The diagnostic role of 2-[18F]FDG PET/CT in critically ill patients with suspected infection of unknown origin: a real-world experience.

IF 9.7 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Domenico Albano, Carlo Rodella, Anna Calabrò, Andor W J M Glaudemans, Giorgio Treglia, Francesco Bertagna
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引用次数: 0

Abstract

Purpose: 2-Deoxy-2-[18F]-fluoro-D-glucose (2-[18F]FDG) positron emission tomography/computed tomography (PET/CT) is a hybrid imaging tool with an emerging role in the study of several infectious and inflammatory diseases. Its role in critically ill patients admitted to the intensive care unit (ICU) is only marginally investigated. This study aimed to investigate the diagnostic performance and the clinical impact of 2-[18F]FDG PET/CT in the management of critically ill patients with suspected infections of unknown origin.

Methods: We retrospectively included 47 ICU patients (mean age 63.6 years, 33 males) who underwent a 2-[18F]FDG PET/CT to look for infection foci. We calculated the diagnostic performance of PET/CT expressed as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. As reference standard, final diagnosis based on microbiological/pathologic data or on clinical follow-up was taken. Moreover, we investigated the impact of PET/CT on clinical management and the association of PET/CT with the main clinical, epidemiological and biochemical parameters.

Results: The overall 2-[18F]FDG PET/CT sensitivity in detecting infectious foci was 80% (95%CI 64-91%), specificity 75% (95%CI 35-97%), PPV 94% (95%CI 83-93%), NPV 43% (95%CI 26-61%) and accuracy 79% (95%CI 65-90%). The absence of kidney failure, increase leukocyte count and low glucose level at the time of PET were significantly associated with true positive PET/CT. No adverse events during the transport and PET/CT procedure were registered.

Conclusion: PET/CT demonstrated to be an accurate toll for the study of critically ill ICU patients with suspected infections. Kidney failure, leukocyte count and blood glucose were associated with true positive PET/CT.

2-[18F]FDG PET/CT在疑似不明原因感染的危重患者中的诊断作用:现实世界的经验
目的:2-脱氧-2-[18F]-氟- d -葡萄糖(2-[18F]FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)是一种混合成像工具,在几种感染性和炎症性疾病的研究中具有新兴的作用。它在重症监护病房(ICU)收治的危重患者中的作用仅被略微调查。本研究旨在探讨2-[18F]FDG PET/CT对疑似不明原因感染的危重患者的诊断性能及临床意义。方法:我们回顾性纳入47例ICU患者(平均年龄63.6岁,男性33例),他们接受了2-[18F]FDG PET/CT检查以寻找感染灶。我们计算PET/CT的诊断性能,表达为敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和准确性。以微生物学/病理资料或临床随访作为最终诊断的参考标准。此外,我们还探讨了PET/CT对临床管理的影响,以及PET/CT与主要临床、流行病学和生化参数的关系。结果:2-[18F]FDG PET/CT检测感染性病灶的总体敏感性为80% (95%CI 64 ~ 91%),特异性为75% (95%CI 35 ~ 97%), PPV为94% (95%CI 83 ~ 93%), NPV为43% (95%CI 26 ~ 61%),准确率为79% (95%CI 65 ~ 90%)。PET检查时无肾衰竭、白细胞计数升高、低血糖水平与PET/CT真阳性显著相关。在运输和PET/CT过程中无不良事件记录。结论:PET/CT对ICU危重患者疑似感染有准确的诊断价值。肾衰竭、白细胞计数和血糖与PET/CT真阳性相关。
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来源期刊
Radiologia Medica
Radiologia Medica 医学-核医学
CiteScore
14.10
自引率
7.90%
发文量
133
审稿时长
4-8 weeks
期刊介绍: Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.
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