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The following is a summary of “[¹⁸F]FDG PET/CT identifies infectious and inflammatory foci in persistent critical illness,” published in the February 2025 issue of Annals of Intensive Care by Leer et al. 

Persistent critical illness continued for some individuals in the ICU despite the resolution of the initial diagnosis, driven by ongoing organ failure, secondary infections, and systemic inflammation, which [¹⁸F]–fluorodeoxyglucose positron emission tomography/computed tomography ([¹⁸F]FDG PET/CT) may help visualize.  

Researchers conducted a retrospective study at 2 centers to evaluate the effectiveness of [¹⁸F]FDG PET/CT in detecting infectious and inflammatory foci in individuals with persistent critical illness and its impact on therapy management.  

They included individuals admitted to the Intensive Care Unit (ICU) from 2017 to 2024 who underwent a [¹⁸ F]FDG PET/CT scan at least 10 days after admission. The [¹⁸F]FDG PET/CT reports were analyzed for diagnoses, and clinical records were reviewed to determine if the diagnosis was new, which diagnostics were conducted before PET/CT, and what therapeutic changes followed the scan. The association between inflammatory parameters and [¹⁸F]FDG PET/CT findings was assessed using a t-test or ANOVA.  

The results showed that 47 individuals with persistent critical illness were included in 2 university medical centers. The median time from admission to [¹⁸F]FDG PET/CT was 21 days (interquartile range [IQR] 14–28). A potential infectious or inflammatory focus was identified in 43 individuals (91%), with 34 (72%) being previously undetected. The [¹⁸F]FDG PET/CT was performed late in the diagnostic process, following a median of 7 (IQR 6.0–8.0) prior to diagnostic procedures. Therapy modifications occurred within 48 hours after PET/CT in 26 individuals (55%).  

Investigators concluded that [¹⁸F]FDG PET/CT identified numerous infectious and inflammatory foci in patients with persistently critical illness, leading to therapy adjustments. 

Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-025-01444-0