Abstract: FR-PO314
Diagnosis of Renal Cyst Infection in Adult Polycystic Kidney Disease (ADPKD) Using 67-Gallium Citrate SPECT/CT: A Case Series
Session Information
- Cystic Kidney Diseases - II
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Genetic Diseases of the Kidney
- 801 Cystic Kidney Diseases
Authors
- Casillas, Ester, Hospital Universitario Ramón y Cajal, Madrid, Madrid, Spain
- Burguera, Victor, Hospital Universitario Ramón y Cajal, Madrid, Madrid, Spain
- Sosa Barrios, Haridian, Hospital Universitario Ramón y Cajal, Madrid, Madrid, Spain
- Delgado yagüe, Maria, Hospital Universitario Ramón y Cajal, Madrid, Madrid, Spain
- Rioja garcia, María eugenia, Hospital Universitario Ramon y cajal, Madrid, Spain
- Blanco, Laura V, Hospital Universitario Ramón y Cajal, Madrid, Madrid, Spain
- Rivera, Maite, Hospital Universitario Ramón y Cajal, Madrid, Madrid, Spain
Background
Renal cyst infection in ADPKD patients is challenging, as it can be the source of life-threatening sepsis and frequently lack localizing symptoms. Recent guidelines establish that intracystic material compatible with infection should be obtained for definite diagnosis. Gold standard imaging to do so is PET/CT, which is expensive and restrained to certain centers. We sought to determine whether 67-Gallium-citrate scintigraphy is a valuable and inexpensive alternative to orientate renal cyst infection in these patients.
Methods
Between January 2015 and January 2016 (both included), five patients with ADPKD diagnosis presented in our center with kidney cyst infection. 3 were female and 2 male with a mean age of 50.4 ±17 years (range 32-72 years). Two patients were on renal replacement therapy (one HD and one PD), one had a functioning renal transplant and the remaining two had CKD. The most frequent presenting symptoms of cyst infection were fever (n=5) and abdominal pain (n=4) (Table).
Results
Ultrasound (US) scanning of both kidneys was done in 4 patients (80%) and computed tomography (CT) in all of them. US was compatible with infected cyst in one patient (sensitivity of 33%) and CT in two patients. 67-Ga-citrate SPECT/CT was positive in 4 patients (80%) and true negative in 1, proving better sensitivity (100%) and specificity than US and CT. During follow-up, we used 67-Ga-citrate scintigraphy in those patients with initial positive results treated to assess resolution and decide whether antibiotics should be discontinued. Two patients (50%) showed persistent tracer uptake despite a complete course of appropriate antibiotics for 6 weeks.
Conclusion
67-Ga-citrate SPECT/CT is a non invasive and inexpensive study available in most centers. It can be used in all ADPKD patients with suspected renal cyst infection regardless of kidney function, being more cost-effective than PET/CT. Due to demonstrated potential as a diagnostic tool in this setting, we think it could be considered as an alternative to the PET/CT.