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Clinical utility of FDG PET/CT in acute complicated pyelonephritis-results from an observational study.
Eur J Nucl Med Mol Imaging ; 45(3): 462-470, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28951990


Acute complicated pyelonephritis (ACP) is an upper urinary tract infection associated with coexisting urinary tract abnormalities or medical conditions that could predispose to serious outcomes or treatment failures. Although CT and magnetic resonance imaging (MRI) are frequently used in patients with ACP, the clinical value of 18F-fluorodeoxyglucose positron emission tomography and computed tomography (FDG PET/CT) has not been systematically investigated. This single-center retrospective study was designed to evaluate the potential usefulness of FDG PET/CT in patients with ACP.


Thirty-one adult patients with ACP who underwent FDG PET/CT were examined. FDG PET/CT imaging characteristics, including tracer uptake patterns, kidney volumes, and extrarenal imaging findings, were reviewed in combination with clinical data and conventional imaging results.


Of the 31 patients, 19 (61%) showed focal FDG uptake. The remaining 12 study participants showed a diffuse FDG uptake pattern. After volumetric approximation, the affected kidneys were found to be significantly enlarged. Patients who showed a focal uptake pattern had a higher frequency of abscess formation requiring drainage. ACP patients showing diffuse tracer uptake patterns had a more benign clinical course. Seven patients had suspected extrarenal coinfections, and FDG PET/CT successfully confirmed the clinical suspicion in five cases. FDG PET/CT was as sensitive as CT in identifying the six patients (19%) who developed abscesses. Notably, FDG PET/CT findings caused a modification to the initial antibiotic regimen in nine patients (29%).


FDG PET/CT may be clinically useful in the assessment of patients with ACP who have a progressive disease course.





Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Pielonefrite / Fluordesoxiglucose F18 / Tomografia Computadorizada com Tomografia por Emissão de Pósitrons Aspecto clínico: Prognóstico Limite: Feminino / Humanos / Masculino / Meia-Idade Idioma: Inglês Revista: Eur J Nucl Med Mol Imaging Assunto da revista: Medicina Nuclear Ano de publicação: 2018 Tipo de documento: Artigo País de afiliação: China