Is There a Role for Fluorine 18 Fluorodeoxyglucose-Positron Emission Tomography and Positron Emission Tomography/Computed Tomography in Evaluating Patients With Mycobacteriosis? A Systematic Review

Treglia, Giorgio; Taralli, Silvia; Calcagni, Maria Lucia; Maggi, Fabio; Giordano, Alessandro; Bonomo, Lorenzo

doi:10.1097/rct.0b013e318219f810

Cited by 36 publications

(25 citation statements)

References 18 publications

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“…It is common that false positivity on PET imaging is caused by tuberculous disease [13,14,15]. Orki et al [8] reported that patients with tuberculous pleuritis could have region of increased 18 F-FDG uptake in the pleura.…”

Section: Discussionmentioning

confidence: 99%

The Role of 18F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion

Sun

et al. 2016

PLoS ONE

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ObjectiveThe aim of our study was to evaluate the role of 18F-FDG PET/CT integrated imaging in differentiating malignant from benign pleural effusion.MethodsA total of 176 patients with pleural effusion who underwent 18F-FDG PET/CT examination to differentiate malignancy from benignancy were retrospectively researched. The images of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were visually analyzed. The suspected malignant effusion was characterized by the presence of nodular or irregular pleural thickening on CT imaging. Whereas on PET imaging, pleural 18F-FDG uptake higher than mediastinal activity was interpreted as malignant effusion. Images of 18F-FDG PET/CT integrated imaging were interpreted by combining the morphologic feature of pleura on CT imaging with the degree and form of pleural 18F-FDG uptake on PET imaging.ResultsOne hundred and eight patients had malignant effusion, including 86 with pleural metastasis and 22 with pleural mesothelioma, whereas 68 patients had benign effusion. The sensitivities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging in detecting malignant effusion were 75.0%, 91.7% and 93.5%, respectively, which were 69.8%, 91.9% and 93.0% in distinguishing metastatic effusion. The sensitivity of 18F-FDG PET/CT integrated imaging in detecting malignant effusion was higher than that of CT imaging (p = 0.000). For metastatic effusion, 18F-FDG PET imaging had higher sensitivity (p = 0.000) and better diagnostic consistency with 18F-FDG PET/CT integrated imaging compared with CT imaging (Kappa = 0.917 and Kappa = 0.295, respectively). The specificities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were 94.1%, 63.2% and 92.6% in detecting benign effusion. The specificities of CT imaging and 18F-FDG PET/CT integrated imaging were higher than that of 18F-FDG PET imaging (p = 0.000 and p = 0.000, respectively), and CT imaging had better diagnostic consistency with 18F-FDG PET/CT integrated imaging compared with 18F-FDG PET imaging (Kappa = 0.881 and Kappa = 0.240, respectively).Conclusion18F-FDG PET/CT integrated imaging is a more reliable modality in distinguishing malignant from benign pleural effusion than 18F-FDG PET imaging and CT imaging alone. For image interpretation of 18F-FDG PET/CT integrated imaging, the PET and CT portions play a major diagnostic role in identifying metastatic effusion and benign effusion, respectively.

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Section: Discussionmentioning

confidence: 99%

The Role of 18F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion

Sun

et al. 2016

PLoS ONE

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“…Thereafter, the latest generation of high-resolution PET scanners is coupled with multidetector CT (PET/CT), allowing a simultaneous co-registration of morphological and functional data [11]. Activated inflammatory cells such as neutrophils, macrophages and lymphocytes present an increased FDG uptake, causing significant FDG accumulation during inflammation [12,13]. Hence, the slight specificity of FDG PET/CT emerges as a potential advantage in the management of patients with inflammatory or infectious diseases [14].…”

Section: Introductionmentioning

confidence: 99%

18F-FDG PET/CT for the Diagnosis of Malignant and Infectious Complications After Solid Organ Transplantation

Muller

Kessler

Caillard

et al. 2016

Nucl Med Mol Imaging

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Purpose Infection and malignancy represent two common complications after solid organ transplantation, which are often characterized by poorly specific clinical symptomatology. Herein, we have evaluated the role of 18 F-fluoro-2-deoxy-Dglucose (FDG) positron emission tomography/computed tomography (PET/CT) in this clinical setting. Methods Fifty-eight consecutive patients who underwent FDG PET/CT after kidney, lung or heart transplantation were included in this retrospective analysis. Twelve patients underwent FDG PET/CT to strengthen or confirm a diagnostic suspicion of malignancies. The remaining 46 patients presented with unexplained inflammatory syndrome, fever of unknown origin (FUO), CMV or EBV seroconversion during post-transplant follow-up without conclusive conventional imaging. FDG PET/CT results were compared to histology or to the finding obtained during a clinical/imaging follow-up period of at least 6 months after PET/CT study. Results Positive FDG PET/CT results were obtained in 18 (31 %) patients. In the remaining 40 (69 %) cases, FDG PET/CT was negative, showing exclusively a physiological radiotracer distribution. On the basis of a patient-based analysis, FDG PET/CT's sensitivity, specificity, PPV and NPV were respectively 78 %, 90 %, 78 % and 90 %, with a global accuracy of 86 %. FDG PET/CT was true positive in 14 patients with bacterial pneumonias (n = 4), pulmonary fungal infection (n = 1), histoplasmosis (n = 1), cutaneous abscess (n = 1), inflammatory disorder (sacroiliitis) (n = 1), lymphoma (n = 3) and NSCLC (n = 3). On the other hand, FDG PET/CT failed to detect lung bronchoalveolar adenocarcinoma, septicemia, endocarditis and graft-versus-host disease (GVHD), respectively, in four patients. FDG PET/CT contributed to adjusting the patient therapeutic strategy in 40 % of cases. Conclusions FDG PET/CT emerges as a valuable technique to manage complications in the post-transplantation period. FDG PET/CT should be considered in patients with severe unexplained inflammatory syndrome or FUO and inconclusive conventional imaging or to discriminate active from silent lesions previously detected by conventional imaging particularly when malignancy is suspected.

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“…Das Lymphknotenmuster ist gekennzeichnet durch einen erhöhten Uptake in vergrößerten mediastinalen und hilären Lymphknoten, wobei der Uptake höher ausfällt als der im Lungengewebe. Hierbei ist insbesondere auf extrathorakale Manifestationen zu achten, die beim Lymphknotenmuster häufi ger auftreten [ 67 ] . Weiterhin wird die PET als Ganzkörperszintigrafi e ausgeführt (jedenfalls vom Schädel bis inklusive des Beckens), wodurch ebenfalls die Detektion extrathorakaler Manifestationen ermöglicht wird, die in der CT geregelt übersehen werden.…”

Section: Pilzinfektionenunclassified

FDG-PET bei entzündlichen Erkrankungen der Lunge

2014

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Zusammenfassung Entz?ndliche Erkrankungen der Lunge sind meistens ein (h?ufiger) Nebenbefund bei der FDG-PET, die f?r die Diagnostik von Malignomen ausgef?hrt wird. Vielfach ergibt sich dadurch ein differenzialdiagnostisches Problem, da die Spezifit?t der PET nur aufgrund der FDG-Aufnahme eine eindeutige Differenzierung zwischen Metastase/Tumor und entz?ndlicher Ursache nicht verl?sslich erm?glicht. Daher ist die Erkennung bestimmter Muster und die korrekte Interpretation der Verteilung von L?sionen im klinischen Kontext entscheidend f?r den Beitrag der PET f?r das klinische Management der Patienten. In dieser Arbeit wird eine ?bersicht ?ber die m?glichen Ursachen und pathophysiologischen Mechanismen entz?ndlicher Ver?nderungen in der Lunge (bakteriell, Pilze, Hefen, Mycobakterien, interstitielle Lungenerkrankungen, Pneumonitis usw.) sowie typische Muster in der PET gegeben, inklusive der Differenzialdiagnosen und Hinweisen zur Bildinterpretation.

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Is There a Role for Fluorine 18 Fluorodeoxyglucose-Positron Emission Tomography and Positron Emission Tomography/Computed Tomography in Evaluating Patients With Mycobacteriosis? A Systematic Review

Cited by 36 publications

References 18 publications

The Role of 18F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion

The Role of 18F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion

18F-FDG PET/CT for the Diagnosis of Malignant and Infectious Complications After Solid Organ Transplantation

FDG-PET bei entzündlichen Erkrankungen der Lunge

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