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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Contribution of 18F-FDG PET/CT imaging in the diagnosis and management of HIV-po...
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Vol. 41. Issue 5.
Pages 275-283 (September - October 2022)
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Vol. 41. Issue 5.
Pages 275-283 (September - October 2022)
Original Article
Contribution of 18F-FDG PET/CT imaging in the diagnosis and management of HIV-positive patients
Contribución de las imágenes PET/TC con 18F-FDG en el diagnóstico y manejo de pacientes VIH-positivos
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Gamze Tatara,
Corresponding author
gamze_tatar@hotmail.com

Corresponding author.
, Tevfik Fikret Çermikb, Göksel Alçınb, Ozge Erol Fenercioglub, Ayşe İncic, Ediz Beyhanb, Nurhan Ergülb
a University of Health Sciences, Istanbul Bagcılar Training and Research Hospital, Department of Nuclear Medicine, Istanbul, Turkey
b University of Health Sciences, Istanbul Training and Research Hospital, Department of Nuclear Medicine, Istanbul, Turkey
c University of Health Sciences, Istanbul Training and Research Hospital, Department of Infectious Disease, Istanbul, Turkey
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Abstract
Introduction and objectives

The human immunodeficiency virus [HIV] is a lentevirus, primarily infects certain cells of the immune system, thereby greatly weakens the body’s own defenses against diseases. This study was aimed to explore the value and significance of 18F-FDG PET/CT in the assessment of patients with HIV infection and to examine the presence of quantitative alterations in 18F-FDG uptake among patients with HIV-related infections or malignant diseases in HIV-positive patients.

Patients and methods

Forty patients with HIV infection were scanned on PET/CT system. The data were registered according to immune status, antiretroviral therapy, and definitive diagnosis. All pathologic lesions and disease related areas were described, 18F-FDG uptake patterns were evaluated. Semiquantitative analysis of 18F-FDG uptake was performed and SUVmax were calculated.

Results

Twenty-eight patients [70%] were diagnosed with HIV-related infection or malignant diseases. The sensitivity of PET/CT was shown to be 100% and the specificity 92% for concomitant diseases requiring additional treatment to antiretroviral therapy. The SUVmax and CD4 counts were not statistically different between HIV-related reactive lymphadenopathy, HIV-related malignancy, and HIV-related infections.

Conclusions

The pattern of distribution of nodal/extranodal uptake on 18F-FDG PET/CT may facilitate distinction between HIV-related generalized lymphadenopathies, HIV-related opportunistic infections, and malignancies. In this context, 18F-FDG PET/CT should be preferred for routine use in the management of patients infected with HIV.

Keywords:
18F-FDG PET/CT
HIV
Infection
Abstracto
Objetivo

El virus de la inmunodeficiencia humana [VIH] es un lentevirus, que infecta principalmente ciertas células del sistema inmunitario, por lo que debilita las defensas propias frente a las enfermedades. El objetivo de este estudio fue analizar el valor y significado de la PET/TC con 18F-FDG en la evaluación de pacientes con infección por VIH y determinar la presencia de diferencias cuantitativas de captación de 18F-FDG entre pacientes con infecciones relacionadas con el VIH o neoplasia maligna en pacientes VIH positivos.

Métodos

Se estudiaron cuarenta pacientes con infección por VIH mediante PET/TC con 18F-FDG. Se registró el estado inmunitario, el tratamiento antirretroviral y el diagnóstico definitivo de cada paciente. Se describieron todas las lesiones patológicas y áreas relacionadas con la enfermedad, se evaluaron los patrones de captación de 18F-FDG. Se realizó un análisis semicuantitativo de la captación de 18F-FDG mediante el calculó SUVmax.

Resultado

Veintiocho pacientes [70%] fueron diagnosticados con infección relacionada con el VIH o neoplasia maligna. La sensibilidad de la PET/TC con 18F-FDG fue del 100% y la especificidad del 92% para las enfermedades concomitantes que requerían tratamiento adicional a la terapia antirretroviral. El SUVmax y el recuento de CD4 no fueron estadísticamente diferentes entre la linfadenopatía reactiva relacionada con el VIH, la neoplasia maligna relacionada con el VIH y las infecciones relacionadas con el VIH.

Conclusion

El patrón de distribución de la captación ganglionar/extraganglionar en la PET/TC con 18F-FDG puede facilitar la distinción entre las adenopatías generalizadas relacionadas con el VIH, las infecciones oportunistas relacionadas con el VIH y las neoplasias malignas. En este contexto, se debe realizar el estudio PET/TC con 18F-FDG de forma rutinaria en el manejo de pacientes infectados por el VIH.

Palabras clave:
18F-FDG PET/TC
VIH
Infección

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