The application of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in inflammation and infectious disease_Journal of Biomedical Engineering

Authors：

YAO Yutang ^1,2 ,  OU Xiaohong ¹

1. Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;
2. PETCT center, Department of Nuclear Medicine,, Sichuan Cancer Hospital&Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, P.R.China;

Corresponding author：

Keywords：

2-［¹⁸F］-fluoro-2-deoxy-D-glucose; positron emission tomography/computed tomography; inflammation; infection

DOI：

10.7507/1001-5515.202002030

Video：

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2-［¹⁸F］-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) combining positron emission tomography with computed tomography is used to evaluate the body's glucose metabolic changes under different conditions. In addition to its established role in oncological imaging, ¹⁸F-FDG PET/CT has clinical utility in suspected inflammation and infection. The technique can identify the source of infection in a timely fashion ahead of morphological changes, map the extent and severity of inflammation, guide the site for tissue biopsy and assess therapy response. This article reviewed the use of ¹⁸F-FDG PET/CT in infection and inflammation, such as fever of unknown origin, sarcoidosis, vessel vasculitis, osteomyelitis, joint prosthesis or implant-related complications, human immunodeficiency virus-related infections, and other indications, such as inflammatory bowel disease, so as to provide reference for clinicians to select ¹⁸F-FDG PET/CT to help them in the diagnosis and treatment of inflammatory diseases.

Citation： YAO Yutang, OU Xiaohong. The application of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in inflammation and infectious disease. Journal of Biomedical Engineering, 2020, 37(4): 730-735. doi: 10.7507/1001-5515.202002030 Copy

1.	Bosch K D, Chicklore S, Cook G J, <italic>et al</italic>. Staging FDG PET-CT changes management in patients with gastric adenocarcinoma who are eligible for radical treatment. Eur J Nucl Med Mol Imaging, 2020, 47(4): 759-767.
2.	Zhuang H, Codreanu I. Growing applications of FDG PET-CT imaging in non-oncologic conditions. J Biomed Res, 2015, 29(3): 189-202.
3.	García-Vicente A M, Tello-Galán M J, Amo-Salas M, et al. Do clinical and laboratory variables have any impact on the diagnostic performance of 18F-FDG PET/CT in patients with fever of unknown origin?. Ann Nucl Med, 2018, 32(2): 123-131.
4.	Kubota R, Yamada S, Kubota K, <italic>et al</italic>. Intratumoral distribution of fluorine-18-fluorodeoxyglucose <italic>in vivo</italic>: high accumulation in macrophages and granulation tissues studied by microautoradiography. J Nucl Med, 1992, 33(11): 1972-1980.
5.	Ertay T, Sencan Eren M, Karaman M, <italic>et al</italic>. (18)F-FDG-PET/CT in initiation and progression of inflammation and infection. Mol Imaging Radionucl Ther, 2017, 26(2): 47-52.
6.	Berg E, Cherry S R. Innovations in instrumentation for positron emission tomography. Semin Nucl Med, 2018, 48(4): 311-331.
7.	Jamar F, Buscombe J, Chiti A, <italic>et al</italic>. EANM/SNMMI guideline for 18F-FDG use in inflammation and infection. J Nucl Med, 2013, 54(4): 647-658.
8.	Kouijzer I E, Mulders-Manders C M, Bleeker-Rovers C P, <italic>et al</italic>. Fever of unknown origin: the value of FDG-PET/CT. Semin Nucl Med, 2018, 48(2): 100-107.
9.	Schönau V, Vogel K, Englbrecht M, <italic>et al</italic>. The value of (18)F-FDG-PET/CT in identifying the cause of fever of unknown origin (FUO) and inflammation of unknown origin (IUO): data from a prospective study. Ann Rheum Dis, 2018, 77(1): 70-77.
10.	Besson F L, Chaumet-Riffaud P, Playe M, <italic>et al</italic>. Contribution of (18)F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): a stratification-based meta-analysis. Eur J Nucl Med Mol Imaging, 2016, 43(10): 1887-1895.
11.	Slart R, Writing G, Reviewer G, <italic>et al</italic>. FDG-PET/CT(A) imaging in large vessel vasculitis and polymyalgia rheumatica: joint procedural recommendation of the EANM, SNMMI, and the PET interest group (PIG), and endorsed by the ASNC. Eur J Nucl Med Mol Imaging, 2018, 45(7): 1250-1269.
12.	Espigol-Frigole G, Prieto-Gonzalez S, Alba M A, <italic>et al</italic>. Advances in the diagnosis of large vessel vasculitis. Rheumatic Disease Clinics of North America, 2015, 41(1): 125-140.
13.	de Boyssonh, Dumont A, Liozon E, <italic>et al</italic>. Giant-cell arteritis: concordance study between aortic CT angiography and FDG-PET/CT in detection of large-vessel involvement. Eur J Nucl Med Mol Imaging, 2017, 44(13): 2274-2279.
14.	Quinn K A, Ahlman M, Malayeri A A, <italic>et al</italic>. Comparison of magnetic resonance angiography and (18)F-fluorodeoxyglucose positron emission tomography in large-vessel vasculitis. Ann Rheum Dis, 2018, 77(8): 1165-1171.
15.	Grayson P C, Alehashemi S, Bagheri A A, <italic>et al</italic>. 18 F-fluorodeoxyglucose-positron emission tomography as an imaging biomarker in a prospective, longitudinal cohort of patients with large vessel vasculitis. Arthritis & Rheumatology, 2018, 70(3): 439-449.
16.	Martínez-Rodríguez I, Jiménez-Alonso M, Quirce R, <italic>et al</italic>. (18)F-FDG PET/CT in the follow-up of large-vessel vasculitis: a study of 37 consecutive patients. Semin Arthritis Rheum, 2018, 47(4): 530-537.
17.	Wilson W R, Bower T C, Creager M, <italic>et al</italic>. Vascular graft infections, mycotic aneurysms, and endovascular infections: a scientific statement from the American heart association. Circulation, 2016, 134(20): e412-e460.
18.	Rojoa D, Kontopodis N, Antoniou S A, <italic>et al</italic>. 18F-FDG PET in the diagnosis of vascular prosthetic graft infection: a diagnostic test accuracy meta-analysis. Eur J Vasc Endovasc Surg, 2019, 57(2): 292-301.
19.	Vaidyanathan S, Patel C N, Scarsbrook A F, <italic>et al</italic>. FDG PET/CT in infection and inflammation-current and emerging clinical applications. Clin Radiol, 2015, 70(7): 787-800.
20.	Tana M, Di Carlo S, Romano M, <italic>et al</italic>. FDG-PET/CT assessment of pulmonary sarcoidosis: a guide for internists. Curr Med Imaging Rev, 2019, 15(1): 21-25.
21.	Govender P, Berman J S. The diagnosis of sarcoidosis. Clin Chest Med, 2015, 36(4): 585-602.
22.	Terasaki F, Azuma A, Anzai T, <italic>et al</italic>. JCS 2016 guideline on diagnosis and treatment of cardiac sarcoidosis-digest version. Circ J, 2019, 83(11): 2329-2388.
23.	Zhao M, Xin Xiaofeng, Hu Huan, <italic>et al</italic>. 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis of benign pulmonary lesions in sarcoidosis. Translational lung cancer research, 2019, 8(3): 208-213.
24.	Termaat M F, Raijmakers P G, Scholten H J, <italic>et al</italic>. The accuracy of diagnostic imaging for the assessment of chronic osteomyelitis: a systematic review and meta-analysis. J Bone Joint Surg Am, 2005, 87(11): 2464-2471.
25.	Signore A, Glaudemans A, Gheysens O, <italic>et al</italic>. Nuclear medicine imaging in pediatric infection or chronic inflammatory diseases. Semin Nucl Med, 2017, 47(3): 286-303.
26.	van der Bruggen W, Bleeker-Rovers C P, Boerman O C, <italic>et al</italic>. PET and SPECT in osteomyelitis and prosthetic bone and joint infections: a systematic review. Semin Nucl Med, 2010, 40(1): 3-15.
27.	Wenter V, Müller J P, Albert N L, <italic>et al</italic>. The diagnostic value of [(18)F]FDG PET for the detection of chronic osteomyelitis and implant-associated infection. Eur J Nucl Med Mol Imaging, 2016, 43(4): 749-761.
28.	Kouijzer I J E, Scheper H, de Rooy J W J, <italic>et al</italic>. The diagnostic value of 18F–FDG-PET/CT and MRI in suspected vertebral osteomyelitis–a prospective study. Eur J Nucl Med Mol Imaging, 2018, 45(5): 798-805.
29.	Palestro C J. Radionuclide imaging of musculoskeletal infection: a review. J Nucl Med, 2016, 57(9): 1406-1412.
30.	Ankrah A O, Glaudemans A W, Klein H C, <italic>et al</italic>. The role of nuclear medicine in the staging and management of human immune deficiency virus infection and associated diseases. Nucl Med Mol Imaging (2010), 2017, 51(2): 127-139.
31.	Lawal I O, Nyakale N E, Harry L M, <italic>et al</italic>. The role of F-18 FDG PET/CT in evaluating the impact of HIV infection on tumor burden and therapy outcome in patients with Hodgkin lymphoma. Eur J Nucl Med Mol Imaging, 2017, 44(12): 2025-2033.
32.	Hammoud D, Sinharay S, Steinbach S, <italic>et al</italic>. Global and regional brain hypometabolism on FDG-PET in treated HIV-infected individuals. Neurology, 2018, 91(17): e1591-e1601.
33.	Martinez-Pimienta G, Noriega-Álvarez E, Simó-Perdigó M. Study of systemic disease IgG4. usefulness of 2-[18F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography for staging, selection of biopsy site, evaluation of treatment response and follow-up. European journal of rheumatology, 2017, 4(3): 222-225.
34.	Giorgio T, Sadeghi R, Viccaro A, <italic>et al</italic>. Clinical role and accuracy of 18F-FDG PET in evaluating disease activity in patients with chronic inflammatory bowel disease: an updated systematic review and a bivariate meta-analysis. Clinical and Translational Imaging, 2017, 5(4): 303-313.
35.	Kubota K, Yamashita H, Mimori A. Clinical value of FDG-PET/CT for the evaluation of rheumatic diseases: rheumatoid arthritis, polymyalgia rheumatica, and relapsing polychondritis. Semin Nucl Med, 2017, 47(4): 408-424.

1. Bosch K D, Chicklore S, Cook G J, <italic>et al</italic>. Staging FDG PET-CT changes management in patients with gastric adenocarcinoma who are eligible for radical treatment. Eur J Nucl Med Mol Imaging, 2020, 47(4): 759-767.
2. Zhuang H, Codreanu I. Growing applications of FDG PET-CT imaging in non-oncologic conditions. J Biomed Res, 2015, 29(3): 189-202.
3. García-Vicente A M, Tello-Galán M J, Amo-Salas M, et al. Do clinical and laboratory variables have any impact on the diagnostic performance of 18F-FDG PET/CT in patients with fever of unknown origin?. Ann Nucl Med, 2018, 32(2): 123-131.
4. Kubota R, Yamada S, Kubota K, <italic>et al</italic>. Intratumoral distribution of fluorine-18-fluorodeoxyglucose <italic>in vivo</italic>: high accumulation in macrophages and granulation tissues studied by microautoradiography. J Nucl Med, 1992, 33(11): 1972-1980.
5. Ertay T, Sencan Eren M, Karaman M, <italic>et al</italic>. (18)F-FDG-PET/CT in initiation and progression of inflammation and infection. Mol Imaging Radionucl Ther, 2017, 26(2): 47-52.
6. Berg E, Cherry S R. Innovations in instrumentation for positron emission tomography. Semin Nucl Med, 2018, 48(4): 311-331.
7. Jamar F, Buscombe J, Chiti A, <italic>et al</italic>. EANM/SNMMI guideline for 18F-FDG use in inflammation and infection. J Nucl Med, 2013, 54(4): 647-658.
8. Kouijzer I E, Mulders-Manders C M, Bleeker-Rovers C P, <italic>et al</italic>. Fever of unknown origin: the value of FDG-PET/CT. Semin Nucl Med, 2018, 48(2): 100-107.
9. Schönau V, Vogel K, Englbrecht M, <italic>et al</italic>. The value of (18)F-FDG-PET/CT in identifying the cause of fever of unknown origin (FUO) and inflammation of unknown origin (IUO): data from a prospective study. Ann Rheum Dis, 2018, 77(1): 70-77.
10. Besson F L, Chaumet-Riffaud P, Playe M, <italic>et al</italic>. Contribution of (18)F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): a stratification-based meta-analysis. Eur J Nucl Med Mol Imaging, 2016, 43(10): 1887-1895.
11. Slart R, Writing G, Reviewer G, <italic>et al</italic>. FDG-PET/CT(A) imaging in large vessel vasculitis and polymyalgia rheumatica: joint procedural recommendation of the EANM, SNMMI, and the PET interest group (PIG), and endorsed by the ASNC. Eur J Nucl Med Mol Imaging, 2018, 45(7): 1250-1269.
12. Espigol-Frigole G, Prieto-Gonzalez S, Alba M A, <italic>et al</italic>. Advances in the diagnosis of large vessel vasculitis. Rheumatic Disease Clinics of North America, 2015, 41(1): 125-140.
13. de Boyssonh, Dumont A, Liozon E, <italic>et al</italic>. Giant-cell arteritis: concordance study between aortic CT angiography and FDG-PET/CT in detection of large-vessel involvement. Eur J Nucl Med Mol Imaging, 2017, 44(13): 2274-2279.
14. Quinn K A, Ahlman M, Malayeri A A, <italic>et al</italic>. Comparison of magnetic resonance angiography and (18)F-fluorodeoxyglucose positron emission tomography in large-vessel vasculitis. Ann Rheum Dis, 2018, 77(8): 1165-1171.
15. Grayson P C, Alehashemi S, Bagheri A A, <italic>et al</italic>. 18 F-fluorodeoxyglucose-positron emission tomography as an imaging biomarker in a prospective, longitudinal cohort of patients with large vessel vasculitis. Arthritis & Rheumatology, 2018, 70(3): 439-449.
16. Martínez-Rodríguez I, Jiménez-Alonso M, Quirce R, <italic>et al</italic>. (18)F-FDG PET/CT in the follow-up of large-vessel vasculitis: a study of 37 consecutive patients. Semin Arthritis Rheum, 2018, 47(4): 530-537.
17. Wilson W R, Bower T C, Creager M, <italic>et al</italic>. Vascular graft infections, mycotic aneurysms, and endovascular infections: a scientific statement from the American heart association. Circulation, 2016, 134(20): e412-e460.
18. Rojoa D, Kontopodis N, Antoniou S A, <italic>et al</italic>. 18F-FDG PET in the diagnosis of vascular prosthetic graft infection: a diagnostic test accuracy meta-analysis. Eur J Vasc Endovasc Surg, 2019, 57(2): 292-301.
19. Vaidyanathan S, Patel C N, Scarsbrook A F, <italic>et al</italic>. FDG PET/CT in infection and inflammation-current and emerging clinical applications. Clin Radiol, 2015, 70(7): 787-800.
20. Tana M, Di Carlo S, Romano M, <italic>et al</italic>. FDG-PET/CT assessment of pulmonary sarcoidosis: a guide for internists. Curr Med Imaging Rev, 2019, 15(1): 21-25.
21. Govender P, Berman J S. The diagnosis of sarcoidosis. Clin Chest Med, 2015, 36(4): 585-602.
22. Terasaki F, Azuma A, Anzai T, <italic>et al</italic>. JCS 2016 guideline on diagnosis and treatment of cardiac sarcoidosis-digest version. Circ J, 2019, 83(11): 2329-2388.
23. Zhao M, Xin Xiaofeng, Hu Huan, <italic>et al</italic>. 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis of benign pulmonary lesions in sarcoidosis. Translational lung cancer research, 2019, 8(3): 208-213.
24. Termaat M F, Raijmakers P G, Scholten H J, <italic>et al</italic>. The accuracy of diagnostic imaging for the assessment of chronic osteomyelitis: a systematic review and meta-analysis. J Bone Joint Surg Am, 2005, 87(11): 2464-2471.
25. Signore A, Glaudemans A, Gheysens O, <italic>et al</italic>. Nuclear medicine imaging in pediatric infection or chronic inflammatory diseases. Semin Nucl Med, 2017, 47(3): 286-303.
26. van der Bruggen W, Bleeker-Rovers C P, Boerman O C, <italic>et al</italic>. PET and SPECT in osteomyelitis and prosthetic bone and joint infections: a systematic review. Semin Nucl Med, 2010, 40(1): 3-15.
27. Wenter V, Müller J P, Albert N L, <italic>et al</italic>. The diagnostic value of [(18)F]FDG PET for the detection of chronic osteomyelitis and implant-associated infection. Eur J Nucl Med Mol Imaging, 2016, 43(4): 749-761.
28. Kouijzer I J E, Scheper H, de Rooy J W J, <italic>et al</italic>. The diagnostic value of 18F–FDG-PET/CT and MRI in suspected vertebral osteomyelitis–a prospective study. Eur J Nucl Med Mol Imaging, 2018, 45(5): 798-805.
29. Palestro C J. Radionuclide imaging of musculoskeletal infection: a review. J Nucl Med, 2016, 57(9): 1406-1412.
30. Ankrah A O, Glaudemans A W, Klein H C, <italic>et al</italic>. The role of nuclear medicine in the staging and management of human immune deficiency virus infection and associated diseases. Nucl Med Mol Imaging (2010), 2017, 51(2): 127-139.
31. Lawal I O, Nyakale N E, Harry L M, <italic>et al</italic>. The role of F-18 FDG PET/CT in evaluating the impact of HIV infection on tumor burden and therapy outcome in patients with Hodgkin lymphoma. Eur J Nucl Med Mol Imaging, 2017, 44(12): 2025-2033.
32. Hammoud D, Sinharay S, Steinbach S, <italic>et al</italic>. Global and regional brain hypometabolism on FDG-PET in treated HIV-infected individuals. Neurology, 2018, 91(17): e1591-e1601.
33. Martinez-Pimienta G, Noriega-Álvarez E, Simó-Perdigó M. Study of systemic disease IgG4. usefulness of 2-[18F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography for staging, selection of biopsy site, evaluation of treatment response and follow-up. European journal of rheumatology, 2017, 4(3): 222-225.
34. Giorgio T, Sadeghi R, Viccaro A, <italic>et al</italic>. Clinical role and accuracy of 18F-FDG PET in evaluating disease activity in patients with chronic inflammatory bowel disease: an updated systematic review and a bivariate meta-analysis. Clinical and Translational Imaging, 2017, 5(4): 303-313.
35. Kubota K, Yamashita H, Mimori A. Clinical value of FDG-PET/CT for the evaluation of rheumatic diseases: rheumatoid arthritis, polymyalgia rheumatica, and relapsing polychondritis. Semin Nucl Med, 2017, 47(4): 408-424.

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