Utility of 18F-FDG PET/CT for Suspected Infection in the Inpatient Setting: a Single Centre Retrospective Cohort Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 266
- 试验地点
- 1
- 主要终点
- Diagnostic yield
研究概览
简要总结
Retrospective cohort study of inpatients at a South Australian tertiary hospital who underwent 18F FDG-PET/CT for investigation of undifferentiated fever or inflammatory syndrome. The aim is to investigate the utility of FDG-PET/CT in the investigation of suspected infection in hospitalised adults. To establish the rate at which FDG-PET/CT contributes to a diagnosis, and how this impacts clinical management and outcomes. From this, to develop further understanding of for which patients this imaging modality contributes meaningfully to outcomes.
详细描述
A retrospective cohort study of consecutive adult inpatients undergoing 18F-FDG PET/CT for suspected infection or inflammation, excluding infective endocarditis and malignancy-directed scans. Pre-PET variables include inflammatory markers, microbiological results, prior imaging findings and infectious diseases (ID) consultation. PET/CT utility will be adjudicated as diagnostic and/or associated with a change in management using a structured consensus process. Associations between pre-PET factors and clinical utility will be explored using descriptive and logistic analyses.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Inpatient at the Royal Adelaide Hospital
- •FDG-PET/CT between 1st January 2022 - 31st December 2023
- •Imaging request query included: infect* AND/OR Fever of Unknown Origin OR FUO AND/OR Pyrexia of Unknown Origin OR PUO AND/OR inflammat*
排除标准
- •- Outpatient PET/CT
- •Comparison imaging for established diagnosed infection
- •PET/CT intended for evaluation of malignancy
- •Evaluation of presumed or confirmed infective endocarditis
- •Age less than 18 years
研究组 & 干预措施
Low CRP prior to PET
干预措施: 18F-FDG PET/CT (Diagnostic Test)
Infectious diseases consultation
干预措施: 18F-FDG PET/CT (Diagnostic Test)
No infectious diseases consultation
干预措施: 18F-FDG PET/CT (Diagnostic Test)
Significant pre-PET imaging finding
干预措施: 18F-FDG PET/CT (Diagnostic Test)
No significant pre-PET imaging finding
干预措施: 18F-FDG PET/CT (Diagnostic Test)
High blood WCC prior to PET
干预措施: 18F-FDG PET/CT (Diagnostic Test)
Low WCC prior to PET
干预措施: 18F-FDG PET/CT (Diagnostic Test)
High CRP prior to PET
干预措施: 18F-FDG PET/CT (Diagnostic Test)
结局指标
主要结局
Diagnostic yield
时间窗: 30 days
• Did PET contribute to diagnostic yield?: * 1 = Yes: PET led to a finding either definitive e.g. confirmed by gold standard (microbiology, histopathology, intraoperative findings etc) or contributory, which guided diagnosis or management even without gold standard confirmation. Examples of contributory: PET showing vascular graft uptake, not explanted due to risk but presumptively treated Vertebral discitis suggested by PET, biopsied without culture, but presumptively treated and clinically improved PET negative - antibiotics ceased, patient remained well * 0 = No: PET provided no new information, was misleading (i.e. PET result contradicted by later results), or no action was taken based on PET
次要结局
- Clinical change in management(30 days)
- Change in antimicrobial management(30 days)
- Final diagnosis(30 days)
研究者
James Kimber
Dr
University of Adelaide