PET Scanning Used for Monitoring Treatment Response in Mycobacterium avium Complex Infection Mimicking Malignancy

Drijkoningen, Jesse; Pol, Harry van der; Vries, Michiel S. de

doi:10.1097/rlu.0b013e3181b7daf6

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…Sato et al reported a case of disseminated MAC infection and a FDG PET/CT performed after 4 and 9 months of antimycobacterial therapy that showed a decreased FDG accumulation [ 61 ]. Drijkoningen et al reported another case of regression of PET avidity in disseminated MAC disease after 2 months of specific therapy [ 62 ]. No specific recommendations exist about the use of PET/CT in the follow-up of NTM disease, but these reports may indicate a possible role in both evaluation of successful treatment and follow-up.…”

Section: Risk Factors For Treatment Failure and Follow-upmentioning

confidence: 99%

Nontuberculous Mycobacteria in Noncystic Fibrosis Bronchiectasis

Bonaiti

Pesci

Marruchella

et al. 2015

BioMed Research International

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During the past decades, a growing interest has been raised in evaluating nontuberculous mycobacteria (NTM) in patients with noncystic fibrosis bronchiectasis (NCFBE). This paper reviews several aspects of the correlations between NTM and NCFBE, including pathogenesis, radiological features, diagnosis, and management. Bronchiectasis and NTM lung disease are connected, but which one comes first is still an unresolved question. The rate of NTM lung disease in NCFBE varies through the studies, from 5% to 30%. The most frequent species isolated is MAC. NCFBE patients affected by NTM infection frequently present coinfections, including both other different NTM species and microorganisms, such as P. aeruginosa. Once a diagnosis of NTM disease has been reached, the initiation of therapy is not always mandatory. NTM species isolated, patients' conditions, and disease severity and its evolution should be considered. Risk factors for disease progression in NCFBE patients with NTM are low body mass index, cavitary disease, consolidations, and macrolide resistance at presentation.

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Section: Risk Factors For Treatment Failure and Follow-upmentioning

confidence: 99%

Nontuberculous Mycobacteria in Noncystic Fibrosis Bronchiectasis

Bonaiti

Pesci

Marruchella

et al. 2015

BioMed Research International

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What, where and why: exploring fluorodeoxyglucose-PET's ability to localise and differentiate infection from cancer

Douglas

Lau

Thursky

et al. 2017

Current Opinion in Infectious Diseases

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Patients with cancer are vulnerable to infection and fever, and the causes of these are frequently unclear using conventional diagnostic methods leading to high morbidity and mortality, length of stay and costs of care. FDG-PET/CT, with its unique complementary functional and anatomical information as well as its whole-body imaging capability, has demonstrated use in detecting occult infection in immunocompromised patients, including invasive fungal and occult bacterial infections, as well as defining extent of infection. By demonstrating disease resolution following treatment and allowing earlier cessation of therapy, FDG-PET acts as a key tool for antimicrobial and antifungal stewardship. Limitations include at times poor differentiation between infection, malignancy and sterile inflammation, however, exciting new technologies specific to infectious pathogens may help alleviate that issue. Further prospective randomised research is needed to explore these benefits in a nonbiased fashion.

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Pulmonary Light and Heavy Chain Deposition Disease

Makis¹,

Derbekyan²,

Novales-Diaz³

2010

Clinical Nuclear Medicine

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A 64-year-old man with a history of smoking and asbestos exposure was referred for an F-18 FDG PET/CT, to evaluate multiple growing lung nodules that had been found incidentally on prior chest CTs. The PET/CT showed multiple hypermetabolic nodules in both the lungs, with varying intensity of FDG uptake, raising the suspicion of multifocal malignancy. Wedge resections of the right lung were done to remove the 2 most hypermetabolic nodules, and histologic evaluation revealed pulmonary light and heavy chain deposition disease. A follow-up PET/CT performed 1 year later showed another slowly growing nodule in the left lung with a significant increase in F-18 FDG uptake. Only 22 cases of pulmonary light chain deposition disease have been reported in the literature. This is a report of F-18 FDG uptake in nodules of pulmonary light chain deposition disease. These nodules can grow in size and can show increased F-18 FDG uptake on follow-up studies, mimicking a growing lung malignancy. man with a history of smoking and asbestos exposure had a contrast-enhanced chest CT for evaluation of pulmonary embolism. An incidental 8-mm nodule was noted in the right upper lung, laterally. B, In August 2008, the patient had another contrast-enhanced chest CT, following a motor vehicle accident. The right upper lung nodule had grown to 1.4 ϫ 1.0 cm and was not calcified. The patient was referred for a PET/CT. C, On the F-18 FDG PET/CT (Discovery ST, GE Healthcare), the 1.4 cm right upper lobe lung nodule had a maximal Standardized uptake value (SUV) of 6.3. There was another subcentimetric nodule in the right lower lobe with SUV 3.5, and an ill-defined 1 cm nodule in the left upper lobe with SUV 1.7. A suspicion for multifocal malignancy was raised. Histologic evaluation of wedge resections of the right upper and right lower lobes showed nodules of amorphous eosinophilic material, congo red negative, with plasma cells expressing kappa light and IgG heavy chains, consistent with monoclonal pulmonary light and heavy chain deposition disease. The diagnosis was confirmed with electron microscopy, which showed linear or nodular deposits of amorphous and granular material in vessel walls and in the interstitium consistent with those found in light and heavy chain deposition diseases. Nonbranching fibrils of 7.5 to 10 nm, characteristic of amyloid, were not seen. Molecular studies showed the presence of a clonal population of B-cells for FR3 (framework region) and for J kappa, and absence of a clonal population of T-cells for T gamma I and II. Molecular studies for FR1 were equivocal, and those for FR2 were negative. D, PET/CT fusion image.

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PET Scanning Used for Monitoring Treatment Response in Mycobacterium avium Complex Infection Mimicking Malignancy

Cited by 3 publications

References 8 publications

Nontuberculous Mycobacteria in Noncystic Fibrosis Bronchiectasis

Nontuberculous Mycobacteria in Noncystic Fibrosis Bronchiectasis

What, where and why: exploring fluorodeoxyglucose-PET's ability to localise and differentiate infection from cancer

Pulmonary Light and Heavy Chain Deposition Disease

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