The role of delayed 18F-FDG PET imaging in the follow-up of patients with alveolar echinococcosis.
Cécile Caoduro
,
Clémence Porot
,
Dominique A Vuitton
(1)
,
Solange Bresson-Hadni
(2)
,
Frédéric Grenouillet
(2, 3)
,
Carine Richou
(4)
,
Hatem Boulahdour
,
Oleg Blagosklonov
(5, 6)
1
CEF2P / CARCINO -
Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181)
2 LCE - Laboratoire Chrono-environnement (UMR 6249)
3 Service de parasitologie et mycologie [CHRU de Besançon]
4 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
5 WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis
6 Service de Médecine nucléaire, biophysique, isotopes [CHRU Besançon]
2 LCE - Laboratoire Chrono-environnement (UMR 6249)
3 Service de parasitologie et mycologie [CHRU de Besançon]
4 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
5 WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis
6 Service de Médecine nucléaire, biophysique, isotopes [CHRU Besançon]
Cécile Caoduro
- Fonction : Auteur
Clémence Porot
- Fonction : Auteur
Solange Bresson-Hadni
- Fonction : Auteur
- PersonId : 1253843
- ORCID : 0000-0003-1258-4050
- IdRef : 058504605
Frédéric Grenouillet
- Fonction : Auteur
- PersonId : 16667
- IdHAL : frederic-grenouillet
- ORCID : 0000-0001-6001-3135
- IdRef : 059337567
Hatem Boulahdour
- Fonction : Auteur
Résumé
UNLABELLED: (18)F-FDG PET has already proved its usefulness in the follow-up of patients with alveolar echinococcosis (AE) and has been proposed as a surrogate marker for therapeutic decisions on structured treatment interruption by benzimidazoles. However, standard PET acquisition (1 h after (18)F-FDG injection) lacks sensitivity, and the parasite may stay viable even if (18)F-FDG perilesional uptake has disappeared. The aim of our study was to evaluate the usefulness of delayed (18)F-FDG PET in the management of AE patients. METHODS: During a 6-y period, 120 PET scans using (18)F-FDG were obtained for 70 AE patients treated by benzimidazoles, without selection. All patients underwent whole-body imaging on a PET/CT device 1 h after (18)F-FDG injection (4 MBq/kg), as well as an acquisition focused on the liver 3 h after the injection. We also analyzed the results of serologic tests. RESULTS: Of the 57 scans considered negative at the standard acquisition, 13 (22.8%) became clearly positive at the delayed acquisition, and 6 (10.5%) became indeterminate at the delayed acquisition. Furthermore, 20 of 22 scans interpreted as indeterminate at the standard acquisition were considered positive because of clear perilesional (18)F-FDG uptake at the delayed acquisition. Thus, delayed acquisition changed the interpretation in 32.5% of cases. Moreover, of 44 patients treated by benzimidazoles and followed for more than 2 y by regular (18)F-FDG PET scans and specific AE serology, 11 (25%) presented pathologic (18)F-FDG uptake at the delayed acquisition but not at the standard one. In these patients, the treatment was continued despite negative results on standard (18)F-FDG PET and negative serologic findings. On the other hand, in 7 patients with negative delayed (18)F-FDG PET and negative serology, the treatment was safely interrupted with no evidence of disease recurrence during 8-37 mo (mean, 23 mo). CONCLUSION: Our study clearly demonstrated that delayed (18)F-FDG PET greatly facilitated the differentiation between active and inactive liver lesions in AE patients. Also, our results strongly suggested that the combination of delayed (18)F-FDG PET and specific serology would prevent most of the recurrences observed after premature interruption of the treatment based only on standard (18)F-FDG PET.
Domaines
MycologieFormat du dépôt | Notice |
---|---|
Type de dépôt | Article dans une revue |
Titre |
en
The role of delayed 18F-FDG PET imaging in the follow-up of patients with alveolar echinococcosis.
|
Résumé |
en
UNLABELLED: (18)F-FDG PET has already proved its usefulness in the follow-up of patients with alveolar echinococcosis (AE) and has been proposed as a surrogate marker for therapeutic decisions on structured treatment interruption by benzimidazoles. However, standard PET acquisition (1 h after (18)F-FDG injection) lacks sensitivity, and the parasite may stay viable even if (18)F-FDG perilesional uptake has disappeared. The aim of our study was to evaluate the usefulness of delayed (18)F-FDG PET in the management of AE patients. METHODS: During a 6-y period, 120 PET scans using (18)F-FDG were obtained for 70 AE patients treated by benzimidazoles, without selection. All patients underwent whole-body imaging on a PET/CT device 1 h after (18)F-FDG injection (4 MBq/kg), as well as an acquisition focused on the liver 3 h after the injection. We also analyzed the results of serologic tests. RESULTS: Of the 57 scans considered negative at the standard acquisition, 13 (22.8%) became clearly positive at the delayed acquisition, and 6 (10.5%) became indeterminate at the delayed acquisition. Furthermore, 20 of 22 scans interpreted as indeterminate at the standard acquisition were considered positive because of clear perilesional (18)F-FDG uptake at the delayed acquisition. Thus, delayed acquisition changed the interpretation in 32.5% of cases. Moreover, of 44 patients treated by benzimidazoles and followed for more than 2 y by regular (18)F-FDG PET scans and specific AE serology, 11 (25%) presented pathologic (18)F-FDG uptake at the delayed acquisition but not at the standard one. In these patients, the treatment was continued despite negative results on standard (18)F-FDG PET and negative serologic findings. On the other hand, in 7 patients with negative delayed (18)F-FDG PET and negative serology, the treatment was safely interrupted with no evidence of disease recurrence during 8-37 mo (mean, 23 mo). CONCLUSION: Our study clearly demonstrated that delayed (18)F-FDG PET greatly facilitated the differentiation between active and inactive liver lesions in AE patients. Also, our results strongly suggested that the combination of delayed (18)F-FDG PET and specific serology would prevent most of the recurrences observed after premature interruption of the treatment based only on standard (18)F-FDG PET.
|
Auteur(s) |
Cécile Caoduro
, Clémence Porot
, Dominique A Vuitton
1
, Solange Bresson-Hadni
2
, Frédéric Grenouillet
2, 3
, Carine Richou
4
, Hatem Boulahdour
, Oleg Blagosklonov
5, 6
1
CEF2P / CARCINO -
Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181)
( 111518 )
- Les hauts de chazal - bât. Recherche - rue Ambroise Paré - 25000 BESANCON
- France
2
LCE -
Laboratoire Chrono-environnement (UMR 6249)
( 57629 )
- 16, route de Gray - 25030 Besançon Cedex
- France
3
Service de parasitologie et mycologie [CHRU de Besançon]
( 487743 )
- 3, boulevard A. Fleming - 25030 Besançon Cedex
- France
4
CHRU Besançon -
Centre Hospitalier Régional Universitaire de Besançon
( 300165 )
- 3, boulevard A. Fleming - 25030 Besançon Cedex
- France
5
WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis
( 88289 )
- University of Franche-Comté 25030 Besançon cedex
- France
6
Service de Médecine nucléaire, biophysique, isotopes [CHRU Besançon]
( 49968 )
- 3, boulevard A. Fleming - 25030 Besançon Cedex
- France
|
Comité de lecture |
Oui
|
Vulgarisation |
Non
|
Langue du document |
Anglais
|
Nom de la revue |
|
Audience |
Internationale
|
Date de publication |
2013-03
|
Date de publication électronique |
2013-01-09
|
Volume |
54
|
Numéro |
3
|
Page/Identifiant |
358-63
|
Domaine(s) |
|
Mots-clés (Mesh) |
|
DOI | 10.2967/jnumed.112.109942 |
Pubmed Id | 23303963 |
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