Computed tomography (CT) and positron emission tomography with [18F]fluoro-2-deoxy-d-glucose (FDG-PET) images of pulmonary cryptococcosis mimicking lung cancer

Igai, Hitoshi; Gotoh, Masashi; Yokomise, Hiroyasu

doi:10.1016/j.ejcts.2006.09.022

Cited by 51 publications

(20 citation statements)

References 9 publications

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“…In addition, [ 18 F]FDG uptake was observed in invasive mould infections, involving the lung and brain [16]. Finally, one case of lung cryptococcosis was also associated with [ 18 F]FDG uptake [17].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic contribution of positron emission tomography with [18F]fluorodeoxyglucose for invasive fungal infections

Hot

Maunoury

Poirée

et al. 2011

Clinical Microbiology and Infection

149

106

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Optimal staging and evaluation of residual lesions of invasive fungal infections (IFIs) are major challenges in the immunocompromised host. Preliminary data have suggested that [¹⁸F]fluorodeoxyglucose ([¹⁸F]FDG) uptake may be observed in the course of active invasive fungal infections. The aim of this study was to assess the role of positron emission tomography with [¹⁸F]FDG ([¹⁸F]FDG-PET) in the diagnosis and staging of IFI. A prospective monocentric study evaluating [¹⁸F]FDG-PET in 30 consecutive adults and children with European Organization for Research and Treatment of Cancer/Mycoses Study Group probable or proven IFI was performed. Twenty males and ten females (median age, 45 years (range 6-7 years)) were enrolled. Twenty-six were immunocompromised, as follows: haematological malignancy (18) with allogeneic stem cell transplantation (16/18), solid tumour (three), solid organ transplantation (two), diabetes mellitus (two) and cystic fibrosis (one). IFIs were acute invasive aspergillosis (ten), chronic disseminated candidiasis (ten), zygomycosis (two), black grains eumycetoma (two), pulmonary Histoplasma capsulatum var. capsulatum histoplasmosis (two), and Phomopsis sp. osteoarthritis, Scedosporium apiospermum and Candida krusei spondylodiscitis, and acute pulmonary coccidioidomycosis in one case each. An increased uptake of [¹⁸F]FDG was observed in all areas previously identified by computed tomography and/or magnetic resonance imaging to be involved by IFI. In 4/10 chronic disseminated candidiasis cases, [¹⁸F]FDG-PET revealed small splenic abscesses that were unapparent on the corresponding computed tomography scan. [¹⁸F]FDG uptake disappeared after 6 months of antifungal therapy in three patients with chronic disseminated candidiasis for whom the [¹⁸F]FDG-PET was performed to assess the evolution of the disease. [¹⁸F]FDG-PET could potentially be useful for the initial diagnosis and staging of IFI. Whether or not [¹⁸F]FDG-PET might be useful for assessing the optimal duration of IFI therapy should now be assessed in a specific prospective study.

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Section: Discussionmentioning

confidence: 99%

Diagnostic contribution of positron emission tomography with [18F]fluorodeoxyglucose for invasive fungal infections

Hot

Maunoury

Poirée

et al. 2011

Clinical Microbiology and Infection

149

106

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“…The role of surgery for patients with isolated pulmonary cryptococcosis is limited [78, 89, 124, 130]. The most common role for surgery is “accidental” and occurs among patients who undergo surgical excision of pulmonary nodule to rule out malignancy but are determined to have isolated pulmonary cryptococcosis.…”

Section: What Are the Appropriate Treatment Strategies For Patiementioning

confidence: 99%

Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update by the Infectious Diseases Society of America

Perfect

Dismukes

Dromer

et al. 2010

Clinical Infectious Diseases

2,302

2,304

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Cryptococcosis is a global invasive mycosis associated with significant morbidity and mortality. These guidelines for its management have been built on the previous Infectious Diseases Society of America guidelines from 2000 and include new sections. There is a discussion of the management of cryptococcal meningoencephalitis in 3 risk groups: (1) human immunodeficiency virus (HIV)–infected individuals, (2) organ transplant recipients, and (3) non–HIV-infected and nontransplant hosts. There are specific recommendations for other unique risk populations, such as children, pregnant women, persons in resource-limited environments, and those with Cryptococcus gattii infection. Recommendations for management also include other sites of infection, including strategies for pulmonary crypto-coccosis. Emphasis has been placed on potential complications in management of cryptococcal infection, including increased intracranial pressure, immune reconstitution inflammatory syndrome (IRIS), drug resistance, and crypto-coccomas. Three key management principles have been articulated: (1) induction therapy for meningoencephalitis using fungicidal regimens, such as a polyene and flucytosine, followed by suppressive regimens using fluconazole; (2) importance of early recognition and treatment of increased intracranial pressure and/or IRIS; and (3) the use of lipid formulations of amphotericin B regimens in patients with renal impairment. Cryptococcosis remains a challenging management issue, with little new drug development or recent definitive studies. However, if the diagnosis is made early, if clinicians adhere to the basic principles of these guidelines, and if the underlying disease is controlled, then cryptococcosis can be managed successfully in the vast majority of patients.

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“…Focal lesions also exhibit increased FDG uptake. Therefore, such lesions maybe mistaken for lung cancer on PET/CT, and imaging does not reduce the need for diagnostic biopsy [50][51][52][53].…”

Section: Endemic Fungi and Cryptococcusmentioning

confidence: 97%

Radiologic Imaging Techniques for the Diagnosis and Management of Invasive Fungal Disease

Hanson

Caligiuri

Wiggins

et al. 2015

Curr Fungal Infect Rep

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Invasive fungal diseases (IFDs) are an important cause of morbidity and mortality, especially in immunocompromised patients. Prompt antifungal therapy is essential for favorable outcomes, but clinical signs and symptoms are nonspecific and mycologic confirmation is often not possible. Radiographic testing is an important adjunct to the diagnosis and management of IFDs. Early imaging has been associated with improved survival, particularly in neutropenic patients with fungal pneumonia or acute invasive fungal sinusitis. This review summarizes common radiologic appearances of IFDs of the lung, sinus, and brain. The advantages and limitations of computed tomography (CT) and magnetic resonance (MR) imaging are discussed as are recent developments in nuclear medicine and proton MR spectroscopy technology.

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Computed tomography (CT) and positron emission tomography with [18F]fluoro-2-deoxy-d-glucose (FDG-PET) images of pulmonary cryptococcosis mimicking lung cancer

Cited by 51 publications

References 9 publications

Diagnostic contribution of positron emission tomography with [18F]fluorodeoxyglucose for invasive fungal infections

Diagnostic contribution of positron emission tomography with [18F]fluorodeoxyglucose for invasive fungal infections

Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update by the Infectious Diseases Society of America

Radiologic Imaging Techniques for the Diagnosis and Management of Invasive Fungal Disease

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