The role of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) in assessment of complex invasive fungal disease and opportunistic co-infections in patients with acute leukemia prior to allogeneic hematopoietic cell transplant.
FDG PET/CT
fusarium
hematopoietic cell transplant
invasive fungal infection
mucormycosis
nocardia
opportunistic infection
scedosporium
Journal
Transplant infectious disease : an official journal of the Transplantation Society
ISSN: 1399-3062
Titre abrégé: Transpl Infect Dis
Pays: Denmark
ID NLM: 100883688
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
revised:
03
12
2020
received:
27
07
2020
accepted:
06
12
2020
pubmed:
19
12
2020
medline:
3
8
2021
entrez:
18
12
2020
Statut:
ppublish
Résumé
Individuals diagnosed with acute lymphoid and myeloid malignancies are at significant risk of invasive fungal and bacterial infections secondary to their marked immunocompromised states with a significant high risk of mortality. The role of metabolic imaging with 18F-Fluorodeoxyglucose (FDG) Positron Emission Tomography/Computed Tomography (PET/CT) has been increasingly recognized in optimizing the diagnosis of invasive infection, monitoring the response to therapy and guiding the duration of antimicrobial therapy or need to escalate to surgical intervention. Two distinct cases of pulmonary co-infection of rare fungal and bacterial pathogens are explored in severely immunocompromised individuals where FDG PET/CT aided both patients to make a full recovery and transition to HCT. The first case explores mixed Scedosporium apiospermum and Rhizomucor pulmonary infection on a background of T cell/myeloid mixed phenotype acute leukemia ultimately warranting long-term antifungal therapy and lobectomy prior to HCT. The second case explores Fusarium and Nocardia pulmonary infection on a background of relapsed AML also warranting surgical resection with lobectomy and long-term antimicrobials prior to transition to HCT. The cases highlight the utility of FDG PET/CT to support the diagnosis of infections, including the presence or absence of disseminated infection, and to provide highly sensitive monitoring of the infection over time. FDG PET/CT played a key role in directing therapy duration decisions and prompted the necessity for surgical intervention. Ultimately, the use of FDG PET/CT allowed for a successful transition to HCT highlighting its value in this clinical setting. FDG PET/CT has an emerging role in the diagnostic and monitoring pathway for complex infections in high-risk immunocompromised patients.
Substances chimiques
Radiopharmaceuticals
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13547Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Böhme A, Ruhnke M, Buchheidt D, et al. Treatment of invasive fungal infections in cancer patients-Recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Ann Hematol. 2009;88(2):97-110. https://doi.org/10.1007/s00277-008-0622-5
Maziarz RT, Brazauskas R, Chen M, et al. Pre-existing invasive fungal infection is not a contraindication for allogeneic HSCT for patients with hematologic malignancies: a CIBMTR study. Bone Marrow Transplant. 2017;52(2):270-278.
Douglas A, Lau E, Thursky K, Slavin M. What, where and why: exploring fluorodeoxyglucose-PET's ability to localise and differentiate infection from cancer. Curr Opin Infect Dis. 2017;30(6):552-564.
Douglas AP, Thursky KA, Worth LJ, et al. FDG PET/CT imaging in detecting and guiding management of invasive fungal infections: a retrospective comparison to conventional CT imaging. Eur J Nucl Med Mol Imaging. 2019;46(1):166-173.
Douglas AP, Thursky KA, Worth LJ, Harrison SJ, Hicks RJ, Slavin MA. FDG-PET/CT in managing infection in patients with hematological malignancy: clinician knowledge and experience in Australia. Leuk Lymphoma. 2019;60(10):2471-2476.
Lau A, Chen S, Sorrell T, et al. Development and clinical application of a panfungal PCR assay to detect and identify fungal DNA in tissue specimens. J Clin Microbiol. 2007;45(2):380-385.
Chamilos G, Macapinlac HA, Kontoyiannis DP. The use of 18F-fluorodeoxyglucose positron emission tomography for the diagnosis and management of invasive mould infections. Med Mycol. 2008;46(1):23-29.
Koh KC, Slavin MA, Thursky KA, et al. Impact of fluorine-18 fluorodeoxyglucose positron emission tomography on diagnosis and antimicrobial utilization in patients with high-risk febrile neutropenia. Leuk Lymphoma. 2012;53(10):1889-1895.
Keyes JW Jr. SUV: standard uptake or silly useless value? J Nucl Med. 1995;36(10):1836-1839.
Hofman MS, Hicks RJ. How we read oncologic FDG PET/CT. Cancer Imaging. 2016;16(1):1-14.
Xiu Y, Bhutani C, Dhurairaj T, et al. Dual-time point FDG PET imaging in the evaluation of pulmonary nodules with minimally increased metabolic activity. Clin Nucl Med. 2007;32(2):101-105.
Zhuang H, Pourdehnad M, Lambright ES, et al. Dual time point 18F-FDG PET imaging for differentiating malignant from inflammatory processes. J Nucl Med. 2001;42(9):1412-1417.
Barnes PD, Marr KA. Risks, diagnosis and outcomes of invasive fungal infections in haematopoietic stem cell transplant recipients. Br J Haematol. 2007;139(4):519-531.
Camus V, Edet-Sanson A, Bubenheim M, et al. (1)(8)F-FDG-PET/CT imaging in patients with febrile neutropenia and haematological malignancies. Anticancer Res. 2015;35(5):2999-3005.
Gafter-Gvili A, Paul M, Bernstine H, et al. The role of (1)(8)F-FDG PET/CT for the diagnosis of infections in patients with hematological malignancies and persistent febrile neutropenia. Leuk Res. 2013;37(9):1057-1062.
Mahfouz T, Miceli MH, Saghafifar F, et al. 18F-fluorodeoxyglucose positron emission tomography contributes to the diagnosis and management of infections in patients with multiple myeloma: a study of 165 infectious episodes. J Clin Oncol. 2005;23(31):7857-7863.
Guy SD, Tramontana AR, Worth LJ, et al. Use of FDG PET/CT for investigation of febrile neutropenia: evaluation in high-risk cancer patients. Eur J Nucl Med Mol Imaging. 2012;39(8):1348-1355.
Jamar F, Buscombe J, Chiti A, et al. EANM/SNMMI guideline for 18F-FDG use in inflammation and infection. J Nucl Med. 2013;54(4):647-658.
Mellinghoff SC, Panse J, Alakel N, et al. Primary prophylaxis of invasive fungal infections in patients with haematological malignancies: 2017 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO). Ann Hematol. 2018;97(2):197-207.
Kontoyiannis D, Marr K, Park B, et al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001-2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin Infect Dis. 2010;50(8):1091-1100.
Upton A, Kirby KA, Carpenter P, Boeckh M, Marr KA. Invasive aspergillosis following hematopoietic cell transplantation: outcomes and prognostic factors associated with mortality. Clin Infect Dis. 2007;44(4):531-540.
Marks DI, Liu Q, Slavin M. Voriconazole for prophylaxis of invasive fungal infections after allogeneic hematopoietic stem cell transplantation. Expert Rev Anti Infect Ther. 2017;15(5):493-502.
Chaney S, Gopalan R, Berggren RE. Pulmonary Pseudallescheria boydii infection with cutaneous zygomycosis after near drowning. South Med J. 2004;97(7):683-687.
Shand JM, Albrecht RM, Burnett HF, Miyake A. Invasive fungal infection of the midfacial and orbital complex due to Scedosporium apiospermum and mucormycosis. J Oral Maxillofac Surg. 2004;62(2):231-234.
Marques DS, Vaz CP, Branca R, et al. Rhizomucor and scedosporium infection post hematopoietic stem-cell transplant. Case Rep Med. 2011;2011:830769.
Blyth CC, Gilroy NM, Guy SD, et al. Consensus guidelines for the treatment of invasive mould infections in haematological malignancy and haemopoietic stem cell transplantation, 2014. Intern Med J. 2014;44(12b):1333-1349.
Ruhnke M, Cornely OA, Schmidt-Hieber M, et al. Treatment of invasive fungal diseases in cancer patients-Revised 2019 Recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Mycoses. 2020;63(7):653-682.
Cornely OA, Arikan-Akdagli S, Dannaoui E, et al. ESCMID and ECMM joint clinical guidelines for the diagnosis and management of mucormycosis 2013. Clin Microbiol Infect. 2014;20(s3):5-26.
Cornely OA, Cuenca-Estrella M, Meis JF, Ullmann AJ. European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Fungal Infection Study Group (EFISG) and European Confederation of Medical Mycology (ECMM) 2013 joint guidelines on diagnosis and management of rare and emerging fungal diseases. Clin Microbiol Infect. 2014;20(s3):1-4.
Seidel D, Meißner A, Lackner M, et al. Prognostic factors in 264 adults with invasive Scedosporium spp. and Lomentospora prolificans infection reported in the literature and FungiScope((R)). Crit Rev Microbiol. 2019;45(1):1-21.
Troke P, Aguirrebengoa K, Arteaga C, et al. Treatment of scedosporiosis with voriconazole: clinical experience with 107 patients. Antimicrob Agents Chemother. 2008;52(5):1743-1750.
McCarthy M, Rosengart A, Schuetz AN, Kontoyiannis DP, Walsh TJ. Mold infections of the central nervous system. N Engl J Med. 2014;371(2):150-160.
Perfect JR. Treatment of non-Aspergillus moulds in immunocompromised patients, with amphotericin B lipid complex. Clin Infect Dis. 2005;40(Suppl 6):S401-S408.
Anagnostou T, Arvanitis M, Kourkoumpetis TK, Desalermos A, Carneiro HA, Mylonakis E. Nocardiosis of the central nervous system: experience from a general hospital and review of 84 cases from the literature. Medicine (Baltimore). 2014;93(1):19-32.
Farmakiotis D, Kontoyiannis DP. Mucormycoses. Infect Dis Clin North Am. 2016;30(1):143-163.
García-Arata MI, Otero MJ, Zomeño M, Figuera MA, Cuevas MC, López-Brea M. Scedosporium apiospermum pneumonia after autologous bone marrow transplantation. Eur J Clin Microbiol Infect Dis. 1996;15(7):600-603.
Spellberg B, Walsh T, Kontoyiannis D, Edwards J, Ibrahim A. Recent advances in the management of mucormycosis: from bench to bedside. Clin Infect Dis. 2009;48(12):1743-1751.
Husain S, Munoz P, Forrest G, et al. Infections due to Scedosporium apiospermum and Scedosporium prolificans in transplant recipients: clinical characteristics and impact of antifungal agent therapy on outcome. Clin Infect Dis. 2005;40(1):89-99.
Tedder M, Spratt JA, Anstadt MP, Hegde SS, Tedder SD, Lowe JE. Pulmonary mucormycosis: results of medical and surgical therapy. Ann Thorac Surg. 1994;57(4):1044-1050.
Person AK, Kontoyiannis DP, Alexander BD. Fungal infections in transplant and oncology patients. Infect Dis Clin North Am. 2010;24(2):439-459.
Muller N, Kessler R, Caillard S, et al. (18)F-FDG PET/CT for the diagnosis of malignant and infectious complications after solid organ transplantation. Nucl Med Mol Imaging. 2017;51(1):58-68.
Mettler FA, Huda W, Yoshizumi TT, Mahesh M. Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology. 2008;248(1):254-263.
Kaushik A, Jaimini A, Tripathi M, et al. Estimation of radiation dose to patients from (18) FDG whole body PET/CT investigations using dynamic PET scan protocol. Indian J Med Res. 2015;142(6):721-731.
Rolle A-M, Hasenberg M, Thornton CR, et al. ImmunoPET/MR imaging allows specific detection of Aspergillus fumigatus lung infection in vivo. Proc Natl Acad Sci USA. 2016;113(8):E1026-E1033.