The use of a visual 4-point scoring scale improves the yield of (18)F-FDG PET-CT imaging in the diagnosis of renal and hepatic cyst infection in patients with autosomal dominant polycystic kidney disease.
[en] PURPOSE: [(18)F]FDG PET/CT (PET/CT) proved useful in the diagnosis of renal and hepatic cyst infection (CyI) in patients with autosomal dominant polycystic kidney disease (ADPKD). However, the definition of CyI by PET/CT is unclear. Here, we characterize the [(18)F]FDG uptake in CyI in order to infer a visual 4-point diagnostic scale. METHODS: All ADPKD patients hospitalized between 2007 and 2019 for suspected CyI and who underwent an [(18)F]FDG PET/CT scan were listed. CyI was defined by 5 concomitant criteria: fever ≥ 38 °C; abdominal pain; peak plasma CRP ≥ 70 mg/L; no other cause of inflammation; and favorable outcomes after antibiotics for ≥ 21 days. First, all PET/CT images were visually interpreted. Next, the [(18)F]FDG uptake around the suspected CyI was scored using a semiquantitative 4-point scale in comparison to blood and liver activities. RESULTS: Sixty [(18)F]FDG PET/CT scans were performed for suspected CyI in 38 ADPKD patients. Twenty-nine episodes met the gold-standard criteria for CyI. The visual assessment of PET/CT images reached a sensitivity of 73.1% and a specificity of 70.6%. Using the 4-point scale, an [(18)F]FDG score ≥ 3 (i.e., cyst uptake > liver) improved the specificity to 85.3%. CONCLUSION: [(18)F]FDG PET-CT is helpful in CyI diagnosis in ADPKD, and the use of a 4-point scoring of [(18)F]FDG uptake improves its diagnostic yield, with positive and negative predictive values of 78.3 and 78.4%, respectively. External validation is required.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
Neuville, Marie ✱; Université de Liège - ULiège > Cardiovascular Sc.-Lab. of Translational Res. in Nephrology
LOVINFOSSE, Pierre ✱; Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de médecine nucléaire et imagerie onco
JADOUL, Alexandre ; Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de médecine nucléaire et imagerie onco
THYS, Marie ; Centre Hospitalier Universitaire de Liège - CHU > Département de gestion des systèmes d'informations (GSI) > Secteur exploitation des données
SEIDEL, Laurence ; Centre Hospitalier Universitaire de Liège - CHU > Département de gestion des systèmes d'informations (GSI) > Secteur d'appui à la recherche clinique et biostatistique
Hustinx, Roland ; Université de Liège - ULiège > Département des sciences cliniques > Médecine nucléaire
Jouret, François ; Université de Liège - ULiège > Cardiovascular Sc.-Lab. of Translational Res. in Nephrology
✱ These authors have contributed equally to this work.
Language :
English
Title :
The use of a visual 4-point scoring scale improves the yield of (18)F-FDG PET-CT imaging in the diagnosis of renal and hepatic cyst infection in patients with autosomal dominant polycystic kidney disease.
Publication date :
2021
Journal title :
European Journal of Nuclear Medicine and Molecular Imaging
Jouret F, Lhommel R, Devuyst O, Annet L, Pirson Y, Hassoun Z, et al. Diagnosis of cyst infection in patients with autosomal dominant polycystic kidney disease: attributes and limitations of the current modalities. Nephrol Dial Transplant. 2012;27:3746–51. DOI: 10.1093/ndt/gfs352
Sallee M, Rafat C, Zahar JR, Paulmier B, Grunfeld JP, Knebelmann B, et al. Cyst infections in patients with autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol. 2009;4:1183–9. DOI: 10.2215/CJN.01870309
Neuville M, Hustinx R, Jacques J, Krzesinski JM, Jouret F. Diagnostic algorithm in the management of acute febrile abdomen in patients with autosomal dominant polycystic kidney disease. PLoS One. 2016;11:e0161277. DOI: 10.1371/journal.pone.0161277
Jouret F, Lhommel R, Beguin C, Devuyst O, Pirson Y, Hassoun Z, et al. Positron-emission computed tomography in cyst infection diagnosis in patients with autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol. 2011;6:1644–50. DOI: 10.2215/CJN.06900810
Pijl JP, Glaudemans A, Slart R, Kwee TC. (18)F-FDG PET/CT in autosomal dominant polycystic kidney disease patients with suspected cyst infection. J Nucl Med. 2018;59:1734–41. DOI: 10.2967/jnumed.117.199448
Lantinga MA, Drenth JP, Gevers TJ. Diagnostic criteria in renal and hepatic cyst infection. Nephrol Dial Transplant. 2015;30:744–51. DOI: 10.1093/ndt/gfu227
Pijl JP, Kwee TC, Slart R, Glaudemans A. FDG-PET/CT for diagnosis of cyst infection in autosomal dominant polycystic kidney disease. Clinical and translational imaging. 2018;6:61–7. DOI: 10.1007/s40336-017-0261-8
Kagna O, Kurash M, Ghanem-Zoubi N, Keidar Z, Israel O. Does antibiotic treatment affect the diagnostic accuracy of (18)F-FDG PET/CT studies in patients with suspected infectious processes? J Nucl Med. 2017;58:1827–30. DOI: 10.2967/jnumed.117.192062
Pijl JP, Glaudemans A, Slart R, Yakar D, Wouthuyzen-Bakker M, Kwee TC. FDG-PET/CT for detecting an infection focus in patients with bloodstream infection: factors affecting diagnostic yield. Clin Nucl Med. 2019;44:99–106. DOI: 10.1097/RLU.0000000000002381
Salomon T, Nganoa C, Gac AC, Fruchart C, Damaj G, Aide N, et al. Assessment of alteration in liver (18)F-FDG uptake due to steatosis in lymphoma patients and its impact on the Deauville score. Eur J Nucl Med Mol Imaging. 2018;45:941–50. DOI: 10.1007/s00259-017-3914-y