Diagnostic value of F-18 FDG PET/CT in fever or inflammation of unknown origin in a large single-center retrospective study

Weitzer, Friedrich; Hooshmand, Tina Nazerani; Pernthaler, Birgit; Sorantin, Erich; Aigner, Reingard

doi:10.1038/s41598-022-05911-7

Cited by 17 publications

(8 citation statements)

References 37 publications

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“…These results are also consistent with studies by Berrevoets et al and Vos et al which reported that use of 18 F-FDG PET/CT was associated with improved outcome in S aureus bacteremia [18,19]. 18 F-FDG PET/CT resulted in a change in management for about 30% of patients with fever of unknown cause (FUO/FUE) which is slightly lower than previously reported data in the literature where clinical utility for FUO has ranged from 33% to 54% [16,[20][21][22][23]. Heterogeneity in the definitions of 'clinical utility' may account for this wide range.…”

Section: Klebsiella Oxytoca + Lactobacillus Rhamnosussupporting

confidence: 91%

Real-world assessment of the clinical utility of whole body 18F-FDG PET/CT in the diagnosis of infection

et al. 2022

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Few studies have aimed to capture the full spectrum of 18fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT) use for evaluation of infections in a real-world context. We performed a retrospective chart review of hospitalized patients who underwent 18F-FDG PET/CT for the workup of infection between April, 2013 and September, 2019. The clinical indications for and impact of 18F-FDG PET/CT on diagnostic and antimicrobial management were evaluated across different infectious indications. Sixty-one patients met the inclusion criteria. The most common indication was identifying a source of a known infection (46%), followed by fever of unknown etiology (FUE)/fever of unknown origin (FUO) (38%), and other (16%). 18F-FDG PET/CT was determined to have had a diagnostic or management clinical impact for a total of 22 patients (36%) including 12/28 (43%) of patients with known infection, 7/23 (30%) of patients with FUE/FUO, and 3/10 (30%) of patients with other indications. 18F-FDG PET/CT confirmed suspected prosthetic endovascular infection for 6/16 (38%) patients. In this study,18F-FDG PET/CT led to a clinical impact on diagnostic and treatment management of hospitalized patients across a variety of syndromes and particularly for source identification in the setting of known infection.

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Section: Klebsiella Oxytoca + Lactobacillus Rhamnosussupporting

confidence: 91%

Real-world assessment of the clinical utility of whole body 18F-FDG PET/CT in the diagnosis of infection

et al. 2022

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“…F-18 FDG PET/CT in patients followed up because of FUO/IUO was determined to have 88.1% sensitivity (95% CI: 74-96%), 37.5% specificity (95% CI: 15-64%), and 74.14% diagnostic accuracy (95% CI: 60-84%). The results of a newly published study showed a sensitivity of 80.2% and specificity of 89.8% for F-18 FDG PET/CT in contributing to the final diagnosis [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Value of Fluoro-18 Fluorodeoxyglucose (F-18 FDG) PET/CT in Fever or Inflammation of Unknown Origin: A Retrospective Study at a Rheumatology Clinic

Öğüt¹,

Erbasan²,

Terzioğlu³

et al. 2022

Cureus

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Introduction Further diagnostic procedures are necessary for patients with fever of unknown origin (FUO) and unknown cause of inflammation (inflammation of unknown origin - IUO) for the identification of the definitive diagnosis. The aim of this study was to evaluate the contribution and roles of F-18 FDG PET/CT (fluoro-18 fluorodeoxyglucose-positron emission tomography/computed tomography) in the diagnostic process of patients with FUO/IUO. Methods The data of 58 patients who had F-18 FDG PET/CT scans for FUO/IUO were re-evaluated retrospectively. The relationships between definitive diagnosis and fluorodeoxyglucose uptake and SUVmax (maximum standardized uptake value) were examined. Results Rheumatic disease was diagnosed in 26 patients (44.5%), malignancy in 20 patients (34.5%), and infectious diseases in six patients (10.3%). The most prevalent rheumatic disease in patients with FUO/IUO was systemic vasculitis (n:10, 17.2%), especially large vessel vasculitis. There were 37 patients (63.7%) with clinically significant true positive fluorodeoxyglucose uptake. True positive fluorodeoxyglucose uptake was significantly higher in patients diagnosed with malignancy (85%, 17/20 patients) compared to other diagnoses. Fluorodeoxyglucose uptake above physiological levels was determined in 15 of the 26 patients (57.6%) diagnosed with rheumatic diseases. Conclusion The results of this study showed that F-18 FDG PET/CT is a useful imaging modality in FUO/IUO patients, who present a challenging diagnostic process for clinicians. In addition to malignancies, the presence of chronic inflammatory diseases, especially early period systemic vasculitis, were diagnosed in these patients.

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“…Another study showed reduced cerebral blood flow during CM using an FDG-PET in a murine model of experimental CM. FDG-PET was recently used systematically in a cohort of patients to help the diagnosis of fever of unknown origin [120], showing that this approach might become available to CM patients soon and may be able to complement the ongoing MRI studies to shed some light on the pathophysiological processes during the neurological syndrome.…”

Section: Investigative Neuro-imaging Toolsmentioning

confidence: 99%

Genetics of cerebral malaria: pathogenesis, biomarkers and emerging therapeutic interventions

et al. 2022

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Background Cerebral malaria (CM) is a preeminent cause of severe disease and premature deaths in Sub-Saharan Africa, where an estimated 90% of cases occur. The key features of CM are a deep, unarousable coma that persists for longer than 1 h in patients with peripheral Plasmodium falciparum and no other explanation for encephalopathy. Significant research efforts on CM in the last few decades have focused on unravelling the molecular underpinnings of the disease pathogenesis and the identification of potential targets for therapeutic or pharmacologic intervention. These efforts have been greatly aided by the generation and study of mouse models of CM, which have provided great insights into key events of CM pathogenesis, revealed an interesting interplay of host versus parasite factors that determine the progression of malaria to severe disease and exposed possible targets for therapeutic intervention in severe disease. Main Body This paper reviews our current understanding of the pathogenic and immunologic factors involved in CM. We present the current view of the roles of certain gene products e.g., the var gene, ABCA-1, ICAM-1, TNF-alpha, CD-36, PfEMP-1 and G6PD, in CM pathogenesis. We also present alterations in the blood–brain barrier as a consequence of disease proliferation as well as complicated host and parasite interactions, including the T-cell immune reaction, reduced deformation of erythrocytes and cytoadherence. We further looked at recent advances in cerebral malaria treatment interventions by emphasizing on biomarkers, new diagnostic tools and emerging therapeutic options. Conclusion Finally, we discuss how the current understanding of some of these pathogenic and immunologic factors could inform the development of novel therapeutic interventions to fight CM.

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Diagnostic value of F-18 FDG PET/CT in fever or inflammation of unknown origin in a large single-center retrospective study

Cited by 17 publications

References 37 publications

Real-world assessment of the clinical utility of whole body 18F-FDG PET/CT in the diagnosis of infection

Real-world assessment of the clinical utility of whole body 18F-FDG PET/CT in the diagnosis of infection

The Diagnostic Value of Fluoro-18 Fluorodeoxyglucose (F-18 FDG) PET/CT in Fever or Inflammation of Unknown Origin: A Retrospective Study at a Rheumatology Clinic

Genetics of cerebral malaria: pathogenesis, biomarkers and emerging therapeutic interventions

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