Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Department of Nuclear Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
J Microbiol Immunol Infect. 2018 Dec;51(6):839-846. doi: 10.1016/j.jmii.2018.08.003. Epub 2018 Aug 23.
BACKGROUND/PURPOSE: Bacteremia portends high rates of morbidity and mortality. Although F-fluorodeoxyglucose positron emission tomography and computed tomography (F-FDG PET/CT) imaging has clinical value in assessing fever of unknown origin, its usefulness in bacteremia has not been entirely elucidated. We therefore designed the current single-center retrospective study to investigate 1) the clinical value of F-FDG PET/CT imaging in assessing bacteremia and 2) the association between laboratory data and imaging findings.
We examined 102 patients with bacteremia who had undergone F-FDG PET/CT imaging. The patients' clinical and laboratory data were reviewed and analyzed in relation to F-FDG PET/CT findings. Patients showing positive results underwent quantitative measurements of F-FDG uptake.
Positive F-FDG PET/CT findings were identified in 74 (72.5%) patients, and 40 (54.1%) underwent modified treatment or management because of the imaging results (p = 0.003). Positive F-FDG PET/CT findings were significantly associated with higher white blood cell (WBC) counts and C-reactive protein (CRP) levels (p = 0.012 and < 0.001, respectively). Notably, CRP levels accurately predicted (area under curve = 0.752; p < 0.001) positive F-FDG PET/CT findings (optimal cut-off point: 54.025 mg/L).
A majority (54.1%, n = 40) of the patients with positive F-FDG PET/CT results underwent treatment modifications; they accounted for most cases (87%) of management changes in our cohort. Leukocytosis and increased CRP levels are significantly associated with positive F-FDG PET/CT findings in patients with bacteremia. CRP levels >54.025 mg/L were accurate predictors of positive F-FDG PET/CT results.
背景/目的：菌血症预示着较高的发病率和死亡率。虽然 F-氟代脱氧葡萄糖正电子发射断层扫描和计算机断层扫描（F-FDG PET/CT）成像在评估不明原因发热方面具有临床价值，但它在菌血症中的作用尚未完全阐明。因此，我们设计了这项单中心回顾性研究，旨在调查 1）F-FDG PET/CT 成像在评估菌血症中的临床价值，以及 2）实验室数据与影像学结果之间的关联。
我们检查了 102 例菌血症患者的 F-FDG PET/CT 图像。回顾并分析了患者的临床和实验室数据与 F-FDG PET/CT 结果的关系。对显示阳性结果的患者进行 F-FDG 摄取的定量测量。
74 例（72.5%）患者的 F-FDG PET/CT 结果为阳性，其中 40 例（54.1%）因影像学结果而进行了改良治疗或管理（p=0.003）。阳性 F-FDG PET/CT 结果与较高的白细胞计数（WBC）和 C 反应蛋白（CRP）水平显著相关（p=0.012 和<0.001）。值得注意的是，CRP 水平准确预测（曲线下面积为 0.752；p<0.001）阳性 F-FDG PET/CT 结果（最佳截断点为 54.025mg/L）。
大多数（54.1%，n=40）F-FDG PET/CT 结果阳性的患者进行了治疗调整；他们占我们队列中大多数（87%）管理变更的病例。菌血症患者中白细胞增多和 CRP 水平升高与 F-FDG PET/CT 阳性结果显著相关。CRP 水平>54.025mg/L 是 F-FDG PET/CT 阳性结果的准确预测因子。
