The role of Gallium-67 imaging in the detection of foci in recent cases of fever of unknown origin

Abstract

We have assembled data from patients with fever of unknown origin who underwent gallium scintigraphy during the past 5 years in order to obtain a more current sampling of patients, and evaluated the role of gallium scintigraphy retrospectively. Of the 36 patients studied, gallium scintigraphy was positive and contributed to the detection of the foci or fever origins in 17 (47.2%). The ratio of neoplastic diseases with myeloproliferative and with lymphoproliferative disorders was relatively high compared with previous reports. However, gallium scintigraphy did not contribute to the diagnosis of collagen disease. With the ability to detect both inflammatory and neoplastic lesions, gallium scintigraphy was useful in detecting the foci of fevers of unknown origin.

Tuberculous epididymo‐orchitis presenting as pyrexia of unknown origin during acute myeloid leukaemia consolidation therapy

“…More importantly, no other diagnostic procedure could show a cause in 34% of cases with a negative scintigram. Other workers have also reported similar yields in approximately 50% of tested cases, causes ranging from the myeloproliferative and lymphoproliferative malignancies to infections 2 . In a large series of 145 cases of PUO, gallium‐67 was found to have made a significant diagnostic contribution in 29%, ultrasound in 6% and CT scanning in 14% 3 .…”

“…Other workers have also reported similar yields in approximately 50% of tested cases, causes ranging from the myeloproliferative and lymphoproliferative malignancies to infections. 2 In a large series of 145 cases of PUO, gallium-67 was found to have made a significant diagnostic contribution in 29%, ultrasound in 6% and CT scanning in 14%. 3 In comparison to positron emission tomography (PET) scanning with 18 F fluorodeoxyglucose, gallium-67 was found to have a sensitivity of 67% and specificity of 78% whereas PET scanning had a sensitivity of 81% and specificity of 86%.…”

Nuklearmedizinische Diagnostik prolongierter Fieberzustände

“…Aufgrund einer Anreicherung in akuten und chronischen Entzündungen und Tumoren [62,148] wurde 67 Ga-Zitrat im Angloamerikanischen Sprachraum bis vor kurzem als Tracer der ersten Wahl bei der Abklärung von FUO angesehen [114]. In den Studien mit 67 Ga-Zitrat bei FUO-Patienten wurden in der Regel, abweichend von der für die 111 In-Leukozytenszintigrafie angewandten Befundinterpretation, solche Szintigramme als richtig positiv angesehen, bei denen der Nachweis eines für das Fieber verantwortlichen tumorösen oder entzündlichen Fokus gelang [24,35,55,71,74,80,96,99,133,138]. Der prozentuale Anzahl der Scans, die wesentlich zur endgültigen Diagnose beitrugen, lag in den publizierten Serien zwischen 12 und 48 % (im Median bei 28 %) und somit höher als bei Verwendung von 111 In-markierten Leukozyten [24,35,55,71,74,80,96,99,133,138].…”

Role of Gallium-67 scintigraphy in the evaluation of occult sepsis in the medical ICU

“…In addition, 67 Ga also binds to lactoferrin and leukocytes, which are present in high concentrations in inflammatory foci [2]. Several studies prove that 67 Ga scanning is clinically effective in the localization of infectious sources [12][13][14][15][16][17]. Among these studies, only one used 67 Ga scans to detect sources of fever in ventilated, critically ill patients [14].…”