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18F-FDG PET/CT for invasive fungal infection in immunocompromised patients

B Leroy-Freschini1, G Treglia2,3,4, X Argemi5,6

  • 1From the Biophysics and Nuclear Medicine, Strasbourg University Hospitals, Strasbourg, France.

QJM : Monthly Journal of the Association of Physicians
|June 20, 2018
PubMed
Abstract

Insights

18F-FDG PET/CT significantly aids in managing invasive fungal infections (IFIs) in immunocompromised patients. This imaging technique improves initial diagnosis, staging, and treatment monitoring, leading to better patient outcomes.

Area of Science:

  • Medical Imaging
  • Nuclear Medicine
  • Infectious Diseases

Background:

  • Invasive fungal infections (IFIs) are challenging to diagnose early in immunocompromised patients.
  • Candida and Aspergillus species are common pathogens affecting multiple organs.

Purpose of the Study:

  • To evaluate the impact of 18F-FDG PET/CT on the management of immunocompromised patients with IFIs.
  • Assess the role of 18F-FDG PET/CT in diagnosis, staging, and treatment monitoring.

Main Methods:

  • Retrospective study of 51 immunocompromised patients with IFI.
  • 83 18F-FDG PET/CT scans performed for primary work-up and follow-up.
  • Histological and microbiological criteria used for IFI diagnosis confirmation.

Main Results:

  • 18F-FDG PET/CT demonstrated high accuracy (90%) in diagnosing IFIs.
  • Influenced primary staging in 55% of treatment-naïve patients.
  • Guided treatment adjustments in 15% (dosage increase/new drugs) and 31% (dosage reduction/withdrawal).

Conclusions:

  • 18F-FDG PET/CT is recommended for improving IFI staging and assessing treatment response/relapse.
  • Integrate 18F-FDG PET/CT with conventional imaging in a diagnostic algorithm.
  • Consider clinical context and modality limitations for optimal IFI management.

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