18F-fluorodeoxyglucose positron emission tomography contributes to the diagnosis and management of infections in patients with multiple myeloma:: A study of 165 infectious episodes

被引:96
作者
Mahfouz, T
Miceli, MH
Saghafifar, F
Stroud, S
Jones-Jackson, L
Walker, R
Grazziutti, ML
Purnell, G
Fassas, A
Tricot, G
Barlogie, B
Anaissie, E
机构
[1] Univ Arkansas Med Sci, Arkansas Canc Res Ctr, Div Support Care Myeloma Inst Res & Therapy, Little Rock, AR 72205 USA
[2] Univ Arkansas Med Sci, Myeloma Inst Res & Therapy, Little Rock, AR 72205 USA
[3] Univ Arkansas Med Sci, Dept Radiol, Little Rock, AR 72205 USA
关键词
D O I
10.1200/JCO.2004.00.8581
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose Correctly identifying infection in cancer patients can be challenging. Limited data suggest that positron emission tomography (PET) using fluorine-18 fluorodeoxyglucose (FDG) may be useful for diagnosing infection. To determine the role of FDG-PET in the diagnosis of infection in patients with multiple myeloma (MM). Patients and Methods The medical records of 248 patients who had FDG-PET performed for MM staging or infection work-up revealing increased uptake at extramedullary sites and/or bones and joints that would be atypical for MM between October 2001 and May 2004 were reviewed to identify infections and evaluate FDG-PET contribution to patient outcome. Results One hundred sixty-five infections were identified in 143 adults with MM. Infections involved the respiratory tract [99; pneumonia (93), sinusitis (six)], bone, joint and soft tissues [26; discitis (10), osteomyelitis (nine), septic arthritis (one), cellulitis (six)], vascular system [18; septic thrombophlebitis (nine), infection of implantable catheter (eight), septic emboli (one)], gastrointestinal tract [12; colitis (seven), abdominal abscess (three), and diverticulitis and esophagitis (one each)], and dentition [periodontal abscess (10)]. Infections were caused by bacteria, mycobacteria, fungi, and viruses. FDG-PET detected infection even in patients with severe neutropenia and lymphopenia (30 episodes). The FDG-PET findings identified infections not detectable by other methods (46 episodes), determined extent of infection (32 episodes), and led to modification of work-up and therapy (55 episodes). Twenty silent, but clinically relevant, infections were detected among patients undergoing staging FDG-PET. Conclusion In patients with MM, FDG-PET is a useful tool for diagnosing and managing infections even in the setting of severe immunosuppression.
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页码:7857 / 7863
页数:7
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