Medical Imaging Center, Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and
Medical Imaging Center, Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and.
J Nucl Med. 2018 Nov;59(11):1734-1741. doi: 10.2967/jnumed.117.199448. Epub 2018 Apr 13.
The objective of this study was to determine the value of F-FDG PET/CT for diagnosing renal or hepatic cyst infection in patients with autosomal dominant polycystic kidney disease (ADPKD). This retrospective, single-center study included all patients who had ADPKD and underwent F-FDG PET/CT because of suspected cyst infection between 2010 and 2017. Thirty F-FDG PET/CT scans of 30 individual patients were included; 19 of them had positive results for cyst infection. According to a previously established clinical and biochemical reference standard, F-FDG PET/CT achieved a sensitivity of 88.9%, a specificity of 75.0%, a positive predictive value of 84.2%, and a negative predictive value of 81.8% for the diagnosis of cyst infection. In 5 cases, F-FDG PET/CT suggested that the symptoms could be explained by a different pathologic process, including pneumonia ( = 1), generalized peritonitis ( = 1), pancreatitis ( = 1), colitis ( = 1), and cholangitis ( = 1). The total duration of the hospital stay and the duration between the F-FDG PET/CT scan and hospital discharge for patients with F-FDG PET/CT scan results that were positive for cyst infection were significantly longer than those for patients with negative scan results ( = 0.005 and = 0.009, respectively). Creatinine levels were significantly higher in patients with F-FDG PET/CT scan results that were positive for cyst infection than in patients with negative scan results ( = 0.015). Other comparisons of clinical parameters (age, sex, presence of fever [>38.5°C] for more than 3 d, abdominal pain, history of solid-organ transplantation and nephrectomy, and immune status), laboratory values (C-reactive protein level, leukocyte count, and estimated glomerular filtration rate), and microbiologic test results (blood and urine cultures) were not significantly different ( = 0.13-1.00) in patients with positive and negative F-FDG PET/CT scan results. F-FDG PET/CT is a useful imaging modality for the evaluation of patients with ADPKD and suspected cyst infection.
本研究旨在确定 18F-FDG PET/CT 对常染色体显性多囊肾病（ADPKD）患者肾或肝囊肿感染的诊断价值。本回顾性单中心研究纳入了 2010 年至 2017 年间因疑似囊肿感染而接受 18F-FDG PET/CT 检查的所有 ADPKD 患者。共纳入 30 例患者的 30 次 18F-FDG PET/CT 扫描，其中 19 次扫描结果提示囊肿感染阳性。根据先前建立的临床和生化参考标准，18F-FDG PET/CT 对囊肿感染的诊断灵敏度为 88.9%，特异度为 75.0%，阳性预测值为 84.2%，阴性预测值为 81.8%。在 5 例患者中，18F-FDG PET/CT 提示症状可能由不同的病理过程引起，包括肺炎（ = 1）、全腹膜炎（ = 1）、胰腺炎（ = 1）、结肠炎（ = 1）和胆管炎（ = 1）。囊肿感染 18F-FDG PET/CT 扫描结果阳性患者的总住院时间和 18F-FDG PET/CT 扫描至出院时间均显著长于扫描结果阴性患者（ = 0.005 和 = 0.009）。囊肿感染 18F-FDG PET/CT 扫描结果阳性患者的血肌酐水平显著高于扫描结果阴性患者（ = 0.015）。阳性和阴性 18F-FDG PET/CT 扫描结果患者的临床参数（年龄、性别、发热[>38.5°C]持续时间超过 3 d、腹痛、实体器官移植和肾切除术史、免疫状态）、实验室值（C 反应蛋白水平、白细胞计数和估计肾小球滤过率）和微生物学检测结果（血和尿培养）的其他比较差异无统计学意义（ = 0.13-1.00）。18F-FDG PET/CT 是评估 ADPKD 合并疑似囊肿感染患者的一种有用的影像学方法。
