Ga-67 Scintigraphy and Computed Tomography in the Diagnosis of Pneumocystis Carinii Pneumonia in Patients with AIDS

Tumeh, Sabah S.; Belville, J S; Pugatch, Robert D.; McNeil, Barbara J.

doi:10.1097/00003072-199205000-00011

Cited by 16 publications

(5 citation statements)

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Section: Clinical Manifestations and Radiological Findingsmentioning

confidence: 99%

“…Other radiological techniques such as 18-fluorodeoxyglucose positron emission tomography (FDG-PET) and Ga-67 scintigraphy have been reported as potential tools to assist in the early diagnosis of Pneumocystis pneumonia [Zhuang and Alavi, 2002;Tumeh et al 1992]. However, these techniques have been most commonly applied for the evaluation of other concomitant problem, with incidental or unexpected uptake in the lung prompting further diagnostic approaches, such as BAL to document Pneumocystis pneumonia.…”

Section: Clinical Manifestations and Radiological Findingsmentioning

confidence: 99%

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Update on the diagnosis and treatment ofPneumocystispneumonia

Carmona

Limper

2010

Ther Adv Respir Dis

166

182

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Pneumocystis is an opportunistic fungal pathogen that causes an often-lethal pneumonia in immunocompromised hosts. Although the organism was discovered in the early 1900s, the first cases of Pneumocystis pneumonia in humans were initially recognized in Central Europe after the Second World War in premature and malnourished infants. This unusual lung infection was known as plasma cellular interstitial pneumonitis of the newborn, and was characterized by severe respiratory distress and cyanosis with little or no fever and no pathognomic physical signs. At that time, only anecdotal cases were reported in adults and usually these patients had a baseline malignancy that led to a malnourished state. In the 1960-1970s additional cases were described in adults and children with hematological malignancies, but Pneumocystis pneumonia was still considered a rare disease. However, in the 1980s, with the onset of the HIV epidemic, Pneumocystis prevalence increased dramatically and became widely recognized as an opportunistic infection that caused potentially life-treating pneumonia in patients with impaired immunity. During this time period, prophylaxis against this organism was more generally instituted in high-risk patients. In the 1990s, with widespread use of prophylaxis and the initiation of highly active antiretroviral therapy (HAART) in the treatment of HIV-infected patients, the number of cases in this specific population decreased. However, Pneumocystis pneumonia still remains an important cause of severe pneumonia in patients with HIV infection and is still considered a principal AIDS-defining illness. Despite the decreased number of cases among HIV-infected patients over the past decade, Pneumocystis pneumonia continues to be a serious problem in immunodeficient patients with other immunosuppressive conditions. This is mostly due to increased use of immunosuppressive medications to treat patients with autoimmune diseases, following bone marrow and solid organ transplantation, and in patients with hematological and solid malignancies. Patients with hematologic disorders and solid organ and hematopoietic stem cell transplantation are currently the most vulnerable groups at risk for developing this infection. However, any patient with an impaired immunity, such as those receiving moderate doses of oral steroids for greater than 4 weeks or those receiving other immunosuppressive medications are at also at significant risk.

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Section: Clinical Manifestations and Radiological Findingsmentioning

confidence: 99%

Section: Clinical Manifestations and Radiological Findingsmentioning

confidence: 99%

Update on the diagnosis and treatment ofPneumocystispneumonia

Carmona

Limper

2010

Ther Adv Respir Dis

166

182

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“…Radioisotope scanning has been used to support the diagnosis of PJP, with gallium scanning shown to demonstrate changes consistent with PJP prior to chest radiograph abnormalities [112]. Recently, 18 F-fluorodeoxyglucose (FDG) PET scanning has been used as an adjunct to traditional diagnostic methods [113][114][115].…”

Section: Petmentioning

confidence: 99%

Pneumocystis jirovecii pneumonia in non-HIV-infected patients

Reid

Chen

Worth

2011

Current Opinion in Infectious Diseases

114

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HIV-negative populations at risk for PJP can be identified. Conventional PCR increases diagnostic sensitivity but may detect asymptomatic colonization. Quantitative PCR demonstrates potential for distinguishing colonization from infection, but clinical validation is required. Serum (1→3)-β-D-glucan may be elevated in PJP, although standardized cut-off values for clinical infection have not been determined. Further validation of serum markers and molecular diagnostic methods is necessary for early and accurate diagnosis in non-HIV populations.

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“…A procedure that is not so laborious and technically demanding would be of great benefit to the patients, referring clinicians and nuclear medicine specialists. Other SPECT tracers such as gallium 67 ( 67 Ga) citrate were used in the past for infection; however, this tracer has largely been replaced by labeled WBC except in a few cases such as vertebral osteomyelitis [13,14]. There are several other SPECT tracers available for imaging microorganisms such as radiolabeled antibiotics, however these tracers are not being used in routine daily practice yet.…”

Section: Spect Imaging In Infectionsmentioning

confidence: 99%

The Role of PET in Monitoring Therapy in Fungal Infections

Ankrah

Klein

Span

et al. 2018

CPD

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Positron emission tomography (PET) is a powerful diagnostic nuclear medicine imaging technique. PET allows in vivo detection of a wide variety of physiologic and pathologic phenomena and it offers a noninvasive tool for the monitoring of therapy in various diseases. Invasive fungal infections (IFIs) are a global concern because of the increasing population of patients at risk of IFIs and the high morbidity and mortality. Therapy with antifungal agents is long-standing and expensive. The emerging resistant fungal strains make the management of IFIs challenging. There is an absolute need for a sensitive noninvasive biomarker capable of monitoring the disease activity of IFIs and determining the efficacy of treatment at an early time point. PET imaging with 18F-fluorodeoxyglucose (FDG) was used to detect and assess disease activity in IFI foci already over 20 years ago. At that time, it was suggested it could be a useful biomarker for monitoring antifungal therapy. However, this knowledge has still not been fully exploited for the management of IFIs. The literature reveals an increasing realization of the usefulness of PET in monitoring therapy of IFIs. In this review, we highlight the advantages of nuclear medicine techniques in the management of IFIs with emphasis of the role of PET in monitoring therapy efficacy.

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Ga-67 Scintigraphy and Computed Tomography in the Diagnosis of Pneumocystis Carinii Pneumonia in Patients with AIDS

Cited by 16 publications

References 0 publications

Update on the diagnosis and treatment ofPneumocystispneumonia

Update on the diagnosis and treatment ofPneumocystispneumonia

Pneumocystis jirovecii pneumonia in non-HIV-infected patients

The Role of PET in Monitoring Therapy in Fungal Infections

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