scholarly journals The Utility of 18FDG-PET/CT in Diagnosing Fever of Unknown Origin: The Experience of a Large Tertiary Medical Center

2021 ◽  
Vol 18 (10) ◽  
pp. 5360
Author(s):  
Hussein Mahajna ◽  
Keren Vaknin ◽  
Jennifer Ben Shimol ◽  
Abdulla Watad ◽  
Arsalan Abu-Much ◽  
...  
Keyword(s):  
Weight Loss ◽  
Predictive Value ◽  
Fever Of Unknown Origin ◽  
Diagnostic Yield ◽  
Medical Center ◽  
False Negative ◽  
Unknown Origin ◽  
18Fdg Pet ◽  
Pet Ct ◽  
Work Up

Fever of unknown origin (FUO) poses a diagnostic challenge, and 18-fluorodexoyglucose positron emission tomography with computed tomography (18FDG-PET/CT) may identify the source. We aimed to evaluate the diagnostic yield of 18FDG-PET/CT in the work-up of FUO. The records of patients admitted to Sheba Medical Center between January 2013 and January 2018 who underwent 18FDG-PET/CT for the evaluation of FUO were reviewed. Following examination of available medical test results, 18FDG-PET/CT findings were assessed to determine whether lesions identified proved diagnostic. Of 225 patients who underwent 18FDG-PET/CT for FUO work-up, 128 (57%) met inclusion criteria. Eighty (62.5%) were males; mean age was 59 ± 20.3 (range: 18–93). A final diagnosis was made in 95 (74%) patients. Of the 128 18FDG-PET/CT tests conducted for the workup of FUO, 61 (48%) were true positive, 26 (20%) false positive, 26 (20%) true negative, and 15 (12%) false negative. In a multivariate analysis, weight loss and anemia were independently associated with having a contributary results of 18FDG-PET/CT. The test yielded a sensitivity of 70%, specificity of 37%, positive predictive value of 70%, and negative predictive value of 37%. 18FDG-PET/CT is a valuable tool in the diagnostic workup of FUO. It proved effective in diagnosing almost half the patients, especially in those with anemia and weight loss.

scholarly journals The utility of PET/CT in diagnosing fever of unknown origin: The experience of a large tertiary medical center

2020 ◽  
Author(s):  
Hussein Mahagna ◽  
Keren Vaknin ◽  
Abdulla Watad ◽  
Arsalan Abu Much ◽  
Naim Mahroum ◽  
...  
Keyword(s):  
Fever Of Unknown Origin ◽  
Medical Center ◽  
Unknown Origin ◽  
Pet Ct

Diagnostic yield of FDG-PET/CT in fever of unknown origin: a systematic review, meta-analysis, and Delphi exercise

2018 ◽  
Vol 73 (6) ◽  
pp. 588-589 ◽  
Author(s):  
I.J.E. Kouijzer ◽  
J.W.M. van der Meer ◽  
W.J.G. Oyen ◽  
C.P. Bleeker-Rovers
Keyword(s):  
Systematic Review ◽  
Fdg Pet ◽  
Fever Of Unknown Origin ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Unknown Origin ◽  
Pet Ct ◽  
Delphi Exercise ◽  
Fdg Pet Ct

Usefulness of 18FDG PET-CT scan as a diagnostic tool of fever of unknown origin

2015 ◽  
Vol 145 (2) ◽  
pp. 62-66
Author(s):  
Francisco Javier García-Gómez ◽  
Irene Acevedo-Báñez ◽  
Rubén Martínez-Castillo ◽  
Manuel García-Gutiérrez ◽  
Juan Luis Tirado-Hospital ◽  
...  
Keyword(s):  
Ct Scan ◽  
Diagnostic Tool ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
18Fdg Pet ◽  
Pet Ct ◽  
Pet Ct Scan

scholarly journals Diagnostic yield of FDG-PET/CT in fever of unknown origin: a systematic review, meta-analysis, and Delphi exercise

2017 ◽  
Vol 72 (9) ◽  
pp. 764-771 ◽  
Author(s):  
T. Bharucha ◽  
A. Rutherford ◽  
S. Skeoch ◽  
A. Alavi ◽  
M. Brown ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fdg Pet ◽  
Fever Of Unknown Origin ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Unknown Origin ◽  
Pet Ct ◽  
Delphi Exercise ◽  
Fdg Pet Ct

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 FDG-PET/CT in intensive care patients with bloodstream infection

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Jordy P. Pijl ◽  
Mark Londema ◽  
Thomas C. Kwee ◽  
Maarten W. N. Nijsten ◽  
Riemer H. J. A. Slart ◽  
...  
Keyword(s):  
Intensive Care ◽  
Image Quality ◽  
Fdg Pet ◽  
Diagnostic Yield ◽  
Unknown Origin ◽  
Intensive Care Patients ◽  
Pet Ct ◽  
Infection Focus ◽  
Focus Of Infection ◽  
Fdg Pet Ct

Abstract Background 2-Deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) is an advanced imaging technique that can be used to examine the whole body for an infection focus in a single examination in patients with bloodstream infection (BSI) of unknown origin. However, literature on the use of this technique in intensive care patients is scarce. The purpose of this study was to evaluate the diagnostic yield of FDG-PET/CT in intensive care patients with BSI. Methods In this retrospective cohort study, all intensive care patients from our Dutch university medical center who had culture-proven BSI between 2010 and 2020 and underwent FDG-PET/CT to find the focus of infection were included. Diagnostic performance was calculated and logistic regression analysis was performed to evaluate the association between FDG-PET/CT outcome and C-reactive protein level (CRP), leukocyte count, duration of antibiotic treatment, duration of ICU stay, quality of FDG-PET/CT, and dependency on mechanical ventilation. In addition, the impact of FDG-PET/CT on clinical treatment was evaluated. Results 30 intensive care patients with BSI were included. In 21 patients, an infection focus was found on FDG-PET/CT which led to changes in clinical management in 14 patients. FDG-PET/CT achieved a sensitivity of 90.9% and specificity of 87.5% for identifying the focus of infection. Poor quality of the FDG-PET images significantly decreased the likelihood of finding an infection focus as compared to reasonable or good image quality (OR 0.16, P = 0.034). No other variables were significantly associated with FDG-PET/CT outcome. No adverse events during the FDG-PET/CT procedure were reported. Conclusion FDG-PET/CT has a high diagnostic yield for detecting the infection focus in patients with BSI admitted to intensive care. Poor PET image quality was significantly associated with a decreased likelihood of finding the infection focus in patients with BSI. This could be improved by adequate dietary preparation and cessation of intravenous glucose and glucose-regulating drugs. Recent advances in PET/CT technology enable higher image quality with shorter imaging time and may contribute to routinely performing FDG-PET/CT in intensive care patients with BSI of unknown origin.

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