2021
DOI: 10.1007/s40121-021-00495-7
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The Role of 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) in Management of Nocardiosis: A Retrospective Study and Review of the Literature

Abstract: Introduction: 18-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is a well-established tool for managing metastatic infections. Nocardiosis, a primarily pulmonary infection, disseminates at high rates. Routine imaging includes chest CT and brain imaging. We examined the use of FDG-PET/CT in nocardiosis and assessed its contribution to diagnosis and management. Methods: A retrospective study in two tertiary medical centers during 2011-2020. Individuals with nocardiosis for whom … Show more

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Cited by 7 publications
(4 citation statements)
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“…Localized lesions (such as skin and soft tissues) should be analyzed according to the best diagnostic method available (ultrasound, CT scan). Interestingly, FDG-PET has recently been considered as a useful tool for the diagnosis and staging of nocardiosis by revealing unknown foci of dissemination and for guiding biopsy; furthermore, it has been deemed useful for monitoring treatment response, shortening treatment duration and ruling out relapses [19]. In one of our patients, FDG-PET was useful in guiding a diagnostic biopsy, resulting in microbiological diagnosis and in staging disease dissemination.…”
Section: Discussionmentioning
confidence: 88%
“…Localized lesions (such as skin and soft tissues) should be analyzed according to the best diagnostic method available (ultrasound, CT scan). Interestingly, FDG-PET has recently been considered as a useful tool for the diagnosis and staging of nocardiosis by revealing unknown foci of dissemination and for guiding biopsy; furthermore, it has been deemed useful for monitoring treatment response, shortening treatment duration and ruling out relapses [19]. In one of our patients, FDG-PET was useful in guiding a diagnostic biopsy, resulting in microbiological diagnosis and in staging disease dissemination.…”
Section: Discussionmentioning
confidence: 88%
“…3 PET/CT is therefore a valuable tool for determining the location for biopsy and management of individuals with nocardiosis. 4 Many inflammatory lesions have a maximum SUV of 2.5, and the specificity of this cutoff SUV is approximately 70%-90%. 5 In our case, marked proliferated blood vessels induced by chronic infection in an immunocompetent host had contributed to extreme neutrophilic and histiocytic infiltration of the lesion, resulting in high FDG uptake (SUVmax 13.46) on PET/CT imaging as in malignant tumors, especially soft tissue sarcoma.…”
Section: Positron Emission Tomography and Computed Tomography Imaging...mentioning
confidence: 99%
“…Whole-body functional imaging with FDG PET/CT has an emerging role in the diagnosis of infection, identifying disease extent, defining the biopsy location, monitoring therapy response, and guiding therapy duration decisions for Nocardia. [1][2][3] Radiological features of pulmonary nocardiosis are nonspecific as it may present as consolidation, infiltration, solitary, or multiple nodules. 4 The clinical and radiological findings along with increased FDG uptake on PET scan may be misdiagnosed as malignancies.…”
mentioning
confidence: 99%
“…Nocardiosis is a rare, localized, or disseminated opportunistic infection caused by a Gram-positive, aerobic, filamentous bacteria, commonly affecting immunosuppressed patients, in whom it most commonly presents as pulmonary disease. Whole-body functional imaging with FDG PET/CT has an emerging role in the diagnosis of infection, identifying disease extent, defining the biopsy location, monitoring therapy response, and guiding therapy duration decisions for Nocardia 1–3 . Radiological features of pulmonary nocardiosis are nonspecific as it may present as consolidation, infiltration, solitary, or multiple nodules 4 .…”
mentioning
confidence: 99%