Does antibiotic treatment affect the diagnostic accuracy of FDG PET/CT studies in patients with suspected infectious processes?

Does antibiotic treatment affect the diagnostic accuracy of FDG PET/CT studies in patients with suspected infectious processes?:

Fluoro-deoxyglucose positron emmission tomography combined with computed tomography (FDG PET/CT) plays a significant role in the assessment of various infectious processes. Patients with suspected or known sites of infection are often referred for FDG imaging while already receiving antibiotic treatment. Current study assesses whether antibiotic therapy affects the detectability rate of infectious processes by FDG PET/CT. Methods: A 5-year retrospective study of all adult patients who underwent FDG PET/CT in search of a focal source of infection was performed. The presence, duration and appropriateness of antibiotic treatment prior to FDG imaging were recorded. Diagnosis of an infectious process was based on microbiological and/or pathological data as well as on clinical and radiological follow-up. Results: Two hundred seventeen patients underwent 243 PET/CT studies in search of a focal source of infection and were included in the study. Sixty seven studies were excluded from further analysis because of a final non-infectious etiology or lack of further follow up or details regarding the antibiotic treatment. The final study population included 176 FDG PET/CT studies in 153 patients (M 107, age 18-86 years). One hundred nineteen studies (68%) were performed in patients receiving antibiotic therapy for a range of 1 to 73 days. Diagnosis of infection was made in 107 true positive cases (61%) including 63 studies (59%) in patients receiving appropriate antibiotic therapy started before the performance of the FDG PET/CT study. There were 52 true negative (29%) and 17 false positive (10%) FDG PET/CT studies. No false negative results were found. Conclusion: FDG PET/CT correctly identified foci of increased uptake compatible with infection in the majority of patients including all patients receiving appropriate antimicrobial therapy, with no false negative cases. Based on current study results administration of antibiotics appears to have no clinically significant impact on the diagnostic accuracy of FDG PET/CT performed for evaluation of known or suspected infectious processes.



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