AI Article Synopsis
- Febrile neutropenia (FNP) is a common issue in cancer patients, often without an identifiable cause; this study aimed to explore the use of FDG PET/CT scanning as a diagnostic tool for these patients.
- A group of 20 adult patients with severe neutropenia and persistent fever underwent FDG PET/CT, revealing a majority of infection sites previously found through standard evaluation, plus additional infection sites that were confirmed later.
- The findings suggest that FDG PET/CT is significantly beneficial in diagnosing infections in severely neutropenic patients with prolonged fever, indicating a need for further research on its role across different types of cancers.
Article Abstract
Purpose: Febrile neutropenia (FNP) is a frequent complication of cancer care and evaluation often fails to identify a cause. [(18) F]FDG PET/CT has the potential to identify inflammatory and infectious foci, but its potential role as an investigation for persistent FNP has not previously been explored. The aim of this study was to prospectively evaluate the clinical utility of FDG PET/CT in patients with cancer and severe neutropenia and five or more days of persistent fever despite antibiotic therapy.
Methods: Adult patients with a diagnosis of an underlying malignancy and persistent FNP (temperature ≥38°C and neutrophil count <500 cells/μl for 5 days) underwent FDG PET/CT as an adjunct to conventional evaluation and management.
Results: The study group comprised 20 patients with FNP who fulfilled the eligibility criteria and underwent FDG PET/CT in addition to conventional evaluation. The median neutrophil count on the day of the FDG PET/CT scan was 30 cells/μl (range 0-730 cells/μl). Conventional evaluation identified 14 distinct sites of infection, 13 (93 %) of which were also identified by FDG PET/CT, including all deep tissue infections. FDG PET/CT identified 9 additional likely infection sites, 8 of which were subsequently confirmed as "true positives" by further investigations. FDG PET/CT was deemed to be of 'high' clinical impact in 15 of the 20 patients (75 %).
Conclusion: This study supports the utility of FDG PET/CT scanning in severely neutropenic patients with five or more days of fever. Further evaluation of the contribution of FDG PET/CT in the management of FNP across a range of underlying malignancies is required.
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| http://dx.doi.org/10.1007/s00259-012-2143-7 | DOI Listing |
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