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Title: What, where and why: exploring fluorodeoxyglucose-PET's ability to localise and differentiate infection from cancer
Austin Authors: Douglas, Abby;Lau, Eddie ;Thursky, Karin A;Slavin, Monica A
Affiliation: Department of Molecular Imaging and Therapy, Centre for PET, Austin Health, Heidelberg, Victoria, Australia
Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
Infectious Diseases Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
The University of Melbourne, Melbourne, Victoria, Australia
The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Victorian Infectious Diseases Service, The Peter Doherty Institute for Immunity and Infection, Royal Melbourne Hospital, Melbourne, Victoria, Australia
National Centre for Antimicrobial Stewardship, Melbourne, Victoria, Australia
Issue Date: Dec-2017
Date: 2017-09-15
Publication information: Current Opinion in Infectious Diseases 2017; 30(6): 552-564
Abstract: PURPOSE OF REVIEW: To review the utility of FDG-PET imaging in detecting the cause of fever and infection in patients with cancer. RECENT FINDINGS: FDG-PET has been shown to have high sensitivity and accuracy for causes of neutropenic fever, leading to higher diagnostic certainty in this group. Recent advances in pathogen-specific labelling in PET to identify Aspergillus spp. and Yersinia spp. infections in mice, as well as differentiating between Gram-positive, Gram-negative and mycobacterial infections are promising. SUMMARY: Patients with cancer are vulnerable to infection and fever, and the causes of these are frequently unclear using conventional diagnostic methods leading to high morbidity and mortality, length of stay and costs of care. FDG-PET/CT, with its unique complementary functional and anatomical information as well as its whole-body imaging capability, has demonstrated use in detecting occult infection in immunocompromised patients, including invasive fungal and occult bacterial infections, as well as defining extent of infection. By demonstrating disease resolution following treatment and allowing earlier cessation of therapy, FDG-PET acts as a key tool for antimicrobial and antifungal stewardship. Limitations include at times poor differentiation between infection, malignancy and sterile inflammation, however, exciting new technologies specific to infectious pathogens may help alleviate that issue. Further prospective randomised research is needed to explore these benefits in a nonbiased fashion.
DOI: 10.1097/QCO.0000000000000405
Journal: Current Opinion in Infectious Diseases
PubMed URL:
Type: Journal Article
Subjects: Cancer
Computerised tomography
Positron emission tomography
Appears in Collections:Journal articles

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