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18F-FDG PET/CT in the diagnosis of occult bacterial infections in children

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Abstract

The role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the diagnosis and follow-up of infectious diseases has expanded recently. The aim of this report is to communicate our experience regarding its role in the diagnosis and management of occult bacterial infections in children. We present three pediatric patients with occult bacterial infections and negative conventional studies in whom 18F-FDG PET/CT had a significant effect on clinical management. One patient had streptococcal endocarditis and prolonged fever. 18F-FDG PET/CT identified pneumonia and osteomyelitis, and was also used to monitor therapeutic response. Other patient had a cerebrospinal shunt fluid infection. 18F-FDG PET/CT was used to determine the exact localization of infection and establish the best surgical approach. The last patient had fever of unknown origin. 18F-FDG PET/CT identified splenic abscesses, which were surgically treated. Conclusion: 18F-FDG PET/CT should be considered as a useful diagnostic tool in children with suspected bacterial infections, if conventional diagnostic imaging techniques have failed to yield positive results.

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References

  1. Balink H, Collins J, Bruyn GA, Gemmel F (2009) F-18 FDG PET/CT in the diagnosis of fever of unknown origin. Clin Nucl Med 34:862–868

    Article  PubMed  Google Scholar 

  2. Basu S, Chryssikos T, Moghadam-Kia S, Zhuang H, Torigian DA, Alavi A (2009) Positron emission tomography as a diagnostic tool in infection: present role and future possibilities. Semin Nucl Med 39:36–51

    Article  PubMed  Google Scholar 

  3. Chavhan GB, Babyn PS (2011) Whole-body MR imaging in children: principles, technique, current applications, and future directions. Radiographics 31:1757–1772

    Article  PubMed  Google Scholar 

  4. Depas G, Decortis T, Francotte N, Bricteux G, Hustinx R (2007) F-18 FDG PET in infectious diseases in children. Clin Nucl Med 32:593–598

    Article  PubMed  Google Scholar 

  5. Glaudemans AW, Quintero AM, Signore A (2012) PET/MRI in infections and inflammatory diseases: will it be a useful improvement? Eur J Nucl Med Mol Imaging 34:745–749

    Article  Google Scholar 

  6. Gotthardt M, Bleeker-Rovers CP, Boerman OC, Oyen WJ (2010) Imaging of inflammation by PET, conventional scintigraphy and other imaging techniques. J Nucl Med 51:1937–1949

    Article  PubMed  Google Scholar 

  7. Hernández IL, Marín D, Rodado S, Couto R, Escabias C, Hernandez AC, Martin-Curto LM (2011) F-18-FDG-PET/CT in the diagnosis of fever of unknown origin. In: Abstracts of the Annual Congress of the European Association of Nuclear Medicine; 2011 October 15-19; Birmingham, United Kingdom. Eur J Nucl Med Mol Imaging 38(Suppl 2):S254

    Google Scholar 

  8. Imperiale A, Federici L, Lefebvre N, Braun JJ, Pfumio F, Kessler K, Hansmann Y, Andres E, Constantinesco A (2010) F-18 FDG PET/CT as a valuable imaging tool for assessing treatment efficacy in inflammatory and infectious diseases. Clin Nucl Med 35:86–90

    Article  PubMed  Google Scholar 

  9. Israel O, Keidar Z (2011) PET/CT imaging in infectious conditions. Ann N Y Acad Sci 1228:150–166

    Article  PubMed  Google Scholar 

  10. Jasper N, Däbritz J, Frosch M, Loeffler M, Weckesser M, Foell D (2010) Diagnostic value of [(18)F]-FDG PET/CT in children with fever of unknown origin or unexplained signs of inflammation. Eur J Nucl Med Mol Imaging 37:136–145

    Article  PubMed  Google Scholar 

  11. Kaste SC (2011) PET-CT in children: where is it appropriate? Pediatr Radiol 41(Suppl 2):509–513

    Article  PubMed  Google Scholar 

  12. Lassmann M, Biassoni L, Monsieurs M, Franzius C, Jacobs F (2007) EANM Dosimetry and Paediatrics Committees. The new EANM paediatric dosage card. Eur J Nucl Med Mol Imaging 34:796–798

    Article  CAS  PubMed  Google Scholar 

  13. Lassmann M, Biassoni L, Monsieurs M, Franzius C (2008) EANM Dosimetry and Paediatrics Committees. The new EANM paediatric dosage card: additional notes with respect to F-18. Eur J Nucl Med Mol Imaging 38:1666–1668

    Article  Google Scholar 

  14. Martinez V, Castilla-Lievre MA, Guillet-Caruba C (2012) (18)F-FDG PET/CT in tuberculosis: an early non-invasive marker of therapeutic response. Int J Tuberc Lung Dis 16:1180–1185

    Article  CAS  PubMed  Google Scholar 

  15. Meller J, Sahlmann CO, Scheel AK (2007) 18F-FDG PET and PET/CT in fever of unknown origin. J Nucl Med 48:35–45

    CAS  PubMed  Google Scholar 

  16. Rehman T, Chohan MO, Yonas H (2011) Diagnosis of ventriculoperitoneal shunt infection using [F-18]-FDG PET: a case report. J Neurosurg Sci 55:161–163

    CAS  PubMed  Google Scholar 

  17. Servaes S (2011) Imaging infection and inflammation in children with (18)F-FDG PET and (18)F-FDG PET/CT. J Nucl Med Technol 39:179–182

    Article  PubMed  Google Scholar 

  18. Shammas A, Lim R, Charron M (2009) Pediatric FDG PET/CT: physiologic uptake, normal variants, and benign conditions. Radiographics 29:1467–1486

    Article  PubMed  Google Scholar 

  19. Strauss J, Franzius C, Pfluger T, Juergens KU, Biassoni L, Begent J, Kluge R, Amthauer H, Voelker T, Hojgaard L, Barrington S, Hain S, Lynch T, Hahn K (2008) Guidelines for 18F-FDG PET and PET-CT imaging in pediatric oncology. Eur J Nucl Med Mol Imaging 35:1581–1588

    Article  Google Scholar 

  20. Van Riet J, Hill EE, Gheysens O, Dymarkowski S, Herregods MC, Herijgers P, Peetermans WE, Mortelmans L (2010) (18)F-FDG PET/CT for early detection of embolism and metastatic infection in patients with infective endocarditis. Eur J Nucl Med Mol Imaging 37:1189–1197

    Article  PubMed  Google Scholar 

  21. Wan DQ, Joseph UA, Barron BJ, Caram P, Nguyen AP (2009) Ventriculoperitoneal shunt catheter and cerebral spinal fluid infection initially detected by FDG PET/CT scan. Clin Nucl Med 34:464–465

    Article  PubMed  Google Scholar 

  22. Zhuang H, Alavi A (2002) 18-fluorodeoxyglucose positron emission tomographic imaging in the detection and monitoring of infection and inflammation. Semin Nucl Med 32:47–59

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare to have no conflicts of interest. No funding was received for this work.

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Correspondence to Teresa del Rosal.

Additional information

Two of the cases included in this report were presented at the 6th Meeting of the Spanish Society for Paediatric Infectious Diseases (Bilbao, Spain, March 2012. Poster nos. 44 and 45).

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del Rosal, T., Goycochea, W.A., Méndez-Echevarría, A. et al. 18F-FDG PET/CT in the diagnosis of occult bacterial infections in children. Eur J Pediatr 172, 1111–1115 (2013). https://doi.org/10.1007/s00431-013-1983-x

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  • DOI: https://doi.org/10.1007/s00431-013-1983-x

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