The role of 18F-FDG PET or PET/CT in the detection of fever of unknown origin

Qiu, Lang; Chen, Yue

doi:10.1016/j.ejrad.2012.05.025

Cited by 18 publications

(16 citation statements)

References 39 publications

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“…As previously reported by Fuchs et al, 18 F-FDG PET/CT increases the overall diagnostic accuracy and has an impact on the medical management in a significant proportion of patients, but it is unlikely to replace biopsy procedures in the near future. PET-CT without contrast allows evaluating the extension of vascular involvement; however, it cannot accurately analyze the vascular wall.…”

Section: Discussionmentioning

confidence: 59%

“…The serum glucose level was measured before 18 F-FDG administration in all patients and was below 120 mg/dl (Glucometer Breeze 2, Bayer Diagnostics). PET scans were performed 60 min after intravenous injection using a venous line of 3,7 MBq/Kg body weight of 18 F-FDG.…”

Section: Patientsmentioning

confidence: 99%

“…In retrospective studies by Cao (2012) Qiu (2012) suggested that for the correct diagnosis with PET the addition of conventional imaging techniques may generally offer improved diagnostic accuracy compared with current standards of practice.…”

Section: Introductionmentioning

confidence: 99%

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Role of 18F-FDG PET-CT in Vasculitis: a Prospective Study

Siczek¹,

Faggioli²,

Venegoni³

et al. 2014

JMED

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Objective: Evaluate the diagnostic accuracy of PET in patients with fever of unknown origin (FUO) and in patients with suspected and/or proved large vessel vasculitis (LVV). Patients and methods: 72 patients (49 females, 23 males; mean age 63 y, range 23-82) were prospectively examined with PET between February 2010 and April 2013; 42 with suspected LVV, 15 with LVV during steroid therapy, and 15 with fever of unknown origin (FUO). Follow-up scans were performed in 19 patients. A semi-quantitative analysis [Vessel SUVmax]/[liver SUVmax] was performed to rate the disease in a 4-step system. PET scans were compared with temporal artery biopsy and MRI and/or angio-CT of a specific region. Results: Pathological 18 F-FDG (FDG) uptake was observed in 30/72 (42%) patients, and negative in 42/72 (58%) patients. In 42 patients with suspected LVV 9 (21%) were positive, and 33 (79%) negative; 11 (73%) of the 15 steroid-treated patients with LVV were positive, and 4 (27%) negative; 10 (67%) of the 15 patients with FUO were positive and 5 (33%) negative. PET had an overall sensitivity of 87% [95% confidence interval (CI) 79-95%], a specificity of 95% (95% CI 90-100%), a positive predictive value of 93% (95% CI 87-99%) and a negative predictive value of 91% (95% CI 84-97%). The diagnostic accuracy of PET was 92% (95% CI 85-98%). Conclusions: 18 F-FDG PET/CT especially that based on semi quantitative analysis is a sensitive and specific imaging tool for the diagnosis of LVV but also for therapy monitoring and follow up.

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Section: Discussionmentioning

confidence: 59%

Section: Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Role of 18F-FDG PET-CT in Vasculitis: a Prospective Study

Siczek¹,

Faggioli²,

Venegoni³

et al. 2014

JMED

View full text Add to dashboard Cite

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“…As reported in the literature, 18 F-FDG PET/CT may help establish the final diagnosis of FUO, as it is sensitive to the major causes of FUO, including infections, malignancies and non-infectious inflammatory diseases (25)(26)(27). Kim et al (26) retrospectively evaluated the role of 18 F-FDG PET/CT in the final diagnosis of FUO and found that it contributed to 65.8% of the cases.…”

Section: Discussionmentioning

confidence: 99%

Fever of unknown origin revealed to be primary splenic lymphoma: A rare case report with review of the literature

Sun

Cheng

Wang

et al. 2016

Molecular and Clinical Oncology

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Abstract. Fever is a common clinical presentation of a number of diseases. A sustained unexplained fever >38.3˚C lasting for >3 weeks without an established diagnosis despite intensive diagnostic evaluation is referred to as fever of unknown origin (FUO). FUO remains a clinical challenge for physicians, as it may be attributed to a wide range of disorders, mainly infections, malignancies, non-infectious inflammatory diseases and miscellaneous diseases. We herein report the case of a 59-year-old male patient who presented with prolonged unexplained fever and was found to have a diffusely enlarged hypermetabolic spleen, as shown on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography examination. Following splenectomy, histopathological examination revealed primary splenic lymphoma (PSL) of B-cell origin. The patient received 6 courses of systemic chemotherapy with rituximab, etoposide, cyclophosphamide, doxorubicin, vincristine and prednisone (R-ECHOP regimen) and responded well to treatment. Thus, in patients with FUO and splenomegaly, the possibility of PSL should be taken into consideration. IntroductionThe term ʻfever of unknown originʼ (FUO) was first introduced by Petersdorf and Beeson in 1961 based on an analysis of 100 cases, and it was defined as recurrent fever >38.3˚C, lasting for >3 weeks, remaining undiagnosed after 1 week of in-hospital evaluation (1). Several decades later, the criteria of FUO diagnosis have changed and it is currently defined by lack of a definitive diagnosis after appropriate inpatient or outpatient evaluation (2). In view of the patient's clinical circumstances and underlying immune status, FUO was categorized into classic, nosocomial, neutropenic and human immunodeffiency virus (HIV)-associated FUO by Durack and Street in 1991 (3). The etiologies of classic FUO mainly include infections, malignancies, non-infectious inflammatory diseases and miscellaneous causes, while some cases remain undiagnosed (4,5).Primary splenic lymphoma (PSL) is a rare malignant lymphoma with an incidence of ~1% among patients with non-Hodgkin lymphoma (NHL) (6), although the spleen is involved in approximately half of the cases of Hodgkin's disease and one-third of NHLs as part of systemic disease (7,8). Dasgupta et al (9) strictly defined PSL as lymphoma originating in the spleen and limited to the spleen and splenic hilum, without invasion of other sites, with an interval of ≥6 months prior to the appearance of lymphoma elsewhere.We herein present the case of a 59-year-old male patient with diffuse large B-cell PSL, who only exhibited sustained fever, without other remarkable complaints. To investigate the cause of the FUO, fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) examination was performed and revealed a diffusely enlarged hypermetabolic spleen. Following diagnostic splenectomy, the histopathological diagnosis was diffuse large B-cell primary splenic NHL. Case reportA 59-year-old male patient presented with a history of fe...

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“…This list includes [ 67 Ga] citrate [2], radiolabeled autologous leukocytes [3], radiolabeled antigranulocyte antibodies [4], radiolabeled cytokines [5], and [ 18 F]FDG [6], which were developed to describe the inflammation processes mainly by observing the nonspecific uptake mechanisms, such as blood supply expansion, vascular permeability increase, and inflammatory cell aggregation. The main disadvantage of these probes, however, is their inability to distinguish infection from sterile inflammation.…”

Section: Introductionmentioning

confidence: 99%