Publication

FDG-PET/CT for Detecting an Infection Focus in Patients With Bloodstream Infection: Factors Affecting Diagnostic Yield

Pijl, J. P., Glaudemans, A. W. J. M., Slart, R. H. J. A., Yakar, D., Wouthuyzen-Bakker, M. & Kwee, T. C., Feb-2019, In : Clinical Nuclear Medicine. 44, 2, p. 99-106 8 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Pijl, J. P., Glaudemans, A. W. J. M., Slart, R. H. J. A., Yakar, D., Wouthuyzen-Bakker, M., & Kwee, T. C. (2019). FDG-PET/CT for Detecting an Infection Focus in Patients With Bloodstream Infection: Factors Affecting Diagnostic Yield. Clinical Nuclear Medicine, 44(2), 99-106. https://doi.org/10.1097/RLU.0000000000002381

Author

Pijl, Jordy P. ; Glaudemans, Andor W. J. M. ; Slart, Riemer H. J. A. ; Yakar, Derya ; Wouthuyzen-Bakker, Marjan ; Kwee, Thomas C. / FDG-PET/CT for Detecting an Infection Focus in Patients With Bloodstream Infection : Factors Affecting Diagnostic Yield. In: Clinical Nuclear Medicine. 2019 ; Vol. 44, No. 2. pp. 99-106.

Harvard

Pijl, JP, Glaudemans, AWJM, Slart, RHJA, Yakar, D, Wouthuyzen-Bakker, M & Kwee, TC 2019, 'FDG-PET/CT for Detecting an Infection Focus in Patients With Bloodstream Infection: Factors Affecting Diagnostic Yield', Clinical Nuclear Medicine, vol. 44, no. 2, pp. 99-106. https://doi.org/10.1097/RLU.0000000000002381

Standard

FDG-PET/CT for Detecting an Infection Focus in Patients With Bloodstream Infection : Factors Affecting Diagnostic Yield. / Pijl, Jordy P.; Glaudemans, Andor W. J. M.; Slart, Riemer H. J. A.; Yakar, Derya; Wouthuyzen-Bakker, Marjan; Kwee, Thomas C.

In: Clinical Nuclear Medicine, Vol. 44, No. 2, 02.2019, p. 99-106.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Pijl JP, Glaudemans AWJM, Slart RHJA, Yakar D, Wouthuyzen-Bakker M, Kwee TC. FDG-PET/CT for Detecting an Infection Focus in Patients With Bloodstream Infection: Factors Affecting Diagnostic Yield. Clinical Nuclear Medicine. 2019 Feb;44(2):99-106. https://doi.org/10.1097/RLU.0000000000002381


BibTeX

@article{a3c518fde8004d6c99fcefb875152c32,
title = "FDG-PET/CT for Detecting an Infection Focus in Patients With Bloodstream Infection: Factors Affecting Diagnostic Yield",
abstract = "PURPOSE: To investigate the diagnostic performance of F-fluoro-2-deoxy-D-glucose (FDG) PET/ CT for the detection of an infection focus in patients with a bloodstream infection (BSI) and to identify factors influencing the diagnostic yield of FDG-PET/CT.METHODS: This retrospective single-center study included 185 consecutive patients with a BSI who underwent an FDG-PET/CT scan for the detection of an infection focus between 2010 and 2017. The final diagnosis at hospital discharge was used as reference standard. Diagnostic performance of FDG-PET/CT for the detection of an infection focus was assessed, and logistic regression analyses were performed to identify factors associated with FDG-PET/CT yield.RESULTS: An infection focus was identified on FDG-PET/CT in 120 (64.8{\%}) of 185 patients. FDG-PET/CT achieved a sensitivity of 80.2{\%}, specificity of 79.6{\%}, positive predictive value of 90.8{\%}, and a negative predictive value of 61.4{\%} for detecting an infection focus in patients with a BSI. Blood cultures positive for enterococci (odds ratio, 0.14; P = 0.019) and days of antibiotic treatment before FDG-PET/CT (odds ratio, 0.94 per day increase; P = 0.014) were statistically significant independent predictors of a lower odds of detecting an infection focus on FDG-PET/CT. In patients who received antibiotics for less than 7 days before FDG-PET/CT, an infection focus was found in 71{\%} (56/79). In patients who received antibiotics for 8 to 14 days before FDG-PET/CT, an infection focus was found in 52{\%} (22/42). After 15 to 21 days of antibiotic treatment, an infection focus was found in 61{\%} (8/13), and for 22 days or more, this declined to 38{\%} (5/13).CONCLUSIONS: FDG-PET/CT is a useful method for detecting an infection focus in patients with BSI. However, longer duration of antibiotic treatment before FDG-PET/CT and bacteremia with enterococci reduce the diagnostic yield of FDG-PET/CT. These factors should be taken into account when considering an FDG-PET/CT scan for this indication.",
keywords = "FDG-PET/CT, infection, focus, bacteremia, sepsis, F-18-FDG PET/CT, COST-EFFECTIVENESS, 30-DAY MORTALITY, BACTEREMIA, INFLAMMATION, RESISTANCE, PITFALLS",
author = "Pijl, {Jordy P.} and Glaudemans, {Andor W. J. M.} and Slart, {Riemer H. J. A.} and Derya Yakar and Marjan Wouthuyzen-Bakker and Kwee, {Thomas C.}",
year = "2019",
month = "2",
doi = "10.1097/RLU.0000000000002381",
language = "English",
volume = "44",
pages = "99--106",
journal = "Clinical Nuclear Medicine",
issn = "0363-9762",
publisher = "LIPPINCOTT WILLIAMS & WILKINS",
number = "2",

}

RIS

TY - JOUR

T1 - FDG-PET/CT for Detecting an Infection Focus in Patients With Bloodstream Infection

T2 - Factors Affecting Diagnostic Yield

AU - Pijl, Jordy P.

AU - Glaudemans, Andor W. J. M.

AU - Slart, Riemer H. J. A.

AU - Yakar, Derya

AU - Wouthuyzen-Bakker, Marjan

AU - Kwee, Thomas C.

PY - 2019/2

Y1 - 2019/2

N2 - PURPOSE: To investigate the diagnostic performance of F-fluoro-2-deoxy-D-glucose (FDG) PET/ CT for the detection of an infection focus in patients with a bloodstream infection (BSI) and to identify factors influencing the diagnostic yield of FDG-PET/CT.METHODS: This retrospective single-center study included 185 consecutive patients with a BSI who underwent an FDG-PET/CT scan for the detection of an infection focus between 2010 and 2017. The final diagnosis at hospital discharge was used as reference standard. Diagnostic performance of FDG-PET/CT for the detection of an infection focus was assessed, and logistic regression analyses were performed to identify factors associated with FDG-PET/CT yield.RESULTS: An infection focus was identified on FDG-PET/CT in 120 (64.8%) of 185 patients. FDG-PET/CT achieved a sensitivity of 80.2%, specificity of 79.6%, positive predictive value of 90.8%, and a negative predictive value of 61.4% for detecting an infection focus in patients with a BSI. Blood cultures positive for enterococci (odds ratio, 0.14; P = 0.019) and days of antibiotic treatment before FDG-PET/CT (odds ratio, 0.94 per day increase; P = 0.014) were statistically significant independent predictors of a lower odds of detecting an infection focus on FDG-PET/CT. In patients who received antibiotics for less than 7 days before FDG-PET/CT, an infection focus was found in 71% (56/79). In patients who received antibiotics for 8 to 14 days before FDG-PET/CT, an infection focus was found in 52% (22/42). After 15 to 21 days of antibiotic treatment, an infection focus was found in 61% (8/13), and for 22 days or more, this declined to 38% (5/13).CONCLUSIONS: FDG-PET/CT is a useful method for detecting an infection focus in patients with BSI. However, longer duration of antibiotic treatment before FDG-PET/CT and bacteremia with enterococci reduce the diagnostic yield of FDG-PET/CT. These factors should be taken into account when considering an FDG-PET/CT scan for this indication.

AB - PURPOSE: To investigate the diagnostic performance of F-fluoro-2-deoxy-D-glucose (FDG) PET/ CT for the detection of an infection focus in patients with a bloodstream infection (BSI) and to identify factors influencing the diagnostic yield of FDG-PET/CT.METHODS: This retrospective single-center study included 185 consecutive patients with a BSI who underwent an FDG-PET/CT scan for the detection of an infection focus between 2010 and 2017. The final diagnosis at hospital discharge was used as reference standard. Diagnostic performance of FDG-PET/CT for the detection of an infection focus was assessed, and logistic regression analyses were performed to identify factors associated with FDG-PET/CT yield.RESULTS: An infection focus was identified on FDG-PET/CT in 120 (64.8%) of 185 patients. FDG-PET/CT achieved a sensitivity of 80.2%, specificity of 79.6%, positive predictive value of 90.8%, and a negative predictive value of 61.4% for detecting an infection focus in patients with a BSI. Blood cultures positive for enterococci (odds ratio, 0.14; P = 0.019) and days of antibiotic treatment before FDG-PET/CT (odds ratio, 0.94 per day increase; P = 0.014) were statistically significant independent predictors of a lower odds of detecting an infection focus on FDG-PET/CT. In patients who received antibiotics for less than 7 days before FDG-PET/CT, an infection focus was found in 71% (56/79). In patients who received antibiotics for 8 to 14 days before FDG-PET/CT, an infection focus was found in 52% (22/42). After 15 to 21 days of antibiotic treatment, an infection focus was found in 61% (8/13), and for 22 days or more, this declined to 38% (5/13).CONCLUSIONS: FDG-PET/CT is a useful method for detecting an infection focus in patients with BSI. However, longer duration of antibiotic treatment before FDG-PET/CT and bacteremia with enterococci reduce the diagnostic yield of FDG-PET/CT. These factors should be taken into account when considering an FDG-PET/CT scan for this indication.

KW - FDG-PET/CT

KW - infection

KW - focus

KW - bacteremia

KW - sepsis

KW - F-18-FDG PET/CT

KW - COST-EFFECTIVENESS

KW - 30-DAY MORTALITY

KW - BACTEREMIA

KW - INFLAMMATION

KW - RESISTANCE

KW - PITFALLS

U2 - 10.1097/RLU.0000000000002381

DO - 10.1097/RLU.0000000000002381

M3 - Article

VL - 44

SP - 99

EP - 106

JO - Clinical Nuclear Medicine

JF - Clinical Nuclear Medicine

SN - 0363-9762

IS - 2

ER -

ID: 71893313