Diagnosis of renal and hepatic cyst infections by 18-F-fluorodeoxyglucose positron emission tomography in autosomal dominant polycystic kidney disease.
BACKGROUND
Infection of a renal or hepatic cyst is a serious complication of autosomal dominant polycystic kidney disease (ADPKD). Although crucial for successful management, early diagnosis is difficult, largely because of nonspecific symptoms and limitations of conventional imaging techniques. Because of an increased metabolic rate, inflammatory cells take up large amounts of glucose. 18-F-fluorodeoxyglucose (FDG), therefore, represents a promising agent for detection of cyst infections using positron emission tomography (PET).


METHODS
The authors studied the results of 7 FDG PET scans in 3 ADPKD patients suspected of renal or hepatic cyst infection. Two PET scans were performed in patient A (PET 1 and 2), one PET scan was performed in patient B (PET 3), and 4 PET scans were performed in patient C (PET 4, 5, 6 and 7).


RESULTS
FDG PET identified the infected cysts in 2 episodes of renal cyst infection (PET 2 and 3), 2 episodes of hepatic cyst infection (PET 6 and 7), and 1 episode of both renal and hepatic cyst infection (PET 1). In patient C, FDG PET was normal after 6 weeks of antibiotic treatment for hepatic cyst infection (PET 4) and again at a time when hepatic cyst infection was suspected, but eventually colchicine intoxication was diagnosed (PET 5).


CONCLUSIONS
In these patients, FDG PET proved very helpful in diagnosing and in excluding renal and hepatic cyst infections. It is concluded that FDG PET is a promising new imaging technique enabling early identification of renal and hepatic cyst infections in ADPKD patients.
Bleeker-Rovers
Chantal P
CP
Department of Internal Medicine, University Medical Center Nijmegen, Nijmegen, The Netherlands. c.bleeker-rovers@nucmed.umcn.nl
de Sévaux
Ruud G L
RG
van Hamersvelt
Henk W
HW
Corstens
Frans H M
FH
Oyen
Wim J G
WJ
D016470:Bacteremia / Q000150:complications; D056486:Chemical and Drug Induced Liver Injury / Q000000981:diagnostic imaging / Q000209:etiology; D003078:Colchicine / Q000009:adverse effects; D003560:Cysts / Q000150:complications* / Q000000981:diagnostic imaging / Q000382:microbiology; D003937:Diagnosis, Differential; D016984:Enterococcus faecium / Q000302:isolation & purification; D017809:Fatal Outcome; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D016908:Gram-Positive Bacterial Infections / Q000000981:diagnostic imaging* / Q000209:etiology; D006505:Hepatitis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000382:microbiology; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000382:microbiology; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications / Q000000981:diagnostic imaging*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011552:Pseudomonas Infections / Q000000981:diagnostic imaging* / Q000209:etiology; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D014055:Tomography, Emission-Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D003078:Colchicine