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. 2023 Aug 14;12(8):1041.
doi: 10.3390/pathogens12081041.

18FDG-PET/CT-Scans and Biomarker Levels Predicting Clinical Outcome in Patients with Alveolar Echinococcosis-A Single-Center Cohort Study with 179 Patients

Lynn Peters  1 , Wanjie Jiang  1 , Nina Eberhardt  2 , Jürgen Benjamin Hagemann  3 , Beate Grüner  1 , Dennis Tappe  4
Affiliations

18FDG-PET/CT-Scans and Biomarker Levels Predicting Clinical Outcome in Patients with Alveolar Echinococcosis-A Single-Center Cohort Study with 179 Patients

Lynn Peters et al. Pathogens. .

Abstract

Background: Alveolar echinococcosis (AE) is a severe larval tapeworm infection with a variable clinical course of the disease. Reliable imaging techniques and biomarkers are needed to predict the course of the disease. Methods: 179 AE patients that received PET/CT scans between 2008 and 2012 were retrospectively included. From stored blood samples taken on the day of the scan, levels of IgE, parasite-specific serology, amyloid A, C-reactive protein, soluble interleukin 2 receptor, cytokeratin fragments, eosinophilic cell count, and eosinophil cationic protein were measured. Additionally, the current clinical outcome (cured, stable, or progressive disease) after a median duration of 8 years after baseline examination was assessed. Ultimately, an ordinal logistic regression was conducted to evaluate which imaging parameters and biomarkers independently influence the clinical outcome. Results: In general, patients in need of medical treatment or with progressive disease, advanced PNM stages, and positive PET/CT scans exhibited higher levels of the respective biomarkers. However, only the parasite-specific serological markers and total IgE levels differed significantly between clinical groups, WHO PNM stages, and the results of the PET/CT scan. In the multivariate analysis, PET/CT results were a strong predictor of the clinical outcome (OR 8.908, 95%CI 3.019-26.285; p < 0.001), and age at baseline was a moderate predictor (OR 1.031, 95%CI 1.003-1.060; p = 0.029). Conclusions: The PET/CT scan is, preferably in combination with parasite-specific serology and IgE levels, a valuable tool in the clinical management of AE and is able to predict the course of the disease.

Keywords: 18FDG; Ck18F; Echinococcus multilocularis; Em2+; IgE; alveolar echinococcosis; cytokeratin fragments; positron-emission tomography; serology; soluble interleukin 2 receptor.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Levels of specific IgE (A) and total IgE (B) in patients with negative versus positive PET scan.
Figure 2
Figure 2
Levels of IHA IgG (A) and number of positive Em2+ assay results (B) in patients with positive versus negative PET scan.
Figure 3
Figure 3
Examples of PET-negative AE lesions (left side) and PET-positive AE lesions (right side). The pictures show in each category the PET/CT fusion image on the left and the contrast-enhanced CT scan on the right.
Figure 4
Figure 4
Levels of specific IgE (A) and total IgE (B) in relation to stage of disease.
Figure 5
Figure 5
Levels of IHA IgG (A) and numbers of positive Em2+ assay result (B) in relation to stage of disease.
Figure 6
Figure 6
Numbers of negative and positive PET/CT scans in relation to stage of disease.
Figure 7
Figure 7
Levels of specific IgE (A) and total IgE (B) in relation to clinical outcome.
Figure 8
Figure 8
Levels of IHA IgG (A) and number of positive Em2+ assay results (B) in relation to clinical outcome.
Figure 9
Figure 9
Numbers of negative and positive PET/CT scans in relation to clinical outcome.
See this image and copyright information in PMC

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