The role of 18F-FDG PET/CT for the diagnosis of infections in patients with hematological malignancies and persistent febrile neutropenia

Anat Gafter-Gvili; Mical Paul; Hanna Bernstine; Liat Vidal; Ron Ram; Pia Raanani; Moshe Yeshurun; Boaz Tadmor; Leonard Leibovici; Ofer Shpilberg; David Groshar

doi:10.1016/j.leukres.2013.06.025

The role of ¹⁸F-FDG PET/CT for the diagnosis of infections in patients with hematological malignancies and persistent febrile neutropenia

Anat Gafter-Gvili^*
, Mical Paul
, Hanna Bernstine
, Liat Vidal
, Ron Ram
, Pia Raanani
, Moshe Yeshurun
, Boaz Tadmor
, Leonard Leibovici
, Ofer Shpilberg
, David Groshar

^*Corresponding author for this work

Rabin Medical Center Israel
Tel Aviv University

Research output: Contribution to journal › Article › peer-review

23 Scopus citations

Abstract

We assessed the performance of PET/CT for diagnosis and management of infections in high-risk hematological cancer patients with persistent febrile neutropenia in a prospective study. ¹⁸F-FDG PET/CT with contrast-enhanced CT was performed on day 5-7 of persistent fever. Between 2008 and 2011, 91 PET/CT examinations were performed for different episodes in 79 patients, resulting in 117 diagnoses. The sensitivity of the PET/CT was 79.8% (71/89) compared to 51.7% (46/89) with chest/sinus CT alone. Specificities were 32.14% (9/28) vs. 42.85% (12/28), respectively. PET/CT resulted in a change from the pre-test diagnosis in 63/91 (69%) of episodes and in modification of patients' management in 46/91 (55%). PET/CT was beneficial in diagnosing abdominal infections. PET/CT has a potential role in the diagnostic evaluation of patients with persistent febrile neutropenia.

Original language	English
Pages (from-to)	1057-1062
Number of pages	6
Journal	Leukemia Research
Volume	37
Issue number	9
DOIs	https://doi.org/10.1016/j.leukres.2013.06.025
State	Published - Sep 2013

Funding

Funders
Israeli Cancer Association
Israeli Ministry of Health Chief Scientist

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

FDG
Febrile neutropenia
Hematological malignancies
Invasive fungal infections
PET/CT

Access to Document

10.1016/j.leukres.2013.06.025

Cite this

Gafter-Gvili, A., Paul, M., Bernstine, H., Vidal, L., Ram, R., Raanani, P., Yeshurun, M., Tadmor, B., Leibovici, L., Shpilberg, O., & Groshar, D. (2013). The role of ¹⁸F-FDG PET/CT for the diagnosis of infections in patients with hematological malignancies and persistent febrile neutropenia. Leukemia Research, 37(9), 1057-1062. https://doi.org/10.1016/j.leukres.2013.06.025

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title = "The role of 18F-FDG PET/CT for the diagnosis of infections in patients with hematological malignancies and persistent febrile neutropenia",

abstract = "We assessed the performance of PET/CT for diagnosis and management of infections in high-risk hematological cancer patients with persistent febrile neutropenia in a prospective study. 18F-FDG PET/CT with contrast-enhanced CT was performed on day 5-7 of persistent fever. Between 2008 and 2011, 91 PET/CT examinations were performed for different episodes in 79 patients, resulting in 117 diagnoses. The sensitivity of the PET/CT was 79.8\% (71/89) compared to 51.7\% (46/89) with chest/sinus CT alone. Specificities were 32.14\% (9/28) vs. 42.85\% (12/28), respectively. PET/CT resulted in a change from the pre-test diagnosis in 63/91 (69\%) of episodes and in modification of patients' management in 46/91 (55\%). PET/CT was beneficial in diagnosing abdominal infections. PET/CT has a potential role in the diagnostic evaluation of patients with persistent febrile neutropenia.",

keywords = "FDG, Febrile neutropenia, Hematological malignancies, Invasive fungal infections, PET/CT",

author = "Anat Gafter-Gvili and Mical Paul and Hanna Bernstine and Liat Vidal and Ron Ram and Pia Raanani and Moshe Yeshurun and Boaz Tadmor and Leonard Leibovici and Ofer Shpilberg and David Groshar",

note = "Funding Information: The authors thank the all the nurses of the Hemato-oncology hospitalization unit and the Bone marrow transplantation unit at the Davidoff Cancer Center for their active participation in the treatment of the patients in this study and Mrs. Nava Kashtan for excellent secretarial assistance. Role of funding . This study was supported by grants from the Israeli Cancer Association , the Israeli Ministry of Health Chief Scientist award , and a research grant for young investigators in Rabin Medical Center , Petah-Tikva, Israel. Author contributions . AG and MP contributed equally as first authors to this work; OS and DG contributed equally as senior authors to this work; AG, LL, HB, DG and MP conceived the idea and protocol design; MP, AG and LL obtained funding for the study; AG, HB, RR, LV, MP, MY and PR provided patient recruitment; AG, LV, RR, HB and MP supplied the data collection; DG and HB provided PET/CT analysis; AG, MP and LL provided the data analysis; AG, LL and MP wrote manuscript and all authors revised manuscript and gave final approval of manuscript submitted. Results of this study were presented in part at the Annual Conference of the Israeli Cancer Association, 8th July 2009, Israel; the American Society of Hematology 51st Annual meeting and Exposition, Dec 4–9, 2009, New-Orleans, LA; the 33rd World Congress of the International Society of Hematology (ISH), October 10–13, 2010 Jerusalem, Israel; and the 17th Congress of the European Hematology Association, 14–17 June 2012, Amsterdam, Netherlands.",

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Gafter-Gvili, A, Paul, M, Bernstine, H, Vidal, L, Ram, R , Raanani, P , Yeshurun, M, Tadmor, B, Leibovici, L, Shpilberg, O & Groshar, D 2013, 'The role of ¹⁸F-FDG PET/CT for the diagnosis of infections in patients with hematological malignancies and persistent febrile neutropenia', Leukemia Research, vol. 37, no. 9, pp. 1057-1062. https://doi.org/10.1016/j.leukres.2013.06.025

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AU - Gafter-Gvili, Anat

AU - Paul, Mical

AU - Bernstine, Hanna

AU - Vidal, Liat

AU - Ram, Ron

AU - Raanani, Pia

AU - Yeshurun, Moshe

AU - Tadmor, Boaz

AU - Leibovici, Leonard

AU - Shpilberg, Ofer

AU - Groshar, David

N1 - Funding Information: The authors thank the all the nurses of the Hemato-oncology hospitalization unit and the Bone marrow transplantation unit at the Davidoff Cancer Center for their active participation in the treatment of the patients in this study and Mrs. Nava Kashtan for excellent secretarial assistance. Role of funding . This study was supported by grants from the Israeli Cancer Association , the Israeli Ministry of Health Chief Scientist award , and a research grant for young investigators in Rabin Medical Center , Petah-Tikva, Israel. Author contributions . AG and MP contributed equally as first authors to this work; OS and DG contributed equally as senior authors to this work; AG, LL, HB, DG and MP conceived the idea and protocol design; MP, AG and LL obtained funding for the study; AG, HB, RR, LV, MP, MY and PR provided patient recruitment; AG, LV, RR, HB and MP supplied the data collection; DG and HB provided PET/CT analysis; AG, MP and LL provided the data analysis; AG, LL and MP wrote manuscript and all authors revised manuscript and gave final approval of manuscript submitted. Results of this study were presented in part at the Annual Conference of the Israeli Cancer Association, 8th July 2009, Israel; the American Society of Hematology 51st Annual meeting and Exposition, Dec 4–9, 2009, New-Orleans, LA; the 33rd World Congress of the International Society of Hematology (ISH), October 10–13, 2010 Jerusalem, Israel; and the 17th Congress of the European Hematology Association, 14–17 June 2012, Amsterdam, Netherlands.

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N2 - We assessed the performance of PET/CT for diagnosis and management of infections in high-risk hematological cancer patients with persistent febrile neutropenia in a prospective study. 18F-FDG PET/CT with contrast-enhanced CT was performed on day 5-7 of persistent fever. Between 2008 and 2011, 91 PET/CT examinations were performed for different episodes in 79 patients, resulting in 117 diagnoses. The sensitivity of the PET/CT was 79.8% (71/89) compared to 51.7% (46/89) with chest/sinus CT alone. Specificities were 32.14% (9/28) vs. 42.85% (12/28), respectively. PET/CT resulted in a change from the pre-test diagnosis in 63/91 (69%) of episodes and in modification of patients' management in 46/91 (55%). PET/CT was beneficial in diagnosing abdominal infections. PET/CT has a potential role in the diagnostic evaluation of patients with persistent febrile neutropenia.

AB - We assessed the performance of PET/CT for diagnosis and management of infections in high-risk hematological cancer patients with persistent febrile neutropenia in a prospective study. 18F-FDG PET/CT with contrast-enhanced CT was performed on day 5-7 of persistent fever. Between 2008 and 2011, 91 PET/CT examinations were performed for different episodes in 79 patients, resulting in 117 diagnoses. The sensitivity of the PET/CT was 79.8% (71/89) compared to 51.7% (46/89) with chest/sinus CT alone. Specificities were 32.14% (9/28) vs. 42.85% (12/28), respectively. PET/CT resulted in a change from the pre-test diagnosis in 63/91 (69%) of episodes and in modification of patients' management in 46/91 (55%). PET/CT was beneficial in diagnosing abdominal infections. PET/CT has a potential role in the diagnostic evaluation of patients with persistent febrile neutropenia.

KW - FDG

KW - Febrile neutropenia

KW - Hematological malignancies

KW - Invasive fungal infections

KW - PET/CT

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JO - Leukemia Research

JF - Leukemia Research

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