Anish Bhattacharya1, Rakesh Kochhar2, Sarika Sharma3, Pallab Ray4, Naveen Kalra5, Niranjan Khandelwal5, Bhagwant R Mittal3. 1. Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India anishpgi@yahoo.co.in. 2. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 3. Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 4. Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India; and. 5. Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
UNLABELLED: Early detection of infection in acute pancreatitis (AP) affects the choice of treatment and clinical outcome. We used PET/CT with (18)F-FDG-labeled autologous leukocytes to detect infection in pancreatic or peripancreatic fluid collections in patients with AP. METHODS: Forty-one patients (28 men and 13 women) who were 21-69 y old (mean ± SD, 41 ± 11.5) and had AP and radiologic evidence of a fluid collection in or around the pancreas were studied. Leukocytes were separated from the patient's venous blood, labeled with (18)F-FDG, and reinjected intravenously; PET/CT images were acquired 2 h later. A final diagnosis of infection was based on microbiologic culture of fluid aspirated from the collection. Patients were treated with supportive care and antibiotics; percutaneous drainage or laparotomy was performed when indicated. RESULTS: Blood glucose level, total leukocyte count, neutrophil count, and leukocyte labeling efficiency varied from 83 to 212 mg/100 mL (118 ± 30), 4,600 to 24,200/mm(3) (11,648 ± 5,376), 55% to 90% (73 ± 10), and 31% to 97% (81 ± 17), respectively. Increased tracer uptake in the fluid collection was seen in 12 of 41 patients; 10 had culture-proven infection and underwent percutaneous drainage, and aspiration was unsuccessful in 2. The scan results were negative for infection in 29 patients; 25 had fluid culture results that were negative for infection, and aspiration was unsuccessful in 4. The sensitivity, specificity, and accuracy of the scan were all 100% in 35 patients for whom fluid culture reports were available. CONCLUSION: PET/CT with (18)F-FDG-labeled leukocytes is a noninvasive and reliable method for the diagnosis of infection in pancreatic or peripancreatic fluid collections in patients with AP.
UNLABELLED: Early detection of infection in acute pancreatitis (AP) affects the choice of treatment and clinical outcome. We used PET/CT with (18)F-FDG-labeled autologous leukocytes to detect infection in pancreatic or peripancreatic fluid collections in patients with AP. METHODS: Forty-one patients (28 men and 13 women) who were 21-69 y old (mean ± SD, 41 ± 11.5) and had AP and radiologic evidence of a fluid collection in or around the pancreas were studied. Leukocytes were separated from the patient's venous blood, labeled with (18)F-FDG, and reinjected intravenously; PET/CT images were acquired 2 h later. A final diagnosis of infection was based on microbiologic culture of fluid aspirated from the collection. Patients were treated with supportive care and antibiotics; percutaneous drainage or laparotomy was performed when indicated. RESULTS: Blood glucose level, total leukocyte count, neutrophil count, and leukocyte labeling efficiency varied from 83 to 212 mg/100 mL (118 ± 30), 4,600 to 24,200/mm(3) (11,648 ± 5,376), 55% to 90% (73 ± 10), and 31% to 97% (81 ± 17), respectively. Increased tracer uptake in the fluid collection was seen in 12 of 41 patients; 10 had culture-proven infection and underwent percutaneous drainage, and aspiration was unsuccessful in 2. The scan results were negative for infection in 29 patients; 25 had fluid culture results that were negative for infection, and aspiration was unsuccessful in 4. The sensitivity, specificity, and accuracy of the scan were all 100% in 35 patients for whom fluid culture reports were available. CONCLUSION: PET/CT with (18)F-FDG-labeled leukocytes is a noninvasive and reliable method for the diagnosis of infection in pancreatic or peripancreatic fluid collections in patients with AP.
Authors: Elham Afghani; Stephen J Pandol; Tooru Shimosegawa; Robert Sutton; Bechien U Wu; Santhi Swaroop Vege; Fred Gorelick; Morihisa Hirota; John Windsor; Simon K Lo; Martin L Freeman; Markus M Lerch; Yoshihisa Tsuji; Gil Y Melmed; Wahid Wassef; Julia Mayerle Journal: Pancreas Date: 2015-11 Impact factor: 3.327
Authors: Xinghai Ning; Wonewoo Seo; Seungjun Lee; Kiyoko Takemiya; Mohammad Rafi; Xuli Feng; Daiana Weiss; Xiaojian Wang; Larry Williams; Vernon M Camp; Malveaux Eugene; W Robert Taylor; Mark Goodman; Niren Murthy Journal: Angew Chem Int Ed Engl Date: 2014-10-21 Impact factor: 15.336
Authors: Nourhan Shalaby; John Kelly; Francisco Martinez; Mathew Fox; Qi Qi; Jonathan Thiessen; Justin Hicks; Timothy J Scholl; John A Ronald Journal: Mol Imaging Biol Date: 2022-02-10 Impact factor: 3.484