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Standardized 4-point scoring scale of [(18)F]-FDG PET/CT imaging helps in the diagnosis of renal and hepatic cyst infections in patients with autosomal dominant polycystic kidney disease: a validation cohort
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is prone to multiple complications, including cyst infection (CyI). 2-Deoxy-2-[(18)F]fluoro-d-glucose positron emission tomography/computed tomography ([(18)F]-FDG PET/CT) imaging has proved useful in the diagnosis of renal and hepatic...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689132/ https://www.ncbi.nlm.nih.gov/pubmed/38046039 http://dx.doi.org/10.1093/ckj/sfad159 |
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author | Demuynck, Selina Lovinfosse, Pierre Seidel, Laurence Jentjens, Sander Mekahli, Djalila Jouret, François Bammens, Bert Goffin, Karolien |
author_facet | Demuynck, Selina Lovinfosse, Pierre Seidel, Laurence Jentjens, Sander Mekahli, Djalila Jouret, François Bammens, Bert Goffin, Karolien |
author_sort | Demuynck, Selina |
collection | PubMed |
description | BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is prone to multiple complications, including cyst infection (CyI). 2-Deoxy-2-[(18)F]fluoro-d-glucose positron emission tomography/computed tomography ([(18)F]-FDG PET/CT) imaging has proved useful in the diagnosis of renal and hepatic CyI. A 4-point scale comparing the uptake of [(18)F]-FDG in the suspected infected cyst versus the hepatic physiological background has been recently proposed. We performed an independent validation of this semi-quantitative scoring system. METHODS: All ADPKD patients hospitalized between January 2009 and November 2019 who underwent an [(18)F]-FDG PET/CT for suspected CyI were retrospectively identified using computer-based databases. Medical files were reviewed. CyI was conventionally defined by the combination of fever (≥38°C), abdominal pain, increased plasma C-reactive protein levels (≥70 mg/L), absence of any other cause of inflammation and favourable outcome after ≥21 days of antibiotics. [(18)F]-FDG uptake of the suspected CyI was evaluated using a 4-point scale comparing the uptake of [(18)F]-FDG around the infected cysts with the uptake in the hepatic parenchyma. Statistics were performed using SAS version 9.4. RESULTS: Fifty-one [(18)F]-FDG PET/CT scans in 51 patients were included, of which 11 were cases of CyI. The agreement between the 4-point scale and the gold-standard criteria of CyI was significant [odds ratio of 6.03 for CyI in case of a score ≥3 (P = .014)]. The corresponding sensitivity, specificity, and positive and negative predictive values of [(18)F]-FDG PET/CT using the 4-point scale were 64% [Clopper–Pearson 95% confidence interval (CI) 30%–89%], 78% (95% CI 62%–89%), 44% (95% CI 20%–70%) and 89% (95% CI 73%–97%), respectively. CONCLUSIONS: Our independent validation cohort confirms the use of a semi-quantitative 4-point scoring system of [(18)F]-FDG PET/CT imaging in the diagnosis of CyI in patients with ADPKD. Considering its performance metrics with high specificity and negative predictive value, the scoring system is particularly useful to distinguish other causes of clinical inflammation than CyI and as such avoid unnecessarily long antibiotic treatment. |
format | Online Article Text |
id | pubmed-10689132 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-106891322023-12-02 Standardized 4-point scoring scale of [(18)F]-FDG PET/CT imaging helps in the diagnosis of renal and hepatic cyst infections in patients with autosomal dominant polycystic kidney disease: a validation cohort Demuynck, Selina Lovinfosse, Pierre Seidel, Laurence Jentjens, Sander Mekahli, Djalila Jouret, François Bammens, Bert Goffin, Karolien Clin Kidney J Original Article BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is prone to multiple complications, including cyst infection (CyI). 2-Deoxy-2-[(18)F]fluoro-d-glucose positron emission tomography/computed tomography ([(18)F]-FDG PET/CT) imaging has proved useful in the diagnosis of renal and hepatic CyI. A 4-point scale comparing the uptake of [(18)F]-FDG in the suspected infected cyst versus the hepatic physiological background has been recently proposed. We performed an independent validation of this semi-quantitative scoring system. METHODS: All ADPKD patients hospitalized between January 2009 and November 2019 who underwent an [(18)F]-FDG PET/CT for suspected CyI were retrospectively identified using computer-based databases. Medical files were reviewed. CyI was conventionally defined by the combination of fever (≥38°C), abdominal pain, increased plasma C-reactive protein levels (≥70 mg/L), absence of any other cause of inflammation and favourable outcome after ≥21 days of antibiotics. [(18)F]-FDG uptake of the suspected CyI was evaluated using a 4-point scale comparing the uptake of [(18)F]-FDG around the infected cysts with the uptake in the hepatic parenchyma. Statistics were performed using SAS version 9.4. RESULTS: Fifty-one [(18)F]-FDG PET/CT scans in 51 patients were included, of which 11 were cases of CyI. The agreement between the 4-point scale and the gold-standard criteria of CyI was significant [odds ratio of 6.03 for CyI in case of a score ≥3 (P = .014)]. The corresponding sensitivity, specificity, and positive and negative predictive values of [(18)F]-FDG PET/CT using the 4-point scale were 64% [Clopper–Pearson 95% confidence interval (CI) 30%–89%], 78% (95% CI 62%–89%), 44% (95% CI 20%–70%) and 89% (95% CI 73%–97%), respectively. CONCLUSIONS: Our independent validation cohort confirms the use of a semi-quantitative 4-point scoring system of [(18)F]-FDG PET/CT imaging in the diagnosis of CyI in patients with ADPKD. Considering its performance metrics with high specificity and negative predictive value, the scoring system is particularly useful to distinguish other causes of clinical inflammation than CyI and as such avoid unnecessarily long antibiotic treatment. Oxford University Press 2023-07-05 /pmc/articles/PMC10689132/ /pubmed/38046039 http://dx.doi.org/10.1093/ckj/sfad159 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Article Demuynck, Selina Lovinfosse, Pierre Seidel, Laurence Jentjens, Sander Mekahli, Djalila Jouret, François Bammens, Bert Goffin, Karolien Standardized 4-point scoring scale of [(18)F]-FDG PET/CT imaging helps in the diagnosis of renal and hepatic cyst infections in patients with autosomal dominant polycystic kidney disease: a validation cohort |
title | Standardized 4-point scoring scale of [(18)F]-FDG PET/CT imaging helps in the diagnosis of renal and hepatic cyst infections in patients with autosomal dominant polycystic kidney disease: a validation cohort |
title_full | Standardized 4-point scoring scale of [(18)F]-FDG PET/CT imaging helps in the diagnosis of renal and hepatic cyst infections in patients with autosomal dominant polycystic kidney disease: a validation cohort |
title_fullStr | Standardized 4-point scoring scale of [(18)F]-FDG PET/CT imaging helps in the diagnosis of renal and hepatic cyst infections in patients with autosomal dominant polycystic kidney disease: a validation cohort |
title_full_unstemmed | Standardized 4-point scoring scale of [(18)F]-FDG PET/CT imaging helps in the diagnosis of renal and hepatic cyst infections in patients with autosomal dominant polycystic kidney disease: a validation cohort |
title_short | Standardized 4-point scoring scale of [(18)F]-FDG PET/CT imaging helps in the diagnosis of renal and hepatic cyst infections in patients with autosomal dominant polycystic kidney disease: a validation cohort |
title_sort | standardized 4-point scoring scale of [(18)f]-fdg pet/ct imaging helps in the diagnosis of renal and hepatic cyst infections in patients with autosomal dominant polycystic kidney disease: a validation cohort |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689132/ https://www.ncbi.nlm.nih.gov/pubmed/38046039 http://dx.doi.org/10.1093/ckj/sfad159 |
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