Jiri Ferda MD, PhD, Presenter: Nothing to Disclose

Eva Ferdova MD, Abstract Co-Author: Nothing to Disclose

Jan Baxa MD, PhD, Abstract Co-Author: Nothing to Disclose

To assess a role of the hybrid imaging with 18-FDG-PET/CT in detection of the cause of sepsis of uncertain origin 

In the sample of 42 adult patients (23 males, 29 females, mean age 43,7 y. ranging 24 – 81 y.), 18-FDG-PET/CT was referred due to the concurrent or recurrent septic state. The changes in the glucose metabolism related to the suspected site of infection were searched. All examinations were conducted after intravenous application of 18F-fluorodeoxyglucose in the dose of 4 MBq/kg of body weight and 60 minutes of radiopharmaceutical accumulation, all PET/CT scans were performed using three-ring-sixteen-slice system (Biograph 16 HR, Siemens, Knoxville, TN, USA) with the intravenous application of 80 ml of iodine contrast material with sub-millimeter spatial resolution. In all patients was investigated microbial infection agens using blood samples or the assessment  of specimen taken from the site of focal infection.

The focal finding allowing detection of the origin of the septic state was found in 39 of 42 pts. (92.8%), three cases remained with undetermined cause of sepsis. Those most frequent sites of the hidden infection were found: spondylodiscitis in 30.7% (12/39), followed by musculoskeletal infection in 25.4% (10/39) including pyogenous arthritis (3 cases), psoatic abscess (2 cases) or joint prosthesis infection (5 cases); cardiovascular infection in 23.1% (9/39) including endocarditis (3 cases), pericarditis (one case), mycotic aneurysm (3 cases) and vascular prosthesis infection (2 cases). Other, less frequent causes of septic or septic-like state were gastrointestinal inflammation in 4 cases, lung infection in 3 cases and one case of Hodgkin lymphoma. The proven bacterial agens was in 37 cases – 16 cases of staphylococcal (including 7 cases of methiciline resistant streptococcus aureus and 5 cases of methiciline sensitive streptococcus aureus); 6 cases of streptococcal; 13 cases of Gramm negative bacterial and 2 cases of mycobacterial infection.

18-FDG-PET/CT reached the sufficient efficiency in detection of the origin of sepsis in patient with uncertain site of infection; the spondylodiscitis is the most frequent finding in septic state.

18-FDG-PET/CT is reaching the positive results in more than 90% cases of referred patients allowing the subsequent targeted therapy.

Ferda, J, Ferdova, E, Baxa, J, A Role of the 18-FDG-PET/CT in the Assessment of Sepsis of Uncertain Origin.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14017274.html