Optimal use of [18F]FDG-PET/CT in patients with fever or inflammation of unknown origin.
Q J Nucl Med Mol Imaging
; 65(1): 51-58, 2021 Mar.
Article
en En
| MEDLINE
| ID: mdl-31271266
ABSTRACT
BACKGROUND:
[18F]FDG-PET/CT is one of the most important diagnostic techniques in the work-up of patients with fever of unknown origin (FUO)/inflammation of unknown origin (IUO). Little is known on how to optimize the diagnostic value of [18F]FDG-PET/CT in patients with FUO/IUO.METHODS:
Retrospective study in all patients who underwent [18F]FDG-PET/CT during the work-up of FUO/IUO in a tertiary expert center between 2005 and 2014. Data were extracted from medical records.RESULTS:
One hundred and four patients were identified, of whom 68 had a final diagnosis (65.4%). Mainly infections (30.8%) and non-infectious inflammatory diseases (30.8%). [18F]FDG-PET/CT contributed to the final diagnosis in 47 of the 68 patients (69.1%). In 21 patients [18F]FDG-PET/CT did not help making a diagnosis. In ten of these patients [18F]FDG-PET/CT was performed while body temperature, CRP and ESR were normal or unknown. Sixteen of 104 patients underwent repeated [18F]FDG-PET/CT. The second scan contributed to the final diagnosis in five of these patients. In two of these patients, the first scan retrospectively was truly non-contributory. In both patients the first [18F]FDG-PET/CT was made while CRP/ESR was low and fever was not present or not measured. A third or fourth scan never contributed to the final diagnosis when the second one did not.CONCLUSIONS:
[18F]FDG-PET/CT contributed to the final diagnosis in 45.2% of patients, but never contributed when both inflammatory parameters and body temperature were normal. Repeating [18F]FDG-PET/CT should only be done in patients with a non-contributory [18F]FDG-PET/CT when new symptoms or signs appear, or when the first scan was made in absence of fever or elevated inflammatory parameters.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Radiofármacos
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Fluorodesoxiglucosa F18
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Fiebre de Origen Desconocido
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Tomografía Computarizada por Tomografía de Emisión de Positrones
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Inflamación
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Año:
2021
Tipo del documento:
Article