Imaging a Fever—Redefining the Role of 2-deoxy-2-[18F]Fluoro-D-Glucose–Positron Emission Tomography/Computed Tomography in Fever of Unknown Origin Investigations

2020 ◽  
Author(s):  
William F Wright ◽  
Paul G Auwaerter ◽  
Elizabeth H Dibble ◽  
Steven P Rowe ◽  
Philip A Mackowiak
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fever Of Unknown Origin ◽  
Imaging Technique ◽  
Unknown Origin ◽  
Emission Tomography ◽  
18Fdg Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Abnormal Uptake

Abstract Growing evidence suggests that 2-deoxy-2-[18F]fluoro-D-glucose (18FDG)–positron emission tomography/computed tomography (PET/CT) is a useful imaging technique for the evaluation of fever of unknown origin (FUO). This imaging technique allows for accurate localization of foci of hypermetabolism based on 18FDG uptake in glycolytically active cells that may represent inflammation, infection, or neoplasia. The presence of abnormal uptake can help direct further investigation that may yield a final diagnosis. A lack of abnormal uptake can be reasonably reassuring that these conditions are not present, thereby avoiding unnecessary additional testing. Insurers have not routinely covered outpatient 18FDG-PET/CT for the indication of FUO in the United States. However, data published since 2007 suggest early use in FUO diagnostic evaluations improves diagnostic efficiency and reduces costs. Clinicians and insurers should consider 18FDG-PET/CT as a useful tool when preliminary studies are unrevealing.

scholarly journals Imaging for biopsies

2018 ◽  
Vol 5 (11) ◽  
pp. 4988
Author(s):  
Musaad AlBalood ◽  
Mohammed Almeshal
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Diagnostic Accuracy ◽  
Imaging Technique ◽  
Ct Imaging ◽  
The Other ◽  
Emission Tomography ◽  
Advanced Technique ◽  
Positron Emission ◽  
Pet Ct

Positron emission tomography/computed tomography (PET/CT) imaging technique is considered to be an advanced technique that emerged recently and has been successfully used to guide several procedures like obtaining biopsies and ablating tumors. In this review, we will thoroughly discuss the indications, uses, and advantages of guiding biopsies with PET/CT techniques, with main focus on the field of oncology. PET/CT techniques are considered to be emerging imaging modalities that have significantly improved diagnostic accuracy of biopsies. The most important advantage of using PET/CT imaging to guide biopsies is its ability to provide accurate visualization of the lesion, with immediate assessment of the procedure following its end. On the other hand, this technique still has some limitations. Most importantly, the significant exposure to radiation to both the patient and the physician.  

scholarly journals Diagnostic utility of 68Ga-citrate and 18FDG PET/CT in sarcoidosis patients

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Cuneyt Tetikkurt ◽  
Halil Yanardag ◽  
Burcak Haluk Sayman ◽  
Muammer Bilir ◽  
Seza Tetikkurt ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Organ Involvement ◽  
18Fdg Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Sarcoidosis is a chronic granulomatous disease of unknown etiology. The disease  most commonly involves the lungs and the mediastinal lymph nodes while extrapulmonary organs such as the skin, eye, liver or spleen may also be comprised. Many imaging modalities have been used for the clinical evaluation of sarcoidosis patients but all have been found to have certain drawbacks for a reliable identification assessment due to the equivocal diagnostic results.  This case series was designed to determine the clinical trenchancy of simultaneous 68Ga citrate PET/CT [Positron emission tomography with 68Ga citrate (68Ga citrate PET/CT)] and 18F-FDG PET/CT [Positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with computed tomography (18F-FDG PET/CT)] imaging in sarcoidosis patients. The main goal of the study was to evaluate sarcoidosis with respect to disease activity and organ involvement. A total of eight sarcoidosis patients with a comorbid disease suspicion were included in the study. Conventional clinical parameters used for  the diagnosis and the activity of sarcoidosis including CT [Computed tomography (CT)] were compared with the 68Ga-citrate PET/CT findings. Concurrent 18F-FDG PET/CT was performed to verify the granulomatous inflammation of sarcoidosis and to determine coexisting malignant or other inflammatory diseases. Our study results revealed that 68Ga citrate PET/CT imaging appears to be highly useful for the diagnosis, activity assessment and extrapulmonary organ involvement in sarcoidosis. Another crucial finding was the detection of extrapulmonary organ disease that are exceptionally involved, almost inaccessible by biopsy and that could not be otherwise displayed by other conventional imaging modalities. The third hallmark was the identification of a clinically asymptomatic and occult malignancy accompanying sarcoidosis that would not be revealed in any way if synchronous 18FDG PET/CT had not been performed. Simultaneous application of 68Ga citrate and 18FDG PET/CT may provide extremely useful data for the clinical evaluation of sarcoidosis patients in terms of the primary disease diagnosis, activity state, extrapulmonary organ involvement unachievable for biopsy and the clinically occult malignant disorders.

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