Aspergillus fumigatus: Is Dual-Tracer 18 FDG/ 68 Ga-FAPI PET/CT Capable of Distinguishing Fungal Infection and Unspecific Inflammation From Recurrent Lung Cancer?

IF 9.6 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Clinical Nuclear Medicine Pub Date : 2024-11-01 Epub Date: 2024-07-31 DOI:10.1097/RLU.0000000000005393

Yannik Kullik, Thomas E Wessendorf, Dirk Theegarten, Jane Winantea, Hubertus Hautzel, Marcel Opitz

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Abstract

Abstract: A 61-year-old woman, referred for recurrent pneumonia over a period of 3 months with insufficient response to antibiotic treatment, presented with coughing and intense right-sided chest pain. Previously, she underwent right upper lobectomy for locally advanced non-small cell lung cancer (squamous cell carcinoma) followed by adjuvant chemotherapy and subsequent partial chest wall resection with polytetrafluoroethylene net insert due to a pleurocutaneous fistula. 18 FDG plus a 68 Ga-labeled fibroblast activation protein inhibitor ( 68 Ga-FAPI) PET/CT scans were performed to rule out non-small cell lung cancer recurrence. Pathological workup with bronchoscopy and endobronchial ultrasound-guided transbronchial fine-needle aspiration of the lymph nodes showed no evidence of malignancy, but microbiology confirmed Aspergillus fumigatus infection of the middle lobe. Thus, the patient transitioned from antibiotic to antifungal therapy; no second-line oncologic treatment was initiated.

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曲霉菌：双示踪剂 18FDG/68Ga-FAPI PET/CT 是否能够区分真菌感染和非特异性炎症与复发性肺癌？

摘要：一名 61 岁的妇女因肺炎反复发作 3 个月，抗生素治疗无效而转诊，出现咳嗽和剧烈右侧胸痛。此前，她曾因局部晚期非小细胞肺癌（鳞状细胞癌）接受过右上叶切除术，随后接受了辅助化疗，由于胸膜瘘，她随后接受了部分胸壁切除术，并插入了聚四氟乙烯网。为排除非小细胞肺癌复发，进行了 18FDG 加 68Ga 标记的成纤维细胞活化蛋白抑制剂（68Ga-FAPI）PET/CT 扫描。通过支气管镜检查和支气管内超声引导下经支气管细针穿刺淋巴结病理检查，未发现恶性肿瘤的证据，但微生物学检查证实中叶感染了曲霉菌。因此，患者从抗生素治疗转为抗真菌治疗，没有进行二线肿瘤治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Nuclear Medicine 医学-核医学

CiteScore

2.90

自引率

31.10%

发文量

1113

审稿时长

2 months

期刊介绍： Clinical Nuclear Medicine is a comprehensive and current resource for professionals in the field of nuclear medicine. It caters to both generalists and specialists, offering valuable insights on how to effectively apply nuclear medicine techniques in various clinical scenarios. With a focus on timely dissemination of information, this journal covers the latest developments that impact all aspects of the specialty. Geared towards practitioners, Clinical Nuclear Medicine is the ultimate practice-oriented publication in the field of nuclear imaging. Its informative articles are complemented by numerous illustrations that demonstrate how physicians can seamlessly integrate the knowledge gained into their everyday practice.