Dataset Information

Does ¹⁸F-FDG PET/CT add value to conventional imaging in clinical assessment of chronic disseminated candidiasis?

ABSTRACT:

Background

Chronic disseminated candidiasis (CDC) classically occurs after profound and prolonged neutropenia. The aim of the CANHPARI study was to assess the clinical value of adding ¹⁸F-fluorodeoxyglucose PET/CT to conventional radiology for initial and subsequent evaluations of CDC.

Materials and methods

A pilot prospective study was conducted in 23 French onco-hematological centers from 2013 to 2017 (NCT01916057). Patients ≥ 18 y.o. suspected for CDC on abdominal conventional imaging (CT or MRI) were included. PET/CT and conventional imaging were performed at baseline and month 3 (M3). Follow-up was assessed until M12. The primary outcome measure was the global response at M3, i.e., apyrexia and complete response to PET/CT. The secondary outcome measure consists in comparison between responses to PET/CT and conventional imaging at diagnosis and M3.

Results

Among 52 included patients, 44 were evaluable (20 probable and 24 possible CDC); 86% had acute leukemia, 55% were male (median age 47 years). At diagnosis, 34% had fever and conventional imaging was always abnormal with microabscesses on liver and spleen in 66%, liver in 25%, spleen in 9%. Baseline PET/CT showed metabolic uptake on liver and/or spleen in 84% but did not match with lesion localizations on conventional imaging in 32%. M3 PET/CT showed no metabolic uptake in 13 (34%) patients, 11 still having pathological conventional imaging. Global response at M3 was observed in eight patients.

Conclusion

Baseline PET/CT does not replace conventional imaging for initial staging of CDC lesions but should be performed after 3 months of antifungal therapy.

Clinical trial registration

[www.clinicaltrials.gov], identifier [NCT01916057].

SUBMITTER: Rammaert B

PROVIDER: S-EPMC9807873 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Does <sup>18</sup>F-FDG PET/CT add value to conventional imaging in clinical assessment of chronic disseminated candidiasis?

Rammaert Blandine B Maunoury Christophe C Rabeony Tioka T Correas Jean-Michel JM Elie Caroline C Alfandari Serge S Berger Pierre P Rubio Marie-Thérèse MT Braun Thorsten T Bakouboula Prissile P Candon Sophie S Montravers Françoise F Lortholary Olivier O

Frontiers in medicine 20221220

<h4>Background</h4>Chronic disseminated candidiasis (CDC) classically occurs after profound and prolonged neutropenia. The aim of the CANHPARI study was to assess the clinical value of adding <sup>18</sup>F-fluorodeoxyglucose PET/CT to conventional radiology for initial and subsequent evaluations of CDC.<h4>Materials and methods</h4>A pilot prospective study was conducted in 23 French onco-hematological centers from 2013 to 2017 (NCT01916057). Patients ≥ 18 y.o. suspected for CDC on abdominal co ...[more]

PMID: 36606049

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Project description:This study aimed to compare contrast-enhanced CT (CE-CT) and 18F-FDG PET/CT for response monitoring in metastatic breast cancer using the standardized response evaluation criteria RECIST 1.1 and PERCIST. The objective was to examine whether progressive disease was detected systematically earlier by one of the modalities. Methods: Women with biopsy-verified metastatic breast cancer were enrolled prospectively and monitored using combined CE-CT and 18F-FDG PET/CT every 9-12 wk to evaluate response to first-line treatment. CE-CT scans and RECIST 1.1 were used for clinical decision-making without accessing the 18F-FDG PET/CT scans. At study completion, 18F-FDG PET/CT scans were unmasked and assessed according to PERCIST. Visual assessment was used if response criteria could not be applied. The modality-specific time to progression was defined as the time from the baseline scan until the first scan demonstrating progression. Paired comparative analyses for CE-CT versus 18F-FDG PET/CT were applied, and the primary endpoint was earlier detection of progression by one modality. Secondary endpoints were time to detection of progression, response categorization, visualization of changes in response over time, and measurable disease according to RECIST and PERCIST. Results: In total, 87 women were evaluable, with a median of 6 (1-11) follow-up scans. Progression was detected first by 18F-FDG PET/CT in 43 (49.4%) of 87 patients and first by CE-CT in 1 (1.15%) of 87 patients (P < 0.0001). Excluding patients without progression (n = 32), progression was seen first on 18F-FDG PET/CT in 78.2% (43/55) of patients. The median time from detection of progression by 18F-FDG PET/CT to that of CE-CT was 6 mo (95% CI, 4.3-6.4 mo). At baseline, 76 (87.4%) of 87 patients had measurable disease according to PERCIST and 51 (58.6%) of 87 patients had measurable disease according to RECIST 1.1. Moreover, 18F-FDG PET/CT provided improved visualization of changes in response over time, as seen in the graphical abstract. Conclusion: Disease progression was detected earlier by 18F-FDG PET/CT than by CE-CT in most patients, with a potentially clinically relevant median 6-mo delay for CE-CT. More patients had measurable disease according to PERCIST than according to RECIST 1.1. The magnitude of the final benefit for patients is a perspective for future research.

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Dataset Information

Does ¹⁸F-FDG PET/CT add value to conventional imaging in clinical assessment of chronic disseminated candidiasis?

Background

Materials and methods

Results

Conclusion

Clinical trial registration

Publications

Does <sup>18</sup>F-FDG PET/CT add value to conventional imaging in clinical assessment of chronic disseminated candidiasis?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Does 18F-FDG PET/CT add value to conventional imaging in clinical assessment of chronic disseminated candidiasis?

Background

Materials and methods

Results

Conclusion

Clinical trial registration

Publications

Does <sup>18</sup>F-FDG PET/CT add value to conventional imaging in clinical assessment of chronic disseminated candidiasis?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Does ¹⁸F-FDG PET/CT add value to conventional imaging in clinical assessment of chronic disseminated candidiasis?