Research Article: Determining the usefulness of systematic 18F-FDG PET/CT for the management of invasive fungal infection (PETIFI project): a prospective national multicentre cohort study protocol
Abstract:
Introduction The evaluation of staging and activity of invasive fungal infection (IFI) is used to adjust the type and duration of antifungal therapy (AT). Typically anatomy-based imaging is used. Positron emission tomography/CT with 18 F-fluorodeoxyglucose ( 18 F-FDG PET/CT) not only evaluates more than one body area in one session, but adds functional information to the anatomic data provided by usual imaging techniques and can potentially improve staging of IFI and monitoring of the response to therapy. Our objective is to analyse the impact of the systematic use of 18 F-FDG PET/CT in IFI diagnostic and therapeutic management. Methods and analysis Multicentre prospective cohort study of IFI with performance of systematic 18 F-FDG PET/CT at diagnosis and follow-up that will be carried out in 14 Spanish tertiary hospitals. It is planned to include 224 patients with IFI over a 2-year study period. Findings and changes in management before and after 18 F-FDG PET/CT will be compared. Additionally, the association of initial quantitative 18 F-FDG PET/CT parameters with response to therapy will be evaluated. The primary endpoint is to compare the yield of 18 F-FDG PET/CT with standard management without 18 F-FDG PET/CT in IFI at initial assessment (staging) and in monitoring the response to treatment. The impact of the results of 18 F-FDG PET/CT on the diagnostic-therapeutic management of patients with IFI (added value), as well as the prognostic ability of different quantification parameters of 18 F-FDG PET/CT will be secondary endpoints. Ethics and dissemination The Clinical Research Ethics Committee of Puerta de Hierro-Majadahonda University Hospital approved the protocol of the study at the primary site. We plan to publish the results in high-impact journals. Trial registration number NCT05688592 .
Introduction:
The diversity of clinical manifestations of invasive fungal infection (IFI) is greater than that caused by most micro-organisms and reflects a complex fungus/host interaction. In addition, the clinical and imaging manifestations in the initial stages are subtle. Multi-organ dissemination can occur, and it is frequently observed in immunocompromised patients. Besides, the evaluation of the response in IFI is complicated due to the absence of reliable markers for follow-up. The duration of treatment is not…
Read more