Fluorodeoxyglucose Positron Emission Tomography Detects the Inflammatory Phase of Sclerosing Peritonitis

Abstract

We studied the effectiveness of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting inflammation in known or suspected cases of sclerosing peritonitis in patients on peritoneal dialysis (PD). We undertook FDG-PET scanning in PD patients presenting with symptoms or signs suggestive of sclerosing peritonitis (SP), and in patients on long-term PD with no symptoms of SP. The study was performed in a PD unit in a tertiary-care hospital. Three patients with known or strongly suspected SP underwent FDG-PET scans, 1 within 3 months of presentation with symptoms and 2 who were scanned more than 9 months after presentation. One patient was scanned at an early and a late time point. Five patients who had been on PD for more than 5 years and who were asymptomatic also underwent FDG-PET scanning. Scans were interpreted by a specialist in nuclear medicine. The scan performed in the early stages of SP showed increased peritoneal uptake. However, three scans taken more than 9 months after presentation with suspected SP showed mild peritoneal abnormalities only. One of 5 asymptomatic long-term PD patients showed increased peritoneal uptake associated with loss of ultrafiltration and high transporter status. FDG-PET scanning may be a useful adjunct in the diagnosis of the acute phase of SP. More study is needed to define its role in the diagnosis of SP in asymptomatic PD patients.