The diagnostic value of [18F]FDG-PET/CT in detecting septic thrombosis in patients with central venous catheter-related Staphylococcus aureus bacteremia

Purpose: Septic thrombosis often complicates Staphylococcus aureus bacteremia (SAB) in patients with a central venous catheter. Currently there is no reference standard for diagnosis. We describe the diagnostic value of [18F]FDG-PET/CT imaging in a patient cohort and the potential contribution of qu...

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Autores principales:	Michelle Gompelman, Renée Tuinte, Erik Aarntzen, Ilse Kouijzer, Eline van Leerdam, Marvin Berrevoets, Jaap Ten Oever, Chantal Bleeker-Rovers, Geert Wanten
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	septic thrombosis Staphylococcus aureus bacteremia catheter-related bloodstream infections [18F]FDG-PET/CT Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/58e3b6e5e5284d1d9cf1313bd4d44b47
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spelling	oai:doaj.org-article:58e3b6e5e5284d1d9cf1313bd4d44b472021-11-14T04:29:21ZThe diagnostic value of [18F]FDG-PET/CT in detecting septic thrombosis in patients with central venous catheter-related Staphylococcus aureus bacteremia0753-332210.1016/j.biopha.2021.112296https://doaj.org/article/58e3b6e5e5284d1d9cf1313bd4d44b472021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S0753332221010805https://doaj.org/toc/0753-3322Purpose: Septic thrombosis often complicates Staphylococcus aureus bacteremia (SAB) in patients with a central venous catheter. Currently there is no reference standard for diagnosis. We describe the diagnostic value of [18F]FDG-PET/CT imaging in a patient cohort and the potential contribution of quantitative measurements in detecting septic thrombosis. Methods: We selected patients with catheter-related SAB from our institutional database (2013–2020). The contribution of [18F]FDG-PET/CT on clinical diagnosis of septic thrombosis was evaluated. Standardized Uptake Values (SUV) were measured and compared with a composite reference standard (clinical signs, initial [18F]FDG-PET/CT result, Multidisciplinary Team (MDT) meeting outcome) to identify a cut-off value for detecting septic thrombosis. Results: We identified 93 patients with a catheter-related SAB. Quantitative measurements were possible for 43/56 patients in whom a [18F]FDG-PET/CT scan was performed. Septic thrombosis was clinically diagnosed in 30% (13/43) of the cases. In 85% of these cases, significant [18F]FDG-PET/CT uptake at the site of the thrombus was the deciding factor for diagnosis of septic thrombosis during the MDT meeting. All mean SUV’s of thrombotic lesions were higher in patients with clinically proven septic thrombosis compared to patients in whom this diagnosis was rejected (p < 0.001). A SUVpeak thrombus/SUVmean blood ratio of 1.6 (AUC-ROC value 0.982) as cut-off to differentiate between septic thrombosis and non-septic thrombosis had a sensitivity of 92% (95% CI 64–100) and specificity of 89% (95% CI 65–99). An algorithm was designed to guide diagnosis of septic thrombosis. Conclusion: Quantitative [18F]FDG-PET/CT-derived parameters seem helpful to differentiate between septic and non-septic thrombosis in patients with catheter-related SAB.Michelle GompelmanRenée TuinteErik AarntzenIlse KouijzerEline van LeerdamMarvin BerrevoetsJaap Ten OeverChantal Bleeker-RoversGeert WantenElsevierarticleseptic thrombosisStaphylococcus aureus bacteremiacatheter-related bloodstream infections[18F]FDG-PET/CTTherapeutics. PharmacologyRM1-950ENBiomedicine & Pharmacotherapy, Vol 144, Iss , Pp 112296- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	septic thrombosis Staphylococcus aureus bacteremia catheter-related bloodstream infections [18F]FDG-PET/CT Therapeutics. Pharmacology RM1-950
spellingShingle	septic thrombosis Staphylococcus aureus bacteremia catheter-related bloodstream infections [18F]FDG-PET/CT Therapeutics. Pharmacology RM1-950 Michelle Gompelman Renée Tuinte Erik Aarntzen Ilse Kouijzer Eline van Leerdam Marvin Berrevoets Jaap Ten Oever Chantal Bleeker-Rovers Geert Wanten The diagnostic value of [18F]FDG-PET/CT in detecting septic thrombosis in patients with central venous catheter-related Staphylococcus aureus bacteremia
description	Purpose: Septic thrombosis often complicates Staphylococcus aureus bacteremia (SAB) in patients with a central venous catheter. Currently there is no reference standard for diagnosis. We describe the diagnostic value of [18F]FDG-PET/CT imaging in a patient cohort and the potential contribution of quantitative measurements in detecting septic thrombosis. Methods: We selected patients with catheter-related SAB from our institutional database (2013–2020). The contribution of [18F]FDG-PET/CT on clinical diagnosis of septic thrombosis was evaluated. Standardized Uptake Values (SUV) were measured and compared with a composite reference standard (clinical signs, initial [18F]FDG-PET/CT result, Multidisciplinary Team (MDT) meeting outcome) to identify a cut-off value for detecting septic thrombosis. Results: We identified 93 patients with a catheter-related SAB. Quantitative measurements were possible for 43/56 patients in whom a [18F]FDG-PET/CT scan was performed. Septic thrombosis was clinically diagnosed in 30% (13/43) of the cases. In 85% of these cases, significant [18F]FDG-PET/CT uptake at the site of the thrombus was the deciding factor for diagnosis of septic thrombosis during the MDT meeting. All mean SUV’s of thrombotic lesions were higher in patients with clinically proven septic thrombosis compared to patients in whom this diagnosis was rejected (p < 0.001). A SUVpeak thrombus/SUVmean blood ratio of 1.6 (AUC-ROC value 0.982) as cut-off to differentiate between septic thrombosis and non-septic thrombosis had a sensitivity of 92% (95% CI 64–100) and specificity of 89% (95% CI 65–99). An algorithm was designed to guide diagnosis of septic thrombosis. Conclusion: Quantitative [18F]FDG-PET/CT-derived parameters seem helpful to differentiate between septic and non-septic thrombosis in patients with catheter-related SAB.
format	article
author	Michelle Gompelman Renée Tuinte Erik Aarntzen Ilse Kouijzer Eline van Leerdam Marvin Berrevoets Jaap Ten Oever Chantal Bleeker-Rovers Geert Wanten
author_facet	Michelle Gompelman Renée Tuinte Erik Aarntzen Ilse Kouijzer Eline van Leerdam Marvin Berrevoets Jaap Ten Oever Chantal Bleeker-Rovers Geert Wanten
author_sort	Michelle Gompelman
title	The diagnostic value of [18F]FDG-PET/CT in detecting septic thrombosis in patients with central venous catheter-related Staphylococcus aureus bacteremia
title_short	The diagnostic value of [18F]FDG-PET/CT in detecting septic thrombosis in patients with central venous catheter-related Staphylococcus aureus bacteremia
title_full	The diagnostic value of [18F]FDG-PET/CT in detecting septic thrombosis in patients with central venous catheter-related Staphylococcus aureus bacteremia
title_fullStr	The diagnostic value of [18F]FDG-PET/CT in detecting septic thrombosis in patients with central venous catheter-related Staphylococcus aureus bacteremia
title_full_unstemmed	The diagnostic value of [18F]FDG-PET/CT in detecting septic thrombosis in patients with central venous catheter-related Staphylococcus aureus bacteremia
title_sort	diagnostic value of [18f]fdg-pet/ct in detecting septic thrombosis in patients with central venous catheter-related staphylococcus aureus bacteremia
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/58e3b6e5e5284d1d9cf1313bd4d44b47
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The diagnostic value of [18F]FDG-PET/CT in detecting septic thrombosis in patients with central venous catheter-related Staphylococcus aureus bacteremia

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