¹⁸F-FDG PET/CT in Autosomal Dominant Polycystic Kidney Disease Patients with Suspected Cyst Infection.

Abstract

The objective of this study was to determine the value of ¹⁸F-FDG PET/CT for diagnosing renal or hepatic cyst infection in patients with autosomal dominant polycystic kidney disease (ADPKD). <b>Methods:</b> This retrospective, single-center study included all patients who had ADPKD and underwent ¹⁸F-FDG PET/CT because of suspected cyst infection between 2010 and 2017. <b>Results:</b> Thirty ¹⁸F-FDG PET/CT scans of 30 individual patients were included; 19 of them had positive results for cyst infection. According to a previously established clinical and biochemical reference standard, ¹⁸F-FDG PET/CT achieved a sensitivity of 88.9%, a specificity of 75.0%, a positive predictive value of 84.2%, and a negative predictive value of 81.8% for the diagnosis of cyst infection. In 5 cases, ¹⁸F-FDG PET/CT suggested that the symptoms could be explained by a different pathologic process, including pneumonia (<i>n</i> = 1), generalized peritonitis (<i>n</i> = 1), pancreatitis (<i>n</i> = 1), colitis (<i>n</i> = 1), and cholangitis (<i>n</i> = 1). The total duration of the hospital stay and the duration between the ¹⁸F-FDG PET/CT scan and hospital discharge for patients with ¹⁸F-FDG PET/CT scan results that were positive for cyst infection were significantly longer than those for patients with negative scan results (<i>P</i> = 0.005 and <i>P</i> = 0.009, respectively). Creatinine levels were significantly higher in patients with ¹⁸F-FDG PET/CT scan results that were positive for cyst infection than in patients with negative scan results (<i>P</i> = 0.015). Other comparisons of clinical parameters (age, sex, presence of fever [>38.5°C] for more than 3 d, abdominal pain, history of solid-organ transplantation and nephrectomy, and immune status), laboratory values (C-reactive protein level, leukocyte count, and estimated glomerular filtration rate), and microbiologic test results (blood and urine cultures) were not significantly different (<i>P</i> = 0.13-1.00) in patients with positive and negative ¹⁸F-FDG PET/CT scan results. <b>Conclusion:</b>¹⁸F-FDG PET/CT is a useful imaging modality for the evaluation of patients with ADPKD and suspected cyst infection.