PET-CT–guided Percutaneous Puncture of an Infected Cyst in Autosomal Dominant Polycystic Kidney Disease: Case Report

Kaim, Achim H.; Burger, Cyrill; Ganter, Christoph C.; Goerres, Gerhard W.; Kamel, Emad Zarief; Weishaupt, Dominik; Dizendorf, Elena; Schaffner, Andreas; Schulthess, Gustav K. von

doi:10.1148/radiol.2213010445

Cited by 39 publications

(20 citation statements)

References 14 publications

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“…Inflammatory cells are indeed characterized by a high metabolic activity and increased uptake of glucose analog, 18 FDG (9). Moreover, the modern combination of PET with computed tomography (CT) may improve the localization of pyocysts by integrating metabolic and anatomical data (12). This study retrospectively investigates the accuracy of PET/CT imaging in diagnosing CI in ADPKD patients.…”

Section: Introductionmentioning

confidence: 99%

Positron-Emission Computed Tomography in Cyst Infection Diagnosis in Patients with Autosomal Dominant Polycystic Kidney Disease

Jouret

Lhommel²,

Beguin³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground Cyst infection remains a challenging issue in patients with autosomal dominant polycystic kidney disease (ADPKD). In most patients, conventional imaging techniques are inconclusive. Isolated observations suggest that 18 fluorodeoxyglucose ( 18 FDG) positron-emission computed tomography (PET/CT) might help detect cyst infection in ADPKD patients.Design, setting, participants, & measurements Comparative assessment of administrative databases from January 2005 to December 2009 identified 27 PET/CT scans performed in 24 ADPKD patients for suspicion of abdominal infection. Cyst infection was definite if confirmed by cyst fluid analysis. Cyst infection was probable if all four of the following criteria were met: temperature of Ͼ38°C for Ͼ3 days, loin or liver tenderness, C-reactive protein plasma level of Ͼ5 mg/dl, and no CT evidence for intracystic bleeding. Episodes with only two or three criteria were grouped as "fever of unknown origin".Results Thirteen infectious events in 11 patients met all criteria for kidney (n ϭ 3) or liver (n ϭ 10) cyst infection. CT was contributive in only one patient, whereas PET/CT proved cyst infection in 11 patients (84.6%). In addition, 14 episodes of "fever of unknown origin" in 13 patients were recorded. PET/CT identified the source of infection in nine patients (64.3%), including 2 renal cyst infections. Conversely, PET/CT showed no abnormal 18 FDG uptake in 5 patients, including 2 intracystic bleeding. The median delay between the onset of symptoms and PET/CT procedure was 9 days.Conclusions This retrospective series underscores the usefulness of PET/CT to confirm and locate cyst infection and identify alternative sources of abdominal infection in ADPKD patients.

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Section: Introductionmentioning

confidence: 99%

Positron-Emission Computed Tomography in Cyst Infection Diagnosis in Patients with Autosomal Dominant Polycystic Kidney Disease

Jouret

Lhommel²,

Beguin³

et al. 2011

Clinical Journal of the American Society of Nephrology

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“…Recently, combined PET/CT scanners have been developed and they are being used for clinical applications [7,8,9]. They provide simultaneous assessment of anatomical and metabolic information.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of image fusion of normal upper abdominal organs visualized with PET/CT

Nakamoto

Tatsumi

Cohade

et al. 2003

Eur J Nucl Med Mol Imaging

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Although PET/CT scanners have the potential for precise fused registration of structures visualized on both PET and CT, physiological motion during the acquisition of both studies may alter the appearance of organ shape, size or location. The degree of possible mismatch in abdominal organ size and position between PET and CT has not been evaluated. The aim of this study was to assess the consistency in location and measured size of upper abdominal organs with PET and CT using a combined PET/CT system. Forty-six consecutive inpatients who underwent clinical PET/CT scans for suspected cancer were evaluated. CT and PET images attenuation corrected by both CT and germanium-68 transmission scans were obtained, and we separately determined the location of the top and bottom (height), anterior and posterior margins (thickness), and right and left margins (width) for each organ, including liver, spleen, and bilateral kidneys, using CT and both sets of PET images. Differences between the two modalities in terms of location and measured organ size were investigated. In the upper margin of the liver and lower margin of the spleen, more than 10% of the cases showed a larger discrepancy (>20 mm) between CT-based and Ge-corrected PET-based measurements, although the differences in the positions of the edges were less than 10 mm in most cases. The center of the liver tended to be located cephalad and to the right of the body, and that of the spleen tended to be cephalad and posterior on PET, as compared with CT. Moreover, the center of both kidneys tended to be seen cephalad, posterior, and to the right on PET. The liver appeared slightly larger on PET than CT in thickness (CT vs CT-corrected PET vs Ge-corrected PET = 156 mm vs 162 mm vs 162 mm) and width (186 mm vs 189 mm vs 188 mm). By contrast, the spleen appeared slightly smaller on PET than CT in height (84 mm vs 77 mm vs 80 mm) and width (85 mm vs 81 mm vs 80 mm). A similar tendency was observed in the left kidney (105 mm vs 100 mm vs 99 mm in height, and 64 mm vs 59 mm vs 58 mm in width) and the right kidney (99 mm vs 93 mm vs 93 mm in height, and 64 mm vs 59 mm vs 60 mm in width). These differences between the two modalities were statistically significant ( P<0.05). In conclusion, minor mismatches in location and organ size were found to exist between CT and PET images, in part due to physiological motion. Although these differences could potentially affect the quality of the image registrations, they were generally of a modest nature.

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“…The actual role of PET/CT is still not clear. A few reports described the role of PET in detecting cyst infection, either renal [9][10][11][12][13] or hepatic [14][15][16][17] or both [18][19][20][21], in patients with ADPKD, particularly recognizing …”

Section: Discussionmentioning

confidence: 99%

18F-FDG PET/CT demonstrated renal and hepatic cyst infection in a patient with autosomal dominant polycystic kidney disease

2016

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Infection of renal or hepatic cyst is a serious complication of autosomal dominant polycystic kidney disease (ADPKD) and early diagnosis is crucial for the correct management. We report a case of 64-year-old male with ADPKD, who required renal transplantation some years before, with recent recurrent episodes of fever and abdominal pain, who underwent 18 F-FDG PET/CT twice at 18 months intervals, after not conclusive conventional imaging studies (CT, ultrasonography).18 F-FDG PET/CT has proven to be a useful method for the diagnosis of renal and hepatic cyst infection in a patient with ADPKD and for the subsequent management.

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PET-CT–guided Percutaneous Puncture of an Infected Cyst in Autosomal Dominant Polycystic Kidney Disease: Case Report

Cited by 39 publications

References 14 publications

Positron-Emission Computed Tomography in Cyst Infection Diagnosis in Patients with Autosomal Dominant Polycystic Kidney Disease

Positron-Emission Computed Tomography in Cyst Infection Diagnosis in Patients with Autosomal Dominant Polycystic Kidney Disease

Accuracy of image fusion of normal upper abdominal organs visualized with PET/CT

18F-FDG PET/CT demonstrated renal and hepatic cyst infection in a patient with autosomal dominant polycystic kidney disease

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