Value of 18-F-FDG PET/CT in assessment of patients with fever of unknown origin

Abdelrahman, Sherif Fathy; Elsayed, Nahla Dessoki; El-nasr, Safaa Ibrahim Saif; Gadalla, Amr A. Elfattah Hassan

doi:10.1016/j.ejrnm.2017.12.015

Cited by 8 publications

(2 citation statements)

References 17 publications

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“…Among the 40 cases with FUO in our study, PET/CT was able to accurately confirm/exclude the diagnosis in 35 cases with diagnostic accuracy of 87.5%. This is close to the reported accuracy in the previous similar studies as those done by Tokmak et al [ 31 ] and Abdelrahman et al [ 32 ] (90% and 94.5%, respectively).…”

Section: Discussionsupporting

confidence: 92%

Diagnostic value of FDG-PET/CT in fever of unknown origin

Elshalakani

Chalabi

Hanafy

et al. 2022

Egypt J Radiol Nucl Med

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Background Fever of unknown origin (FUO) is a challenging clinical problem in medicine that needs collaboration of various diagnostic techniques to establish the accurate diagnosis. We evaluated the diagnostic performance of 18F-FDG PET/CT in patients who presented themselves with FUO. Our study included 40 patients with FUO who underwent PET/CT examination and their results were compared to the results of laboratory, histopathological, microbiological investigations and/or response to therapy. Results The final diagnosis included malignancy in 20 patients (50%), infectious causes in 7 patients (17.5%) and non-infectious inflammatory causes in 6 patients (15%). Fever resolved without diagnosis in 4 patients (10%), while no definite diagnosis was reached in 3 patients (7%). PET/CT successfully contributed to diagnosis of 35 out of 40 patients with diagnostic accuracy of 87.5%. The sensitivity, specificity, positive predictive value and negative predictive value of PET/CT in our study were 93.5%, 66.7%, 90.6% and 75%, respectively. Conclusion PET/CT is a useful tool to investigate and diagnose the cause of FUO. It provides information that can guide the treatment strategy of the patients.

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Section: Discussionsupporting

confidence: 92%

Diagnostic value of FDG-PET/CT in fever of unknown origin

Elshalakani

Chalabi

Hanafy

et al. 2022

Egypt J Radiol Nucl Med

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“…Unpublished data from 5 studies were provided by the authors. Finally, after excluding 84 citations, a total of 13 publications met our eligibility criteria, [ 12 – 24 ] including 4 studies (128 patients) on PET results and 9 studies (418 patients) evaluating PET/CT results (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Association of 18F-FDG PET or PET/CT results with spontaneous remission in classic fever of unknown origin

et al. 2018

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EANM consensus document on the use of [18F]FDG PET/CT in fever and inflammation of unknown origin

Hess,

Noriega-Álvarez,

Leccisotti

et al. 2024

Eur J Nucl Med Mol Imaging

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Purpose Patients with fever and inflammation of unknown origin (FUO/IUO) are clinically challenging due to variable clinical presentations with nonspecific symptoms and many differential diagnoses. Positron emission tomography/computed tomography (PET/CT) with 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) is increasingly used in FUO and IUO, but the optimal diagnostic strategy remains controversial. This consensus document aims to assist clinicians and nuclear medicine specialists in the appropriate use of [18F]FDG-PET/CT in FUO and IUO based on current evidence. Methods A working group created by the EANM infection and inflammation committee performed a systematic literature search based on PICOs with “patients with FUO/IUO” as population, “[18F]FDG-PET/CT” as intervention, and several outcomes including pre-scan characteristics, scan protocol, diagnostic yield, impact on management, prognosis, and cost-effectiveness. Results We included 68 articles published from 2001 to 2023: 9 systematic reviews, 49 original papers on general adult populations, and 10 original papers on specific populations. All papers were analysed and included in the evidence-based recommendations. Conclusion FUO and IUO remains a clinical challenge and [18F]FDG PET/CT has a definite role in the diagnostic pathway with an overall diagnostic yield or helpfulness in 50–60% of patients. A positive scan is often contributory by directly guiding treatment or subsequent diagnostic procedure. However, a negative scan may be equally important by excluding focal disease and predicting a favorable prognosis. Similar results are obtained in specific populations such as ICU-patients, children and HIV-patients.

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Value of 18-F-FDG PET/CT in assessment of patients with fever of unknown origin

Cited by 8 publications

References 17 publications

Diagnostic value of FDG-PET/CT in fever of unknown origin

Diagnostic value of FDG-PET/CT in fever of unknown origin

Association of 18F-FDG PET or PET/CT results with spontaneous remission in classic fever of unknown origin

EANM consensus document on the use of [18F]FDG PET/CT in fever and inflammation of unknown origin

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