Determining the usefulness of systematic ¹⁸F-FDG PET/CT for the management of invasive fungal infection (PETIFI project): a prospective national multicentre cohort study protocol.

Abstract

The evaluation of staging and activity of invasive fungal infection (IFI) is used to adjust the type and duration of antifungal therapy (AT). Typically anatomy-based imaging is used. Positron emission tomography/CT with ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG PET/CT) not only evaluates more than one body area in one session, but adds functional information to the anatomic data provided by usual imaging techniques and can potentially improve staging of IFI and monitoring of the response to therapy. Our objective is to analyse the impact of the systematic use of ¹⁸F-FDG PET/CT in IFI diagnostic and therapeutic management. Multicentre prospective cohort study of IFI with performance of systematic ¹⁸F-FDG PET/CT at diagnosis and follow-up that will be carried out in 14 Spanish tertiary hospitals. It is planned to include 224 patients with IFI over a 2-year study period. Findings and changes in management before and after ¹⁸F-FDG PET/CT will be compared. Additionally, the association of initial quantitative ¹⁸F-FDG PET/CT parameters with response to therapy will be evaluated.The primary endpoint is to compare the yield of ¹⁸F-FDG PET/CT with standard management without ¹⁸F-FDG PET/CT in IFI at initial assessment (staging) and in monitoring the response to treatment.The impact of the results of ¹⁸F-FDG PET/CT on the diagnostic-therapeutic management of patients with IFI (added value), as well as the prognostic ability of different quantification parameters of ¹⁸F-FDG PET/CT will be secondary endpoints. The Clinical Research Ethics Committee of Puerta de Hierro-Majadahonda University Hospital approved the protocol of the study at the primary site. We plan to publish the results in high-impact journals. NCT05688592.