematopoietic elements Ganglioneuroma [199][200][201] Generally low grade FDG uptake, occasionally mildly increased FDG uptake above liver background…”

Section: Normal Adrenal Anatomy and Metabolic Featuresmentioning

confidence: 99%

Metabolic and anatomic characteristics of benign and malignant adrenal masses on positron emission tomography/computed tomography: a review of literature

et al. 2014

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PET/CT with (18)F-fluorodeoxyglucose (FDG) or using different radiocompounds has proven accuracy for detection of adrenal metastases in patients undergoing cancer staging. It can assist the diagnostic work-up in oncology patients by identifying distant metastases to the adrenal(s) and defining oligometastatic disease that may benefit from targeted intervention. In patients with incidentally discovered adrenal nodules, so-called adrenal "incidentaloma" FDG PET/CT is emerging as a useful test to distinguish benign from malignant etiology. Current published evidence suggests a role for FDG PET/CT in assessing the malignant potential of an adrenal lesion that has been 'indeterminately' categorized with unenhanced CT, adrenal protocol contrast-enhanced CT, or chemical-shift MRI. FDG PET/CT could be used to stratify patients with higher risk of malignancy for surgical intervention, while recommending surveillance for adrenal masses with low malignant potential. There are caveats for interpretation of the metabolic activity of an adrenal nodule on PET/CT that may lead to false-positive and false-negative interpretation. Adrenal lesions represent a wide spectrum of etiologies, and the typical appearances on PET/CT are still being described, therefore our goal was to summarize the current diagnostic strategies for evaluation of adrenal lesions and present metabolic and anatomic appearances of common and uncommon adrenal lesions. In spite of the emerging role of PET/CT to differentiate benign from malignant adrenal mass, especially in difficult cases, it should be emphasized that PET/CT is not needed for most patients and that many diagnostic problems can be resolved by CT and/or MR imaging.

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“…[82][83][84][85][86][87][88], and also the other causes of IFIs such as Zygomycosis sp. [84,[90][91][92], Histoplasmosis sp [94,95], Coccidimycosis, Phomopsis, Mycetomas spp. [85] and Crytococcus sp.…”

Section: Monitoring Ifis With Fdg Petmentioning

confidence: 99%

The Role of PET in Monitoring Therapy in Fungal Infections

Ankrah

Klein

Span

et al. 2018

CPD

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Positron emission tomography (PET) is a powerful diagnostic nuclear medicine imaging technique. PET allows in vivo detection of a wide variety of physiologic and pathologic phenomena and it offers a noninvasive tool for the monitoring of therapy in various diseases. Invasive fungal infections (IFIs) are a global concern because of the increasing population of patients at risk of IFIs and the high morbidity and mortality. Therapy with antifungal agents is long-standing and expensive. The emerging resistant fungal strains make the management of IFIs challenging. There is an absolute need for a sensitive noninvasive biomarker capable of monitoring the disease activity of IFIs and determining the efficacy of treatment at an early time point. PET imaging with 18F-fluorodeoxyglucose (FDG) was used to detect and assess disease activity in IFI foci already over 20 years ago. At that time, it was suggested it could be a useful biomarker for monitoring antifungal therapy. However, this knowledge has still not been fully exploited for the management of IFIs. The literature reveals an increasing realization of the usefulness of PET in monitoring therapy of IFIs. In this review, we highlight the advantages of nuclear medicine techniques in the management of IFIs with emphasis of the role of PET in monitoring therapy efficacy.

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18F-fluorodeoxyglucose positron emission tomography for the initial evaluation and monitoring of therapeutic response in bilateral adrenal histoplasmosis

Cited by 16 publications

References 11 publications

Monitoring Response to Therapy

Monitoring Response to Therapy

Metabolic and anatomic characteristics of benign and malignant adrenal masses on positron emission tomography/computed tomography: a review of literature

The Role of PET in Monitoring Therapy in Fungal Infections

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