Diagnostic and therapeutic impact of whole body positron emission tomography using fluorine-18-fluoro-2-deoxy-D-glucose in children with chronic granulomatous disease

Aims-To compare whole body positron emission tomography (PET) using fluorin e-18-fluoro-2-deoxy-D-glucose (FDG) with computed tomography (CT) in detect ing active infective foci in children with chronic granulomatous disease. Methods-We performed 22 whole body FDG PET studies in seven children with X linked (n = 6) or autosomal recessive (n = 1) CGD. All had clinical signs of infection and/or were evaluated prior to bone marrow transplantation (BM T). Nineteen PET studies were also correlated with chest and/or abdominal C T. All PET scans were interpreted blinded to the CT findings. Diagnoses wer e confirmed histologically and bacteriologically. Results-We detected 116 lesions in 22 FGD PETs and 126 lesions on 19 CTs. O nly two of the latter could be classified reliably as active lesions by vir tue of contrast enhancement suggesting abscess formation. PET excluded 59 l esions suspicious for active infection on CT and revealed 49 infective lesi ons not seen on CT. All seven active infective lesions were identified by P ET, allowing targeted biopsy and identification of the infective agent foll owed by specific antimicrobial treatment, surgery, or subsequent BMT. Conclusions-Identification of infective organisms is more precise if active lesions are biopsied. CT does not discriminate between active and inactive lesions. Whole body FDG PET can be used to screen for active infective les ions in CGD patients.