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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 2/2023

Open Access 27.09.2022 | Image of the Month

Ultra-low dose infection imaging of a newborn without sedation using long axial field-of-view PET/CT

verfasst von: N. D. van Rijsewijk, B. van Leer, O. V. Ivashchenko, E. H. Schölvinck, F. van den Heuvel, J. H. van Snick, R. H. J. A. Slart, W. Noordzij, A. W. J. M. Glaudemans

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 2/2023

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  A 10-week-old newborn presenting with Staphylococcus aureus sepsis of unknown origin was referred to our nuclear medicine department for 18F-FDG PET/CT imaging. His medical history consisted of several congenital defects, including Fallot’s tetralogy and jejunal atresia. A total body 18F-FDG PET/CT imaging was performed in 3 min (1-bed position) without sedation on the Biograph Vision Quadra system (Siemens Healthineers, Erlangen, Germany) using only 12 MBq of activity, representing less than half of the minimum activity recommended by the EANM dose chart [1]. Effective patient dose was 1.3 mSv for internal radiation (PET) [2], while external radiation from low-dose CT contributed an additional 0.65 mSv [3]. Values remained at least two times below international recommendations [1, 4].
The scan showed normal physiological uptake in the kidneys, bladder, myocardium, and developing brain, including physiological hypometabolism in the frontal cortex (A). The intense 18F-FDG uptake in the mouth region is due to the use of a pacifier (A, B). Two infectious foci were detected: the first at the dorsum of the right foot (A and B: green arrow) around the intravenous access line and the second at the bottom of the right atrium near the entrance of the inferior caval vein (C: yellow arrow). Reactive bone marrow uptake is also visible (A). Ultrasound of the foot revealed a subcutaneous abscess, which was drained; culturing detected S. aureus. The 18F-FDG uptake in the heart corresponded with a solid, echodense structure suggestive of a thrombus or vegetation. This is seen on transthoracic echocardiography (D: blue arrow) at the eustachian valve (usually absent by adulthood), indicative of possible endocarditis. The patient improved under antibiotic therapy.
This case confirms the power to image infections at such a young age by using ultrafast long axial field-of-view (LAFOV) PET/CT with ultra-low dose administered activity without the need for sedation [5].

Declarations

Ethics approval

This article does not contain any research studies with human participants performed by any of the authors.
Not required.

Conflict of interest

Partnership of UMCG-Siemens for building the future of Health (PUSH). Siemens was not involved in the imaging process nor in the writing phase of this case.
Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.

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Literatur
2.
Zurück zum Zitat ICRP. Radiation dose to patients from radiopharmaceuticals Addendum 3 to ICRP Publication 53. ICRP Publication 106. Ann ICRP. 2008;38(1–2):1–197. ICRP. Radiation dose to patients from radiopharmaceuticals Addendum 3 to ICRP Publication 53. ICRP Publication 106. Ann ICRP. 2008;38(1–2):1–197.
3.
Zurück zum Zitat Valentin J, International Commission on Radiation Protection. Managing patient dose in multi-detector computed tomography(MDCT). ICRP Publication 102. Ann ICRP. 2007;37(1):1–79. Valentin J, International Commission on Radiation Protection. Managing patient dose in multi-detector computed tomography(MDCT). ICRP Publication 102. Ann ICRP. 2007;37(1):1–79.
5.
Zurück zum Zitat Slart RHJA, Tsoumpas C, Glaudemans AWJM, Noordzij W, Willemsen ATM, Borra RJH, et al. Long axial field of view PET scanners: a road map to implementation and new possibilities. Eur J Nucl Med Mol Imaging. 2021;48(13):4236–45.CrossRef Slart RHJA, Tsoumpas C, Glaudemans AWJM, Noordzij W, Willemsen ATM, Borra RJH, et al. Long axial field of view PET scanners: a road map to implementation and new possibilities. Eur J Nucl Med Mol Imaging. 2021;48(13):4236–45.CrossRef
Metadaten
Titel
Ultra-low dose infection imaging of a newborn without sedation using long axial field-of-view PET/CT
verfasst von
N. D. van Rijsewijk
B. van Leer
O. V. Ivashchenko
E. H. Schölvinck
F. van den Heuvel
J. H. van Snick
R. H. J. A. Slart
W. Noordzij
A. W. J. M. Glaudemans
Publikationsdatum
27.09.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 2/2023
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-022-05979-3

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