18F-FDG PET/CT in Autosomal Dominant Polycystic Kidney Disease Patients with Suspected Cyst Infection

  1. Thomas C. Kwee1
  1. 1Medical Imaging Center, Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and
  2. 2Department of Biomedical Photonic Imaging (BMPI), University of Twente, Enschede, The Netherlands
  1. For correspondence or reprints contact: Jordy P. Pijl, Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. E-mail: j.p.pijl{at}umcg.nl

Abstract

The objective of this study was to determine the value of 18F-FDG PET/CT for diagnosing renal or hepatic cyst infection in patients with autosomal dominant polycystic kidney disease (ADPKD). Methods: This retrospective, single-center study included all patients who had ADPKD and underwent 18F-FDG PET/CT because of suspected cyst infection between 2010 and 2017. Results: Thirty 18F-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, 18F-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, 18F-FDG PET/CT suggested that the symptoms could be explained by a different pathologic process, including pneumonia (n = 1), generalized peritonitis (n = 1), pancreatitis (n = 1), colitis (n = 1), and cholangitis (n = 1). The total duration of the hospital stay and the duration between the 18F-FDG PET/CT scan and hospital discharge for patients with 18F-FDG PET/CT scan results that were positive for cyst infection were significantly longer than those for patients with negative scan results (P = 0.005 and P = 0.009, respectively). Creatinine levels were significantly higher in patients with 18F-FDG PET/CT scan results that were positive for cyst infection than in patients with negative scan results (P = 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 (P = 0.13–1.00) in patients with positive and negative 18F-FDG PET/CT scan results. Conclusion: 18F-FDG PET/CT is a useful imaging modality for the evaluation of patients with ADPKD and suspected cyst infection.

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  • Published online Apr. 13, 2018.

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  1. J Nucl Med vol. 59 no. 11 1734-1741
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