The role of ¹⁸F-FDG PET/CT for the diagnosis of infections in patients with hematological malignancies and persistent febrile neutropenia

Leuk Res. 2013 Sep;37(9):1057-62. doi: 10.1016/j.leukres.2013.06.025. Epub 2013 Jul 10.

Abstract

We assessed the performance of PET/CT for diagnosis and management of infections in high-risk hematological cancer patients with persistent febrile neutropenia in a prospective study. (18)F-FDG PET/CT with contrast-enhanced CT was performed on day 5-7 of persistent fever. Between 2008 and 2011, 91 PET/CT examinations were performed for different episodes in 79 patients, resulting in 117 diagnoses. The sensitivity of the PET/CT was 79.8% (71/89) compared to 51.7% (46/89) with chest/sinus CT alone. Specificities were 32.14% (9/28) vs. 42.85% (12/28), respectively. PET/CT resulted in a change from the pre-test diagnosis in 63/91 (69%) of episodes and in modification of patients' management in 46/91 (55%). PET/CT was beneficial in diagnosing abdominal infections. PET/CT has a potential role in the diagnostic evaluation of patients with persistent febrile neutropenia.

Keywords: FDG; Febrile neutropenia; Hematological malignancies; Invasive fungal infections; PET/CT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fever / diagnosis*
  • Fever / etiology
  • Fluorodeoxyglucose F18*
  • Follow-Up Studies
  • Hematologic Neoplasms / complications
  • Hematologic Neoplasms / microbiology*
  • Hematologic Neoplasms / virology*
  • Humans
  • Male
  • Middle Aged
  • Neutropenia / diagnosis*
  • Neutropenia / etiology
  • Positron-Emission Tomography*
  • Prognosis
  • Prospective Studies
  • Radiopharmaceuticals
  • Reference Standards
  • Sensitivity and Specificity
  • Tertiary Care Centers
  • Tomography, X-Ray Computed*
  • Young Adult

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18