News | August 06, 2014

PET/CT Using FDG-labeled Leucocytes May Detect Infection in Acute Pancreatitis

August 6, 2014 — A new clinical study diagnosing infection in patients with pancreatic fluid collections may swiftly and accurately rule out active infection in the body. As reported in the August issue of The Journal of Nuclear Medicine, this treatment may assist in bringing nuclear medicine to the forefront of clinical management.

Acute pancreatitis (AP) is a sudden inflammation of the pancreas. It can have severe complications and high mortality despite treatment. While mild cases of AP are often successfully treated with conservative measures, such as nil per os (NPO) and aggressive intravenous fluid rehydration, severe cases may require admission to the intensive care unit or even surgery to deal with complications of the disease process. Early detection of infection in AP affects the choice of treatment and clinical outcome.

"Documenting infection of pancreatic necrosis/pancreatic or peripancreatic fluid collections is one of the key questions in managing such patients. So far only fine needle aspiration under radiological guidance could establish that with limitations of invasive procedure and at times insufficient amount of aspirate," said Anish Bhattacharya, M.D., lead author of the study "PET/CT using 18F-fluorodeoxyglucose-labeled autologous leucocytes in the diagnosis of infected fluid collections in acute pancreatitis." He continued, "The present study, for the first time, gives evidence of a non-invasive investigation that can answer the question of infected pancreatic fluid collections. It even distinguishes two collections, one with and the other without infection. It could also be used to follow up with such patients after a radiological or endoscopic intervention."

In the study, researchers from the Postgraduate Institute of Medical Education and Research, Chandigarh, India, studied 41 patients — 28 male and 13 female — aged 21-69 with AP and radiological evidence of fluid collection in or around the pancreas. Leucocytes were separated from the patient's venous blood, labeled with 18F-fluorodeoxyglucose (FDG) and re-injected intravenously, followed by positron emission tomography/computed tomography (PET/CT) imaging two hours later. A final diagnosis of infection was based on microbiological culture of fluid aspirated from the collection. Patients were managed with supportive care and antibiotics; percutaneous drainage/laparotomy were performed when indicated.

Blood glucose, total leucocyte count, neutrophil count and leucocyte labeling efficiency varied from 83 to 212 (118±30) mg/100ml, 4600 to 24,200 (11648 ± 5376)/mm3, 55% to 90% (73 ± 10) and 31% to 97% (81 ± 17) respectively. Increased tracer uptake was seen in the collection in 12 out of 41 patients; 10 had culture-proven infection and underwent percutaneous drainage, while aspiration was unsuccessful in two. The scan was negative for infection in 29 patients (25 out of 29 fluid cultures negative for infection and aspiration unsuccessful in four). Sensitivity, specificity and accuracy of the scan were 100% in 35 patients in whom fluid culture reports were available.

"This research uses a new technique to diagnose infection occurring in patients with pancreatic fluid collections. The patient is spared empirical antibiotic therapy or radiological intervention followed by time-consuming microbiological work-up," noted Bhattacharya.

The search for the ideal infection imaging radiopharmaceutical agent/technique has continued for several decades now, noted Bhattacharya. "This study suggests that PET-CT using FDG-labeled leucocytes may be useful in swiftly and accurately detecting or ruling out active infection in any part of the body, bringing nuclear medicine to the forefront of clinical management in these situations. This would encourage researchers to identify more such techniques in future," he said.

For more information: jnm.snmjournals.org

Related Content

Houston Methodist Hospital Enters Multi-Year Technology and Research Agreement With Siemens Healthineers
News | Imaging | August 17, 2017
Houston Methodist Hospital and Siemens Healthineers have entered into a multi-year agreement to bring cutting-edge...
Study Demonstrates First Human Application of Novel PET Tracer for Prostate Cancer

Transaxial 11Csarcosine hybrid PET/CT showed a (triangulated) adenocarcinoma in the transition zone of the anterior right prostate gland on PET (A), CT (B), and a separately obtained T2?weighted MR sequence (C) with resulting PET/MRI registration (D). Image courtesy of M. Piert et al., University of Michigan, Ann Arbor, Mich.

News | Radiopharmaceuticals and Tracers | August 16, 2017
In the featured translational article in the August issue of The Journal of Nuclear Medicine, researchers at the...
MRI Reveals Striking Brain Differences in People with Genetic Autism

Example images for a control participant , a deletion carrier, and a duplication carrier. In the sagittal image of the deletion carrier, the thick corpus callosum, dens and craniocervical abnormality, and cerebellar ectopia are shown. For the duplication carrier, the sagittal image shows the thin corpus callosum and the axial image shows the increased ventricle size and decreased white matter volume. Image courtesy of the Radiological Society of North America (RSNA).

News | Neuro Imaging | August 09, 2017
August 9, 2017 — In the first major study of its kind, researchers using magnetic...
Clinical Data Supports Use of Xoft System for Endometrial Cancer
News | Brachytherapy Systems | August 03, 2017
Researchers presented clinical data supporting use of the Xoft Axxent Electronic Brachytherapy (eBx) System for the...
brain with chronic traumatic injury
News | Magnetic Resonance Imaging (MRI) | August 02, 2017
Fighters are exposed to repeated mild traumatic brain injury (mTBI), which has been associated with neurodegenerative...
NIH-funded scientists have discovered that Parkinson’s disease increases the amount of “free” water in a particular brain area

NIH-funded scientists have discovered that Parkinson’s disease increases the amount of “free” water in a particular brain area. Image courtesy of David Vaillancourt, Ph.D., University of Florida.

News | Neuro Imaging | July 31, 2017
Scientists at the University of Florida have discovered a new method of observing the brain changes caused by Parkinson...
more healthcare providers and patients are choosing options such as Gamma Knife stereotactic radiosurgery
News | Radiation Therapy | July 31, 2017
Each year, up to 650,000 people who were previously diagnosed with various forms of cancer will develop brain...
"Residual Echo" of Ancient Humans May Hold Clues to Mental Disorders

MRI data shows (left) areas of the skull preferentially affected by the amount of Neanderthal-derived DNA and (right) areas of the brain’s visual system in which Neanderthal gene variants influenced cortex folding (red) and gray matter volume (yellow). Image courtesy of Michael Gregory, M.D., NIMH Section on Integrative Neuroimaging

News | Neuro Imaging | July 26, 2017
Researchers from the National Institute of Mental Health (NIMH) have produced the first direct evidence that parts of...
New York Hospital Finds Significant Cost Savings With Toshiba’s Aquilion One CT
News | Computed Tomography (CT) | July 25, 2017
In five years, Kaleida Health’s Stroke Care Center (SCC) at the Gates Vascular Institute in Buffalo, N.Y., has realized...
Overlay Init