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Does Antibiotic Treatment Affect the Diagnostic Accuracy of 18F-FDG PET/CT Studies in Patients with Suspected Infectious Processes?

  • Kagna, Olga1
  • Kurash, Marina2
  • Ghanem-Zoubi, Nesrin3
  • Keidar, Zohar2
  • Israel, Ora2
  • 1 Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel; and [email protected] , (Israel)
  • 2 Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel; and. , (Israel)
  • 3 Department of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel. , (Israel)
Published Article
Publication Date
Nov 01, 2017
DOI: 10.2967/jnumed.117.192062
PMID: 28473596


18F-FDG PET/CT plays a significant role in the assessment of various infectious processes. Patients with suspected or known sites of infection are often referred for 18F-FDG imaging while already receiving antibiotic treatment. The current study assessed whether antibiotic therapy affected the detectability rate of infectious processes by 18F-FDG PET/CT. Methods: A 5-y retrospective study of all adult patients who underwent 18F-FDG PET/CT in search of a focal source of infection was performed. The presence, duration, and appropriateness of antibiotic treatment before 18F-FDG imaging were recorded. Diagnosis of an infectious process was based on microbiologic or pathologic data as well as on clinical and radiologic follow-up. Results: Two hundred seventeen patients underwent 243 PET/CT studies in search of a focal source of infection and were included in the study. Sixty-seven studies were excluded from further analysis because of a final noninfectious etiology or lack of further follow-up or details regarding the antibiotic treatment. The final study population included 176 18F-FDG PET/CT studies in 153 patients (107 men, 46 women; age range, 18-86 y). One hundred nineteen studies (68%) were performed in patients receiving antibiotic therapy for a range of 1-73 d. A diagnosis of infection was made in 107 true-positive cases (61%), including 63 studies (59%) in patients receiving appropriate antibiotic therapy started before the performance of the 18F-FDG PET/CT study. There were 52 true-negative (29%) and 17 false-positive (10%) 18F-FDG PET/CT studies. No false-negative results were found. Conclusion:18F-FDG PET/CT correctly identified foci of increased uptake compatible with infection in most patients, including all patients receiving appropriate antimicrobial therapy, with no false-negative cases. On the basis of the current study results, the administration of antibiotics appears to have no clinically significant impact on the diagnostic accuracy of 18F-FDG PET/CT performed for evaluation of known or suspected infectious processes.

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