What do we know About the Usefulness of 18F-FDG PET-CT for the Management of Invasive Fungal Infection? An International Survey

IF 3.6 3区 生物学 Q2 MYCOLOGY Mycopathologia Pub Date : 2024-09-16 DOI:10.1007/s11046-024-00881-y
A. Gutiérrez-Villanueva, J. Calderón-Parra, A. Callejas-Diaz, E. Muñez-Rubio, K. Velásquez, A. Ramos-Martínez, B. Rodríguez-Alfonso, A. Fernández-Cruz
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Abstract

Background

Recent data support 18F-FDG PET-CT for the management of infections in immunocompromised patients, including invasive fungal infection (IFI). However, its role is not well established in clinical practice. We performed an international survey to evaluate the knowledge of physicians about the usefulness of 18F-FDG PET-CT in IFI, in order to define areas of uncertainty.

Methods

An online survey was distributed to infectious diseases working groups in December 2023-January 2024. It included questions regarding access to 18F-FDG PET-CT, knowledge on its usefulness for IFI and experience of the respondents. A descriptive analysis was performed.

Results

180 respondents answered; 60.5% were Infectious Diseases specialists mainly from Spain (52.8%) and Italy (23.3%). 84.4% had access to 18F-FDG PET-CT at their own center. 85.6% considered that 18F-FDG PET-CT could be better than conventional tests for IFI. In the context of IFI risk, 81.1% would consider performing 18F-FDG PET-CT to study fever without a source and around 50% to evaluate silent lesions and 50% to assess response, including distinguishing residual from active lesions. Based on the results of the follow-up 18F-FDG PET-CT, 56.7% would adjust antifungal therapy duration. 60% would consider a change in the diagnostic or therapeutic strategy in case of increased uptake or new lesions. Uncovering occult lesions (52%) and diagnosing/excluding endocarditis (52.7%) were the situations in which 18F-FDG PET-CT was considered to have the most added value. There was a great variability in responses about timing, duration of uptake, the threshold for discontinuing treatment or the influence of immune status.

Conclusion

Although the majority considered that 18F-FDG PET-CT may be useful for IFI, many areas of uncertainty remain. There is a need for protocolized research to improve IFI management.

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我们对 18F-FDG PET-CT 在治疗侵袭性真菌感染中的作用了解多少?一项国际调查
背景最近的数据支持 18F-FDG PET-CT 用于治疗免疫功能低下患者的感染,包括侵袭性真菌感染(IFI)。然而,其在临床实践中的作用尚未得到充分确定。我们进行了一项国际调查,以评估医生对 18F-FDG PET-CT 在 IFI 中的作用的了解程度,从而确定不确定的领域。方法于 2023 年 12 月至 2024 年 1 月向传染病工作组分发了一份在线调查。调查内容包括 18F-FDG PET-CT 的获取途径、对其在 IFI 中的作用的了解以及受访者的经验。结果 180 名受访者作了回答;60.5% 是传染病专家,主要来自西班牙(52.8%)和意大利(23.3%)。84.4%的受访者所在的中心可以使用 18F-FDG PET-CT。85.6% 的人认为 18F-FDG PET-CT 比传统的 IFI 检测更好。在 IFI 风险方面,81.1% 的人会考虑实施 18F-FDG PET-CT 来研究无病源的发热,约 50%的人会考虑评估无声病灶,50%的人会考虑评估反应,包括区分残留病灶和活动病灶。根据随访 18F-FDG PET-CT 的结果,56.7% 的人会调整抗真菌治疗的持续时间。60%的人会考虑在摄取量增加或出现新病灶时改变诊断或治疗策略。发现隐匿病灶(52%)和诊断/排除心内膜炎(52.7%)是 18F-FDG PET-CT 被认为具有最大附加值的情况。尽管大多数人认为 18F-FDG PET-CT 可能对 IFI 有用,但仍有许多不确定因素。有必要开展规范化研究,以改善 IFI 的管理。
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来源期刊
Mycopathologia
Mycopathologia 生物-真菌学
CiteScore
6.80
自引率
3.60%
发文量
76
审稿时长
3 months
期刊介绍: Mycopathologia is an official journal of the International Union of Microbiological Societies (IUMS). Mycopathologia was founded in 1938 with the mission to ‘diffuse the understanding of fungal diseases in man and animals among mycologists’. Many of the milestones discoveries in the field of medical mycology have been communicated through the pages of this journal. Mycopathologia covers a diverse, interdisciplinary range of topics that is unique in breadth and depth. The journal publishes peer-reviewed, original articles highlighting important developments concerning medically important fungi and fungal diseases. The journal highlights important developments in fungal systematics and taxonomy, laboratory diagnosis of fungal infections, antifungal drugs, clinical presentation and treatment, and epidemiology of fungal diseases globally. Timely opinion articles, mini-reviews, and other communications are usually invited at the discretion of the editorial board. Unique case reports highlighting unprecedented progress in the diagnosis and treatment of fungal infections, are published in every issue of the journal. MycopathologiaIMAGE is another regular feature for a brief clinical report of potential interest to a mixed audience of physicians and laboratory scientists. MycopathologiaGENOME is designed for the rapid publication of new genomes of human and animal pathogenic fungi using a checklist-based, standardized format.
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