Contribution of 18fluoro-deoxyglucose PET/CT for the diagnosis of infectious diseases.
The diagnosis of some infectious diseases is sometimes difficult to make and new diagnostic tools have been regularly assessed to that end. 18fluoro-deoxyglucose ((18)FDG) positron-emission tomography (PET) coupled with computed tomography (CT) is one of these new procedures. It has been evaluated for numerous infectious diseases with uneven results. A literature review allowed drawing some conclusions. First, (18)FDG-PET/CT is not currently a first-line procedure for infectious diseases. Second, it has proved useful for the evaluation of patients presenting with fever of unknown origin (FUO). Its negative predictive value is 100%: the symptoms of patients experiencing FUO with negative first-line investigations and a negative (18)FDG-PET/CT will almost always spontaneously disappear. Third, (18)FDG-PET/CT also seems to be contributive for the diagnosis of vascular prosthesis infections or osteomyelitis. Fourth, it has promising results for patients presenting with infective endocarditis, especially for secondary infectious foci, or for patients presenting with suspected infection of pacemakers or implanted defibrillator; but results are still preliminary and must be confirmed. Finally(18)FDG-PET/CT cannot be recommended yet for other infectious diseases due to lack of published data.
Service des maladies infectieuses et réanimation médicale, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France; CIC Inserm 0203, université Rennes 1, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France. Electronic address: matthieu.revest@chu-rennes.fr.
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Revest
Service des maladies infectieuses et réanimation médicale, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
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Patrat-Delon
Service de médecine nucléaire, centre régional de lutte contre le cancer Eugène-Marquis, avenue Bataille-Flandres-Dunkerque, 35042 Rennes cedex, France.
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Devillers
Service des maladies infectieuses et réanimation médicale, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France; CIC Inserm 0203, université Rennes 1, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France; Inserm U835, université Rennes 1, 2, avenue du Professeur Léon-Bernard, 35043 Rennes cedex, France.
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Tattevin
Service des maladies infectieuses et réanimation médicale, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France; CIC Inserm 0203, université Rennes 1, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
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Michelet
D016470:Bacteremia / Q000000981:diagnostic imaging; D017147:Defibrillators, Implantable / Q000009:adverse effects; D017719:Diabetic Foot / Q000000981:diagnostic imaging; D015299:Discitis / Q000000981:diagnostic imaging; D042241:Early Diagnosis; D004696:Endocarditis / Q000000981:diagnostic imaging; D005335:Fever of Unknown Origin / Q000000981:diagnostic imaging; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007239:Infections / Q000000981:diagnostic imaging*; D007249:Inflammation / Q000000981:diagnostic imaging; D015201:Meta-Analysis as Topic; D064847:Multimodal Imaging; D010019:Osteomyelitis / Q000000981:diagnostic imaging; D010138:Pacemaker, Artificial / Q000009:adverse effects; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
(18)FDG-PET/CT; Endocardite infectieuse; Fever of unknown origin; Fièvre d’origine indéterminée; Infection de prothèse vasculaire; Infective endocarditis; Osteomyelitis; Ostéomyélite; Vascular prosthesis infection