Article (Scientific journals)
Positron-emission computed tomography in cyst infection diagnosis in patients with autosomal dominant polycystic kidney disease.
JOURET, François; Lhommel, Renaud; Beguin, Claire et al.
2011In Clinical Journal of the American Society of Nephrology, 6 (7), p. 1644-50
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Keywords :
Gram-Negative Bacterial Infections/diagnosis/microbiology/radiography/radionuclide imaging; Humans; Liver Diseases/diagnosis/radiography/radionuclide imaging; Magnetic Resonance Imaging; Male; Middle Aged; Polycystic Kidney, Autosomal Dominant/complications; Positron-Emission Tomography; Predictive Value of Tests; Radiopharmaceuticals/diagnostic use; Retrospective Studies; Tomography, X-Ray Computed
Abstract :
[en] BACKGROUND: 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 ((1)(8)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 >38 degrees C for >3 days, loin or liver tenderness, C-reactive protein plasma level of >5 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 = 3) or liver (n = 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 (1)(8)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.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
JOURET, François  ;  Centre Hospitalier Universitaire de Liège - CHU > Néphrologie
Lhommel, Renaud
Beguin, Claire
Devuyst, Olivier
Pirson, Yves
Hassoun, Ziad
Kanaan, Nada
Language :
English
Title :
Positron-emission computed tomography in cyst infection diagnosis in patients with autosomal dominant polycystic kidney disease.
Publication date :
2011
Journal title :
Clinical Journal of the American Society of Nephrology
ISSN :
1555-9041
eISSN :
1555-905X
Publisher :
American Society of Nephrology, United States
Volume :
6
Issue :
7
Pages :
1644-50
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 20 November 2012

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