PT  - JOURNAL ARTICLE
AU  - Anish Bhattacharya
AU  - Rakesh Kochhar
AU  - Sarika Sharma
AU  - Pallab Ray
AU  - Naveen Kalra
AU  - Niranjan Khandelwal
AU  - Bhagwant R. Mittal
TI  - PET/CT with <sup>18</sup>F-FDG–Labeled Autologous Leukocytes for the Diagnosis of Infected Fluid Collections in Acute Pancreatitis
AID  - 10.2967/jnumed.114.137232
DP  - 2014 Aug 01
TA  - Journal of Nuclear Medicine
PG  - 1267--1272
VI  - 55
IP  - 8
4099  - http://jnm.snmjournals.org/content/55/8/1267.short
4100  - http://jnm.snmjournals.org/content/55/8/1267.full
SO  - J Nucl Med2014 Aug 01; 55
AB  - Early detection of infection in acute pancreatitis (AP) affects the choice of treatment and clinical outcome. We used PET/CT with 18F-FDG–labeled autologous leukocytes to detect infection in pancreatic or peripancreatic fluid collections in patients with AP. Methods: Forty-one patients (28 men and 13 women) who were 21–69 y old (mean ± SD, 41 ± 11.5) and had AP and radiologic evidence of a fluid collection in or around the pancreas were studied. Leukocytes were separated from the patient’s venous blood, labeled with 18F-FDG, and reinjected intravenously; PET/CT images were acquired 2 h later. A final diagnosis of infection was based on microbiologic culture of fluid aspirated from the collection. Patients were treated with supportive care and antibiotics; percutaneous drainage or laparotomy was performed when indicated. Results: Blood glucose level, total leukocyte count, neutrophil count, and leukocyte labeling efficiency varied from 83 to 212 mg/100 mL (118 ± 30), 4,600 to 24,200/mm3 (11,648 ± 5,376), 55% to 90% (73 ± 10), and 31% to 97% (81 ± 17), respectively. Increased tracer uptake in the fluid collection was seen in 12 of 41 patients; 10 had culture-proven infection and underwent percutaneous drainage, and aspiration was unsuccessful in 2. The scan results were negative for infection in 29 patients; 25 had fluid culture results that were negative for infection, and aspiration was unsuccessful in 4. The sensitivity, specificity, and accuracy of the scan were all 100% in 35 patients for whom fluid culture reports were available. Conclusion: PET/CT with 18F-FDG–labeled leukocytes is a noninvasive and reliable method for the diagnosis of infection in pancreatic or peripancreatic fluid collections in patients with AP.