FDG PET in Evaluation of Patients With Fever of Unknown Origin: AJR Expert Panel Narrative Review.
AJR Am J Roentgenol
; 221(2): 151-162, 2023 08.
Article
en En
| MEDLINE
| ID: mdl-36722759
ABSTRACT
Fever of unknown origin (FUO) is a diagnostic challenge, with its cause remaining undiagnosed in approximately half of patients. Nuclear medicine tests typically are performed after a negative or inconclusive initial workup. Gallium-67 citrate and labeled leukocytes were previous mainstays of radionuclide imaging for FUO, although they had limited diagnostic performance. FDG PET/CT has subsequently emerged as the nuclear medicine imaging test of choice, supported by a growing volume of evidence. A positive FDG PET/CT result contributes useful information by identifying potential causes of fever, localizing sites for further evaluation, and guiding further management; a negative result contributes useful information by excluding focal disease as the cause of fever and predicts a favorable prognosis. In 2021, CMS rescinded a prior national noncoverage determination for FDG PET for infection and inflammation, leading to increasing national utilization of FDG PET/CT for FUO workup. This article reviews the current status of the role of FDG PET/CT in the evaluation of patients with FUO. The literature reporting the diagnostic performance and yield of FDG PET/CT in FUO workup is summarized, with comparison with historically used nuclear medicine tests included. Attention is also given to the test's clinical impact; protocol, cost, and radiation considerations; and application in children.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Fluorodesoxiglucosa F18
/
Fiebre de Origen Desconocido
Tipo de estudio:
Guideline
/
Prognostic_studies
Límite:
Child
/
Humans
Idioma:
En
Revista:
AJR Am J Roentgenol
Año:
2023
Tipo del documento:
Article