Zanoni, Lucia

Varani, Stefania

Attard, Luciano

Morigi, Joshua James

Vanino, Elisa

Ortalli, Margherita

Fonti, Cristina

Viale, Pierluigi

Re, Maria Carla

Fanti, Stefano

Ambrosini, Valentina

2019-09

Visceral leishmaniasis (VL) is the most severe manifestation of the infection caused by the protozoan Leishmania, recently on increase in Italy and Spain. The aim of the study was to describe FDG uptake patterns in VL patients (pts) who underwent 18F-FDG PET/CT. A retrospective monocentric study of pts who underwent FDG PET/CT between 2008 and 2017 and later diagnosed with VL was performed. Semi-quantitative parameters were calculated in FDG-positive lesions: SUVmax, SUVmax spleen/SUVmax liver ratio (SLR), SUVmax focal/diffuse spleen ratio (FDR). Overall, 23 pts were included. PET/CT was negative in 2 immunocompromised pts, positive in 21/23 (91%) [6 spleen only, 2 spleen + nodes, 7 spleen + bone marrow (BM), 4 spleen + BM + nodes, 1 spleen + BM + lung, 1 BM only + nodes, 2 nodes only]. Splenic involvement was demonstrated in 20/23 (87%) pts. Two different splenic patterns were observed: diffuse (13/20 pts, mean spleen SUVmax = 7.3 ± 4.2 [4.0-14.1], mean SLR = 2.2 ± 1.6 [1.3-6.7]) and focal over diffuse (7/20 pts, mean SUVmax = 12.6 ± 4.5 [9.5-20.5], mean SLR = 2.8 ± 0.8 [2.1-4.4], mean FDR = 2.1 ± 0.8 [1.2-3.6]). Extra-splenic FDG-avid findings were detected in 15/21 pts (65%): bone marrow in 13/15 (mean SUVmax = 4.0 ± 1.3 [2.8-6.0]), nodes in 67/15 and lung in 1/15. PET/CT demonstrated splenic FDG uptake in all immunocompetent VL pts; two splenic patterns (diffuse/focal over diffuse) were observed and indistinguishable from splenic involvement by other disorders. The most frequent extra-splenic FDG-positive sites were BM and lymph nodes. Considering the potential disease aggressiveness and recent outbreaks in north-eastern Italy, VL should be considered in the differential diagnosis of FDG-positive splenic findings in pts from endemic areas or reporting travels to endemic countries.

Nuclear Medicine, S.Orsola-Malpighi Hospital, Azienda ospedaliero-universitaria di Bologna, Policlinico S.Orsola-Malpighi, Via Albertoni 15, 40138, Bologna, BO, Italy. lucia.zanoni@aosp.bo.it..

Unit of Microbiology, S.Orsola-Malpighi Hospital, Bologna, Italy.. Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy..

Unit of Infectious Diseases, S.Orsola-Malpighi Hospital, Bologna, Italy..

Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.. PET/CT Unit, Royal Darwin Hospital, 105 Rocklands drive, Tiwi, NT, Australia..

Unit of Infectious Diseases, S.Orsola-Malpighi Hospital, Bologna, Italy.. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy..

Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy..

Nuclear Medicine, S.Orsola-Malpighi Hospital, Azienda ospedaliero-universitaria di Bologna, Policlinico S.Orsola-Malpighi, Via Albertoni 15, 40138, Bologna, BO, Italy..

Unit of Infectious Diseases, S.Orsola-Malpighi Hospital, Bologna, Italy.. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy..

Unit of Microbiology, S.Orsola-Malpighi Hospital, Bologna, Italy.. Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy..

Nuclear Medicine, S.Orsola-Malpighi Hospital, Azienda ospedaliero-universitaria di Bologna, Policlinico S.Orsola-Malpighi, Via Albertoni 15, 40138, Bologna, BO, Italy.. Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy..

Nuclear Medicine, S.Orsola-Malpighi Hospital, Azienda ospedaliero-universitaria di Bologna, Policlinico S.Orsola-Malpighi, Via Albertoni 15, 40138, Bologna, BO, Italy.. Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy..

Annals of nuclear medicine 2019-09; 33(9): 716-723

http://orcid.org/0000-0002-6784-8220

https://pubmed.ncbi.nlm.nih.gov/31254270/?otool=iaurydwlib

https://hdl.handle.net/10137/7768

18F-FDG

Positron emission tomography computed tomography

Splenomegaly

Visceral leishmaniasis

18F-FDG PET/CT in visceral leishmaniasis: uptake patterns in the context of a multiannual outbreak in Northern Italy.

Journal Article

Publication