TY - JOUR
T1 - The value of 18F-FDG PET/CT in diagnosis and during follow-up in 273 patients with chronic Q fever
AU - Kouijzer, Ilse J.E.
AU - Kampschreur, Linda M.
AU - Wever, Peter C.
AU - Hoekstra, Corneline
AU - Van Kasteren, Marjo E.E.
AU - De Jager-Leclercq, Monique G.L.
AU - Nabuurs-Franssen, Marrigje H.
AU - Wegdam-Blans, Marjolijn C.A.
AU - Ammerlaan, Heidi S.M.
AU - Buijs, Jacqueline
AU - de Geus-Oei, Lioe Fee
AU - Oyen, Wim J.G.
AU - Bleeker-Rovers, Chantal P.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - In 1%–5% of all acute Q fever infections, chronic Q fever develops, mostly manifesting as endocarditis, infected aneurysms, or infected vascular prostheses. In this study, we investigated the diagnostic value of 18F-FDG PET/CT in chronic Q fever at diagnosis and during follow-up. Methods: All adult Dutch patients suspected of chronic Q fever who were diagnosed since 2007 were retrospectively included until March 2015, when at least one 18F-FDG PET/CT scan was obtained. Clinical data and results from 18F-FDG PET/CT at diagnosis and during follow-up were collected. 18F-FDG PET/CT scans were prospectively reevaluated by 3 nuclear medicine physicians using a structured scoring system. Results: In total, 273 patients with possible, probable, or proven chronic Q fever were included. Of all 18F-FDG PET/CT scans performed at diagnosis, 13.5% led to a change in diagnosis. Q fever–related mortality rate in patients with and without vascular infection based on 18F-FDG PET/CT was 23.8% and 2.1%, respectively (P 5 0.001). When 18F-FDG PET/CT was added as a major criterion to the modified Duke criteria, 17 patients (1.9-fold increase) had definite endocarditis. At diagnosis, 19.6% of 18F-FDG PET/CT scans led to treatment modification. During follow-up, 57.3% of 18F-FDG PET/CT scans resulted in treatment modification. Conclusion: 18F-FDG PET/CT is a valuable technique in diagnosis of chronic Q fever and during follow-up, often leading to a change in diagnosis or treatment modification and providing important prognostic information on patient survival.
AB - In 1%–5% of all acute Q fever infections, chronic Q fever develops, mostly manifesting as endocarditis, infected aneurysms, or infected vascular prostheses. In this study, we investigated the diagnostic value of 18F-FDG PET/CT in chronic Q fever at diagnosis and during follow-up. Methods: All adult Dutch patients suspected of chronic Q fever who were diagnosed since 2007 were retrospectively included until March 2015, when at least one 18F-FDG PET/CT scan was obtained. Clinical data and results from 18F-FDG PET/CT at diagnosis and during follow-up were collected. 18F-FDG PET/CT scans were prospectively reevaluated by 3 nuclear medicine physicians using a structured scoring system. Results: In total, 273 patients with possible, probable, or proven chronic Q fever were included. Of all 18F-FDG PET/CT scans performed at diagnosis, 13.5% led to a change in diagnosis. Q fever–related mortality rate in patients with and without vascular infection based on 18F-FDG PET/CT was 23.8% and 2.1%, respectively (P 5 0.001). When 18F-FDG PET/CT was added as a major criterion to the modified Duke criteria, 17 patients (1.9-fold increase) had definite endocarditis. At diagnosis, 19.6% of 18F-FDG PET/CT scans led to treatment modification. During follow-up, 57.3% of 18F-FDG PET/CT scans resulted in treatment modification. Conclusion: 18F-FDG PET/CT is a valuable technique in diagnosis of chronic Q fever and during follow-up, often leading to a change in diagnosis or treatment modification and providing important prognostic information on patient survival.
KW - 18F-FDG PET/CT
KW - Endocarditis
KW - Q fever
KW - Vascular infection
KW - n/a OA procedure
UR - http://www.scopus.com/inward/record.url?scp=85040036031&partnerID=8YFLogxK
U2 - 10.2967/jnumed.117.192492
DO - 10.2967/jnumed.117.192492
M3 - Article
AN - SCOPUS:85040036031
SN - 0161-5505
VL - 59
SP - 127
EP - 133
JO - The Journal of nuclear medicine
JF - The Journal of nuclear medicine
IS - 1
ER -