scholarly journals Inflammation of Unknown Origin: Evaluation and Prognosis of 57 Cases

2021 ◽  
Vol 11 (1) ◽  
pp. 32
Author(s):  
Suzanne Béra ◽  
Yvan Jamilloux ◽  
Mathieu Gerfaud-Valentin ◽  
Stéphane Durupt ◽  
Raphaèle Nove-Josserand ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Hematological Malignancies ◽  
Inflammatory Diseases ◽  
Unknown Origin ◽  
Final Diagnosis ◽  
Diagnostic Value ◽  
Empirical Treatment ◽  
Pet Ct ◽  
Fdg Pet Ct

(1) Background: there are few studies on the inflammation of unknown origin (IUO). We sought to determine the etiologies and prognosis of IUO, as well as the contribution of complementary examinations. (2) Methods: this retrospective study analyzed patients meeting the Vanderschueren’s criteria in the Hospices Civils de Lyon from 2005 to 2020. (3) Results: a total of 57 patients (mean age: 67 years; interquartile range: 55–79) were included. Final diagnoses were made for 26 (46%) patients. Non-infectious inflammatory diseases were the most common diagnoses (13/26, 50%), followed by neoplasms (10/26, 38%; 8/10 hematological malignancies), infections (2/26, 8%), and miscellaneous causes (1/26, 4%). Moreover, 18-FDG-PET/CT was contributory in 12/42 cases. Anti-neutrophil cytoplasmic antibodies, serology, temporal biopsies, and bone marrow aspirates were contributory in 3/41, 1/57, 5/23, and 3/19 cases, respectively. At last follow-up (mean follow-up duration: 48 months), 8/31 undiagnosed patients were cured (five received an empirical treatment), and 5/31 died (one death was related to the empirical treatment). (4) Conclusion: more than half of the IUO remained undiagnosed. Non-infectious inflammatory diseases and hematological malignancies were the most common etiologies. Moreover, 18-FDG-PET/CT had the highest diagnostic value. Most IUO without final diagnosis persisted. The role of empirical treatments remains to be explored.

Diagnostic value of [18F]-FDG PET/CT in children with fever of unknown origin or unexplained signs of inflammation

2009 ◽  
Vol 37 (1) ◽  
pp. 136-145 ◽  
Author(s):  
Niklas Jasper ◽  
Jan Däbritz ◽  
Michael Frosch ◽  
Markus Loeffler ◽  
Matthias Weckesser ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Diagnostic Value ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Evaluation of FDG-PET/CT Use in Children with Suspected Infection or Inflammation

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 715
Author(s):  
Fabienne G. Ropers ◽  
Robin M. P. van Mossevelde ◽  
Chantal P. Bleeker-Rovers ◽  
Floris H. P. van Velden ◽  
Danielle M. E. van Assema ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Final Diagnosis ◽  
Management Decisions ◽  
Multicenter Cohort Study ◽  
Disease Manifestation ◽  
Suspected Infection ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
The Impact

[18F]-FDG-PET/CT ([18F]-fluoro-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT)) is increasingly used as a diagnostic tool in suspected infectious or inflammatory conditions. Studies on the value of FDG-PET/CT in children are scarce. This study assesses the role of FDG-PET/CT in suspected infection or inflammation in children. In this multicenter cohort study, 64 scans in 59 children with suspected infection or inflammation were selected from 452 pediatric FDG-PET/CT scans, performed in five hospitals between January 2016 and August 2017. Main outcomes were diagnostic information provided by FDG-PET/CT for diagnostic scans and impact on clinical management for follow-up scans. Of these 64 scans, 50 were performed for primary diagnosis and 14 to monitor disease activity. Of the positive diagnostic scans, 23/27 (85%) contributed to establishing a diagnosis. Of the negative diagnostic scans, 8/21 (38%) contributed to the final diagnosis by narrowing the differential or by providing information on the disease manifestation. In all follow-up scans, FDG-PET/CT results guided management decisions. CRP was significantly higher in positive scans than in negative scans (p = 0.004). In 6% of diagnostic scans, relevant incidental findings were identified. In conclusion, FDG-PET/CT performed in children with suspected infection or inflammation resulted in information that contributed to the final diagnosis or helped to guide management decisions in the majority of cases. Prospective studies assessing the impact of FDG-PET/CT results on diagnosis and patient management using a structured diagnostic protocol are feasible and necessary.

scholarly journals Diagnostic Value of 18F-FDG-PET/CT in Patients with FUO

2020 ◽  
Vol 9 (7) ◽  
pp. 2112
Author(s):  
Stamata Georga ◽  
Paraskevi Exadaktylou ◽  
Ioannis Petrou ◽  
Dimitrios Katsampoukas ◽  
Vasilios Mpalaris ◽  
...  
Keyword(s):  
Predictive Value ◽  
Fdg Pet ◽  
Final Diagnosis ◽  
Diagnostic Value ◽  
Whole Body ◽  
Considerable Proportion ◽  
Clinical Criteria ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Conventional diagnostic imaging is often ineffective in revealing the underlying cause in a considerable proportion of patients with fever of unknown origin (FUO). The aim of this study was to assess the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients with FUO. We retrospectively reviewed 18F-FDG-PET/CT scans performed on 50 consecutive adult patients referred to our department for further investigation of classic FUO. Final diagnosis was based on histopathological and microbiological findings, clinical criteria, or clinical follow-up. Final diagnosis was established in 39/50 (78%) of the patients. The cause of FUO was infection in 20/50 (40%), noninfectious inflammatory diseases in 11/50 (22%), and malignancy in 8/50 (16%) patients. Fever remained unexplained in 11/50 (22%) patients. 18F-FDG-PET/CT scan substantially contributed to the diagnosis in 70% of the patients, either by identifying the underlying cause of FUO or by directing to the most appropriate site for biopsy. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of 18F-FDG-PET/CT for active disease detection in patients with FUO were 94.7%, 50.0%, 84.0%, 85.7%, and 75.0%, respectively. In conclusion, whole-body 18F-FDG-PET/CT is a highly sensitive method for detection of the underlining cause of FUO or for correctly targeting suspicious lesions for further evaluation.

18F-FDG-PET/CT in unexplained elevated inflammatory markers

2016 ◽  
Vol 55 (06) ◽  
pp. 242-249 ◽  
Author(s):  
Isabell Braune ◽  
Birgit Meller ◽  
Carsten Sahlmann ◽  
Carsten Ritter ◽  
Johannes Meller ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Unknown Origin ◽  
Final Diagnosis ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Pet Ct ◽  
Significant Difference ◽  
18F Fdg ◽  
Fdg Pet Ct

SummaryThe diagnostic strategy in patients with fever or inflammation of unknown origin remains a major clinical challenge. The aim of this study was to evaluate the role of 18F-FDG-PET/CT in patients with unexplained elevated C-reactive protein with or without fever. Contribution of 18F-FDG-PET/CT to the final diagnosis was evaluated. In addition we determined whether a differentiation between patients with or without fever is clinically reasonable. Patients, methods: We retrospectively analysed 72 consecutive patients with unexplained elevated C-reactive protein levels (above 8mg/l) that underwent 18F-FDG-PET/ CT in our facility between 10/2009 and 11/2012. 18F-FDG-PET/CT was considered a so-called diagnostic scan when results decisively led to a final diagnosis and adequate therapy with a response of symptoms was initiated due to the PET/CT result. Results: In 60/72 patients (83%) a final diagnosis was established. Diagnoses included infections (58%), non-infectious inflammatory diseases (29%) and malignancies (8%). 18F-FDG-PET/CT was true positive in 47 cases (65%) and the diagnostic scan in 29 patients (40%). Sensitivity of 18F-FDG-PET/CT was 81% and specificity was 86%. Diagnostics, final diagnoses, 18F-FDG-PET/CT results, SUVmax, C-reactive protein levels and the diagnostic scan did not differ significantly between patients with fever and patients without fever. Conclusion: 18F-FDG-PET/CT is a useful method in the diagnostic workup of patients with inflammation of unknown origin. In our series there was no significant difference between patients with or without fever. Regarding 18F-FDG-PET/CT-imaging inflammation of unknown origin and unexplained fever can be joined to one entity.

Diagnostic value of 18F-FDG PET/CT in patients with fever of unknown origin

2012 ◽  
Vol 42 (7) ◽  
pp. 834-837 ◽  
Author(s):  
Y. J. Kim ◽  
S. I. Kim ◽  
K-W. Hong ◽  
M. W. Kang
Keyword(s):  
Fdg Pet ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Diagnostic Value ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

The value of 18F-FDG-PET/CT in identifying the cause of fever of unknown origin (FUO) and inflammation of unknown origin (IUO): data from a prospective study

2017 ◽  
Vol 77 (1) ◽  
pp. 70-77 ◽  
Author(s):  
Verena Schönau ◽  
Kristin Vogel ◽  
Matthias Englbrecht ◽  
Jochen Wacker ◽  
Daniela Schmidt ◽  
...  
Keyword(s):  
Prospective Study ◽  
Fdg Pet ◽  
Fever Of Unknown Origin ◽  
Correct Diagnosis ◽  
Unknown Origin ◽  
Ct Scanning ◽  
Final Diagnosis ◽  
Intermittent Fever ◽  
Pet Ct ◽  
Fdg Pet Ct

BackgroundFever of unknown origin (FUO) and inflammation of unknown origin (IUO) are diagnostically challenging conditions. Diagnosis of underlying disease may be improved by 18F-fluorodesoxyglucose positron emission tomography (18F-FDG-PET).MethodsProspective study to test diagnostic utility of 18F-FDG-PET/CT in a large cohort of patients with FUO or IUO and to define parameters that increase the likelihood of diagnostic 18F-FDG-PET/CT. Patients with FUO or IUO received 18F-FDG-PET/CT scanning in addition to standard diagnostic work-up. 18F-FDG-PET/CT results were classified as helpful or non-helpful in establishing final diagnosis. Binary logistic regression was used to identify clinical parameters associated with a diagnostic 18F-FDG-PET/CT.Results240 patients were enrolled, 72 with FUO, 142 with IUO and 26 had FUO or IUO previously (exFUO/IUO). Diagnosis was established in 190 patients (79.2%). The leading diagnoses were adult-onset Still’s disease (15.3%) in the FUO group, large vessel vasculitis (21.1%) and polymyalgia rheumatica (18.3%) in the IUO group and IgG4-related disease (15.4%) in the exFUO/IUO group. In 136 patients (56.7% of all patients and 71.6% of patients with a diagnosis), 18F-FDG-PET/CT was positive and helpful in finding the diagnosis. Predictive markers for a diagnostic 18F-FDG-PET/CT were age over 50 years (p=0.019), C-reactive protein (CRP) level over 30 mg/L (p=0.002) and absence of fever (p=0.001).Conclusion18F-FDG-PET/CT scanning is helpful in ascertaining the correct diagnosis in more than 50% of the cases presenting with FUO and IUO. Absence of intermittent fever, higher age and elevated CRP level increase the likelihood for a diagnostic 18F-FDG-PET/CT.

scholarly journals The diagnostic value of 18F-FDG PET/CT in identifying the causes of fever of unknown origin

2020 ◽  
Vol 20 (5) ◽  
pp. 449-453 ◽  
Author(s):  
Wan Zhu ◽  
Wenxia Cao ◽  
Xuting Zheng ◽  
Xuena Li ◽  
Yaming Li ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Diagnostic Value ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

2014 ◽  
Vol 41 (10) ◽  
pp. 1916-1923 ◽  
Author(s):  
Gijsbert J. Blokhuis ◽  
Chantal P. Bleeker-Rovers ◽  
Marije G. Diender ◽  
Wim J. G. Oyen ◽  
Jos M. Th. Draaisma ◽  
...  
Keyword(s):  
Immune Suppression ◽  
Fdg Pet ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Diagnostic Value ◽  
Pet Ct ◽  
Unexplained Fever ◽  
Fdg Pet Ct

scholarly journals Diagnosis of an intestinal mucormycosis ‘fungus ball’ located with PET/CT with [18F] FDG-PET/CT

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Franklin Gallo ◽  
Lavinia Vija ◽  
Sophie Le Grand ◽  
Nada Moukarbel ◽  
Koen Mortele ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Fungal Infections ◽  
Abdominal Mass ◽  
Unknown Origin ◽  
Final Diagnosis ◽  
Fungus Ball ◽  
Pet Ct ◽  
Life Threatening ◽  
Primary Location ◽  
Fdg Pet Ct

AbstractMucormycosis is a life-threatening infection with most commonly rhino-orbital-cerebral and pulmonary syndromes that mostly occurs in immunocompromised patients. FDG-PET/CT emerged as a sensitive non-invasive tool to identify systemic mucormycosis. We present a 59-year-old woman for whom a PET/CT with 18F-FDG was performed in search of a primary location of mucormycosis with non-contributive conventional workup. A large left abdominal mass was seen, compatible with a fungus ball, with intense parietal uptake and without any central uptake. The localization of the infection provided a target for surgery and permitted to adapt the therapeutic strategy. After resection, the final diagnosis was consistent with mucormycosis. To our knowledge, this is the first report of a PET/CT image with FDG showing an intestinal fungus ball. PET/CT with 18F-FDG may contribute to the management of patients with fungal infections of unknown origin.

Sign in / Sign up

Export Citation Format

Share Document