Utility of F-Fluorodeoxyglucose Positron Emission Tomography in Evaluating Disseminated Nontuberculous Mycobacterial Infection in Patients With Anti-interferon-γ Autoantibodies.
Journal
Open forum infectious diseases
Journal Volume
11
Journal Issue
12
Start Page
論文號碼 ofae708
ISSN
2328-8957
Date Issued
2024-12-01
Author(s)
Chuang, Pei-Ju
Lan, Wei-Cheng
Lin, Chi-Ying
Abstract
Background: Managing disseminated nontuberculous mycobacterial (NTM) infection in patients with neutralizing anti-interferon-γ autoantibodies (AIGAs) poses substantial challenges due to the lack of established treatment guidance and predictive tools for clinical outcomes. In this study, we investigated the utility of 18F-fluorodeoxyglucose (2-[18F]FDG) positron emission tomography (PET) in guiding treatment decisions, with a focus on its ability to predict rehospitalization outcomes.
Methods: We conducted a post hoc analysis of the first available 2-[18F]FDG PET scans of patients with AIGAs and disseminated NTM infection from a prospective observational multicenter cohort. Cox proportional hazards regression was used to determine predictors for disease-related rehospitalization within 1 year of the examination.
Results: Of the patients with AIGAs evaluated, 41.9% required rehospitalization within 1 year following the initial 2-[18F]FDG PET evaluation. Slowly growing mycobacteria were isolated in 64.5% of patients. Multivariable analysis identified splenic involvement (adjusted hazard ratio, 7.97; 95% CI, 2.34-27.16; P < .001) as a significant predictor of disease-related rehospitalization within 1 year following the examination. Moreover, mediastinal node involvement (adjusted odds ratio, 14.77; 95% CI, 1.01-216.76; P = .049) and axial skeleton involvement (adjusted odds ratio, 14.93; 95% CI, 1.11-201.43; P = .042) were significantly associated with the isolation of slowly growing mycobacteria.
Conclusions: 2-[18F]FDG PET appears useful in initial evaluation of disease extent and microbiology in patients with AIGAs and disseminated NTM infection. Identifying splenic involvement through this modality may help recognize patients at increased risk of disease-related rehospitalization within 1 year. These findings suggest that 2-[18F]FDG PET could inform management decisions in this challenging population.
Subjects
PET
anti-interferon-gamma autoantibodies
fluorodeoxyglucose F18
immunodeficiency
nontuberculous mycobacterial infection
SDGs
Type
journal article