Hyun Woo Kwon1, Ho-Young Lee, Young-Hwan Hwang, Hayne Cho Park, Curie Ahn, Keon Wook Kang. 1. Departments of aNuclear Medicine bInternal Medicine, Seoul National University College of Medicine cCancer Research Institute, Seoul National University dDepartment of Internal Medicine, Eulji University School of Medicine, Seoul eDepartment of Internal Medicine, The Korean Armed Forces Capital Hospital fDepartment of Nuclear Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
Abstract
OBJECTIVES: Cyst infection (CI) is a common problem in patients with autosomal dominant polycystic kidney disease (ADPKD) and the accurate detection of infected cysts is very important. We evaluated the diagnostic performance of fluorine-18 fluorodeoxyglucose-labeled white blood cell (WBC) PET/computed tomography (CT) for detection of infected cysts in patients with ADPKD. PATIENTS AND METHODS: Seventeen patients with ADPKD (male : female, 6 : 11; age, 53±9 years) and suspected CI were enrolled in this prospective study. Patients were classified as having definite/probable/possible CI. All patients underwent WBC PET/CT within 2 days of starting antibiotic treatment. The degree of WBC accumulation was evaluated qualitatively by nuclear medicine physicians. The diagnostic performance of WBC PET/CT was evaluated by sensitivity, specificity, positive predictive values, and negative predictive values. These values were compared with those generated from CT scans and MRI. RESULTS: Seven patients were classified as having renal CI (definite 6, probable 1). In this group, WBC PET/CT showed six positive findings and one equivocal finding. Seven patients were diagnosed with possible infection. In this group, WBC PET/CT showed six negative findings and one indeterminate finding. The diagnostic performance of WBC PET/CT showed advantages over CT or MRI scans (sensitivity 85.7%, specificity 87.5%, positive predictive value 85.7%, negative predictive value 87.5%). CONCLUSION: This prospective study shows that WBC PET/CT can provide an accurate diagnosis of CI in patients with ADPKD.
OBJECTIVES:Cyst infection (CI) is a common problem in patients with autosomal dominant polycystic kidney disease (ADPKD) and the accurate detection of infected cysts is very important. We evaluated the diagnostic performance of fluorine-18 fluorodeoxyglucose-labeled white blood cell (WBC) PET/computed tomography (CT) for detection of infected cysts in patients with ADPKD. PATIENTS AND METHODS: Seventeen patients with ADPKD (male : female, 6 : 11; age, 53±9 years) and suspected CI were enrolled in this prospective study. Patients were classified as having definite/probable/possible CI. All patients underwent WBC PET/CT within 2 days of starting antibiotic treatment. The degree of WBC accumulation was evaluated qualitatively by nuclear medicine physicians. The diagnostic performance of WBC PET/CT was evaluated by sensitivity, specificity, positive predictive values, and negative predictive values. These values were compared with those generated from CT scans and MRI. RESULTS: Seven patients were classified as having renal CI (definite 6, probable 1). In this group, WBC PET/CT showed six positive findings and one equivocal finding. Seven patients were diagnosed with possible infection. In this group, WBC PET/CT showed six negative findings and one indeterminate finding. The diagnostic performance of WBC PET/CT showed advantages over CT or MRI scans (sensitivity 85.7%, specificity 87.5%, positive predictive value 85.7%, negative predictive value 87.5%). CONCLUSION: This prospective study shows that WBC PET/CT can provide an accurate diagnosis of CI in patients with ADPKD.
Authors: Laura Onuchic; Victor Augusto Hamamoto Sato; Precil Diego Miranda de Menezes Neves; Bruno Eduardo Pedroso Balbo; Antônio Abel Portela-Neto; Fernanda Trani Ferreira; Elieser Hitoshi Watanabe; Andreia Watanabe; Maria Cláudia Stockler de Almeida; Leonardo de Abreu Testagrossa; Pedro Renato Chocair; Luiz Fernando Onuchic Journal: BMC Infect Dis Date: 2019-10-29 Impact factor: 3.090