Usefulness of positron emission tomography in the differentiation between tumor and infectious lesions in pediatric oncology: a case report

Tibúrcio, Fernanda Rodrigues; Rodrigues, Karla Emília de Sá; Vasconcelos, Hérika Martins Mendes; Miranda, Débora Marques de; Silva, Ana Cristina Simões e

doi:10.1186/s12887-015-0427-3

Cited by 5 publications

(9 citation statements)

References 11 publications

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“…However, these risk factors rarely occur in isolation, which is not surprising given the nature of typical cancer‐related induction therapy. For example, treatment for oncology patients typically involves both chemotherapy preceded by steroid therapy which leads to immunosuppression and neutropenia 7,11,13–17,20 . Thus, an index of suspicion for fungal infection should be built up in paediatric oncology patients dependent on these risk factors.…”

Section: Resultsmentioning

confidence: 99%

“…Abdominal ultrasound imaging was used in all cases in the literature as a screening or diagnostic measure, with or without suspicion for fungal infection 7,10–20 . In most cases of abdominal fungal infection, ultrasound imaging was not the primary diagnostic measure 10,11,13–15,17 . Rather, blood culture, fine‐needle aspiration, histopathological investigations or other imaging studies were the primary determining procedure in confirming a fungal infection 10,11,13–15,17 .…”

Section: Resultsmentioning

confidence: 99%

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The utility of abdominal ultrasonography in the diagnosis of fungal infections in children: a narrative review

Sungkana

Edwards

Reddan

2020

J of Medical Radiation Sci

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In paediatric patients, ultrasonography is one of the preferred medical imaging modalities due to the lack of ionising radiation. Abdominal ultrasonography can be a useful tool in diagnosing cases of fungal infections but may introduce some risks for further infection in vulnerable patients or cause anxiety and discomfort. The aim of this narrative review is to analyse the utility of abdominal ultrasonography in diagnosing fungal infections in children in terms of its positive hit rates and utility in typical use. Text words and indexed terms related to ‘fungal infection and ultrasonography’ and ‘children’ were searched on MEDLINE, EMBASE, Cochrane Library and Scopus. Paediatric oncology patients, neonates and generally immunocompromised children were found to be at‐risk groups with increasing susceptibility to risk factors for contracting fungal infections. Abdominal ultrasonography was found to aid in the diagnosis of fungal infection in many cases, but not all patients with the identified risk factors were diagnosed with fungal infections and not all patients diagnosed with fungal infections had identified risk factors. Ultrasonography was found to be overutilised and the current decision process in requesting abdominal ultrasonography in diagnosing fungal infection should be revised. Further study into an effective criterion in requesting abdominal ultrasonography is suggested to reduce the overutilisation of ultrasonography, thus reducing risk of infection and discomfort while also saving time and money.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The utility of abdominal ultrasonography in the diagnosis of fungal infections in children: a narrative review

Sungkana

Edwards

Reddan

2020

J of Medical Radiation Sci

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“…Indeed, in a 6-year-old patient with IFI, it was the pattern of uptake that was similar to the uptake in adults. This enabled a diagnosis of a Candida infection to be made rather than a recurrent malignant disease when other imaging modalities were unhelpful in this regard [ 76 ]. In all cases of children presented, the IFI lesions showed uptake similar to the cases in adults.…”

Section: Imagingmentioning

confidence: 99%

“…-lung, uptake in a suspected case of invasive pulmonary was persistent on follow-up Avet et al [ 52 ] EJNMMI 16 years Acute leukemia and completion of chemotherapy Candida sp .-disseminated. Previously undiagnosed metastatic foci detected after completion of antifungal therapy Tibúrcio et al [ 76 ] BMC Pediatr 6 years Neuroblastoma on treatment with febrile neutropenia Candida sp . –spleen, helped diagnosis, other imaging modalities were equivocal Franzius et al [ 65 ] Clin Nucl Med 3 months (2 pts-twins) Chronic granulomatous disease Aspergillus sp.…”

Section: Imagingmentioning

confidence: 99%

Imaging fungal infections in children

Ankrah

Sathekge

Dierckx

et al. 2016

Clin Transl Imaging

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Fungal infections in children rarely occur, but continue to have a high morbidity and mortality despite the development of newer antifungal agents. It is essential for these infections to be diagnosed at the earliest possible stage so appropriate treatment can be initiated promptly. The addition of high-resolution computer tomography (HR CT) has helped in early diagnosis making; however, it lacks both sensitivity and specificity. Metabolic changes precede anatomical changes and hybrid imaging with positron emission tomography (PET) integrated with imaging modalities with high anatomical resolution such as CT or magnetic resonance imaging (MRI) is likely to detect these infections at an earlier stage with higher diagnostic accuracy rates. Several authors presented papers highlighting the advantages of PET/CT in imaging fungal infections. These papers, however, usually involve a limited number of patients and mostly adults. Fungal infections behave different in children than in adults, since there are differences in epidemiology, imaging findings, and response to treatment with antifungal drugs. This paper reviews the literature and explores the use of hybrid imaging for diagnosis and therapy decision making in children with fungal infections.

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“…These findings suggest that, although imaging studies such as fluorodeoxyglucose-positron emission tomography/ computed tomography, are useful for detecting malignant lesions, fluorodeoxyglucose uptake may be observed in an infectious lesion and that abdominal abscesses, although rare, can be easily misdiagnosed. 3 Therefore, we should consider the possibility of an abdominal abscess when an abdominal tumor is found.…”

mentioning

confidence: 99%