

@article {2917,
	title = {The role of delayed 18F-{FDG} {PET} imaging in the follow-up of patients with alveolar echinococcosis},
	journal = {Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine},
	volume = {54},
	number = {3},
	year = {2013},
	month = {mar},
	pages = {358{\textendash}363},
	abstract = {(18)F-FDG PET has already proved its usefulness in the follow-up of patients with alveolar echinococcosis (AE) and has been proposed as a surrogate marker for therapeutic decisions on structured treatment interruption by benzimidazoles. However, standard PET acquisition (1 h after (18)F-FDG injection) lacks sensitivity, and the parasite may stay viable even if (18)F-FDG perilesional uptake has disappeared. The aim of our study was to evaluate the usefulness of delayed (18)F-FDG PET in the management of AE patients. METHODS: During a 6-y period, 120 PET scans using (18)F-FDG were obtained for 70 AE patients treated by benzimidazoles, without selection. All patients underwent whole-body imaging on a PET/CT device 1 h after (18)F-FDG injection (4 MBq/kg), as well as an acquisition focused on the liver 3 h after the injection. We also analyzed the results of serologic tests. RESULTS: Of the 57 scans considered negative at the standard acquisition, 13 (22.8\%) became clearly positive at the delayed acquisition, and 6 (10.5\%) became indeterminate at the delayed acquisition. Furthermore, 20 of 22 scans interpreted as indeterminate at the standard acquisition were considered positive because of clear perilesional (18)F-FDG uptake at the delayed acquisition. Thus, delayed acquisition changed the interpretation in 32.5\% of cases. Moreover, of 44 patients treated by benzimidazoles and followed for more than 2 y by regular (18)F-FDG PET scans and specific AE serology, 11 (25\%) presented pathologic (18)F-FDG uptake at the delayed acquisition but not at the standard one. In these patients, the treatment was continued despite negative results on standard (18)F-FDG PET and negative serologic findings. On the other hand, in 7 patients with negative delayed (18)F-FDG PET and negative serology, the treatment was safely interrupted with no evidence of disease recurrence during 8-37 mo (mean, 23 mo). CONCLUSION: Our study clearly demonstrated that delayed (18)F-FDG PET greatly facilitated the differentiation between active and inactive liver lesions in AE patients. Also, our results strongly suggested that the combination of delayed (18)F-FDG PET and specific serology would prevent most of the recurrences observed after premature interruption of the treatment based only on standard (18)F-FDG PET.},
	keywords = {80 and over, Adolescent, Adult, Aged, Animals, Anthelmintics, Antigens, Benzimidazoles, Child, Echinococcosis, Echinococcus, Female, Fluorine Radioisotopes, Fluorodeoxyglucose F18, Helminth, Hepatic, Humans, Male, Middle Aged, Positron-Emission Tomography, Preschool, Prospective Studies, Radiopharmaceuticals, Recurrence, Time Factors, Young Adult},
	issn = {1535-5667},
	doi = {10.2967/jnumed.112.109942},
	author = {Caoduro, C{\'e}cile and Porot, Cl{\'e}mence and Vuitton, Dominique A. and Bresson-Hadni, Solange and Grenouillet, Fr{\'e}d{\'e}ric and Richou, Carine and Boulahdour, Hatem and Blagosklonov, Oleg}
}
