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Published on: April 19, 2017
Imaging fungal infections in children
Alfred O Ankrah1, Mike M Sathekge2, Rudi A J O Dierckx3
1Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO 9700 RB Groningen, The Netherlands ; Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa.
Abstract:
Fungal infections in children rarely occur, but continue to have a high morbidity and mortality despite the development of newer antifungal agents. It is essential for these infections to be diagnosed at the earliest possible stage so appropriate treatment can be initiated promptly. The addition of high-resolution computer tomography (HR CT) has helped in early diagnosis making; however, it lacks both sensitivity and specificity. Metabolic changes precede anatomical changes and hybrid imaging with positron emission tomography (PET) integrated with imaging modalities with high anatomical resolution such as CT or magnetic resonance imaging (MRI) is likely to detect these infections at an earlier stage with higher diagnostic accuracy rates. Several authors presented papers highlighting the advantages of PET/CT in imaging fungal infections. These papers, however, usually involve a limited number of patients and mostly adults. Fungal infections behave different in children than in adults, since there are differences in epidemiology, imaging findings, and response to treatment with antifungal drugs. This paper reviews the literature and explores the use of hybrid imaging for diagnosis and therapy decision making in children with fungal infections.
Insights
Hybrid imaging, like PET/CT, shows promise for early and accurate diagnosis of rare but serious fungal infections in children. This approach may improve treatment decisions and patient outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Medical Imaging
- Nuclear Medicine
Background:
- Fungal infections in children are rare but carry high morbidity and mortality.
- Early diagnosis is crucial for prompt and effective treatment.
- Current imaging like high-resolution computed tomography (HR CT) has limitations in sensitivity and specificity.
Approach:
- This review explores the literature on hybrid imaging, specifically positron emission tomography/computed tomography (PET/CT), for diagnosing fungal infections in pediatric patients.
- It examines the potential of integrating metabolic information from PET with anatomical detail from CT or MRI.
- The focus is on improving diagnostic accuracy and aiding therapy decisions.
Key Points:
- Metabolic changes often precede anatomical alterations in fungal infections.
- Hybrid imaging (PET/CT, PET/MRI) offers higher diagnostic accuracy than conventional methods.
- Pediatric fungal infections differ from adult infections in epidemiology, imaging, and treatment response.
Conclusions:
- Hybrid imaging presents a promising avenue for earlier and more accurate diagnosis of fungal infections in children.
- This technology can significantly aid in clinical decision-making for treatment strategies.
- Further research focusing on pediatric populations is warranted to fully establish the role of hybrid imaging.
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