Role of PET/CT in Diagnosis and Treatment

Introduction

Liver cyst infection is a rare but potentially life-threatening complication in patients with autosomal dominant polycystic kidney disease (ADPKD), particularly those who have undergone kidney transplantation. Diagnosis remains challenging due to nonspecific symptoms and the limitations of conventional imaging techniques. However, positron emission tomography/computed tomography (PET/CT) has emerged as a valuable tool in both diagnosing and monitoring these infections.

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Case Report Summary

64-year-old kidney transplant patient with ADPKD presented with:
Fever & abdominal pain
Weakness & appetite loss
Chronic cholestasis & multiple infections history

Key Diagnostic Findings:

• Elevated CRP levels (140 mg/L) & leukocytosis
• CT scan suggested peritoneal carcinomatosis but was inconclusive.
• PET/CT confirmed metabolic activity indicating liver cyst infection.

Treatment & Follow-up

Initial Therapy: Antibiotics (Piperacillin/Tazobactam, later switched to Meropenem)
Persistent Infection: Despite antibiotics, inflammation markers remained elevated, and fever recurred.
Intervention Required: Percutaneous drainage of the infected liver cyst
Final Outcome: PET/CT showed successful resolution after 6 weeks of treatment.

Why PET/CT is Crucial in ADPKD Liver Cyst Infections

Higher Sensitivity & Accuracy – Superior to ultrasound, MRI, and CT for detecting infected cysts.
Guides Treatment Decisions – Helps assess antibiotic efficacy and the need for cyst drainage.
Reduces Misdiagnosis – Avoids confusion with cystic hemorrhage or malignancy.

Key Takeaways for Clinicians

Consider PET/CT in suspected liver cyst infections where standard imaging is inconclusive.
Early intervention with antibiotics & drainage can prevent severe complications.
Monitor CA19-9 levels & CRP to assess treatment response.

Read the full study: https://doi.org/10.29328/journal.jcn.1001019

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