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Intensive Care Medicine
Published in: Intensive Care Medicine 3/2010

Open Access 01-03-2010 | Original

F-18-fluorodeoxyglucose positron emission tomography combined with CT in critically ill patients with suspected infection

Authors: Koen S. Simons, Peter Pickkers, Chantal P. Bleeker-Rovers, Wim J. G. Oyen, Johannes G. van der Hoeven

Published in: Intensive Care Medicine | Issue 3/2010

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Abstract

Purpose

To assess the value of F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) combined with CT in critically ill patients suspected of having an infection.

Methods

FDG-PET CT scans requested for evaluation of a suspected infection or inflammatory process in critically ill, mechanically ventilated patients were analyzed (blinded for the final clinical diagnosis) and compared with clinical follow-up.

Results

Thirty-five FDG-PET/CT scans performed in 33 ICU patients (28 adults and 5 children), median age 58 years (range 1 month–72 years), were analyzed. Twenty-one FDG-PET/CT scans were true positive. Three FDG-PET/CT scans were considered false positive, in one case leading to additional diagnostic procedures (specificity 79%). Additionally, 11 true negatives were found (sensitivity 100%), leading to an overall accuracy of 91%.

Conclusions

FDG-PET/CT scanning is of additional value in the evaluation of suspected infection in critically ill patients in whom conventional diagnostics did not lead to a diagnosis. Apart from the high accuracy, in this study it appeared that, in addition to conventional diagnostic techniques that were routinely performed, a normal FDG-PET/CT ruled out important infections requiring prolonged antibiotic therapy or drainage. Since sensitivity is lower in highly metabolic active tissues (e.g., endocarditis, meningitis), the FDG-PET/CT scan is not suited to detect infections in these tissues.
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Metadata
Title
F-18-fluorodeoxyglucose positron emission tomography combined with CT in critically ill patients with suspected infection
Authors
Koen S. Simons
Peter Pickkers
Chantal P. Bleeker-Rovers
Wim J. G. Oyen
Johannes G. van der Hoeven
Publication date
01-03-2010
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 3/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-009-1697-8

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