Ces radiol. 2008, 62(1):23-33

Fever of unknown origin, a value of hybrid 18F-FDG PET/CT imagingOriginal article

Eva Ferdova1,2, Jan Záhlava1, Jiří Ferda1,2
1 Oddělení Nukleární medicíny LF UK a FN, Plzeň
2 Radiodiagnostická klinika LF UK a FN, Plzeň

Aim: The aim of the presented work is to evaluate the clinical value of 18F-FDG-PET/CT in patients with fever of unknown origin (FUO) and to compare the detected cause with the results of subsequent examinations.

Method: Forty eight patients, 24 men, 24 women, mean age 57.6 years with range 15-89 years, underwent 18F-FDG-PET/CT due to the fever of unknown origin. All examinations were performed using complex PET/CT protocol combining PET and contrast enhanced CT with sub-millimeter spatial resolution (except for patients with history of iodine hypersensitivity or severe renal impairment). CT images were reconstructed with soft tissue and high-resolution algorithm. PET/CT findings were compared with results of biopsies, immunology, microbiology, or autopsy.

Results: The cause of FUO was explained according to the PET/CT findings and subsequently confirmed in 44 of 48 cases (92 %). There were 18 cases of microbial infections, 9 cases of autoimmune inflammations, 4 cases of non-infectious granulomatous diseases, 8 cases of malignancies and 5 cases of proved immunity disorders. In 46 cases, the PET/CT interpretation was correct. The cause of FUO was overlooked in one case and uptake in atherosclerotic plaques was misinterpreted as vasculitis in the other case. The achieved sensitivity was 97 % (43/44), and specificity 75 % (3/4) respectively.

Conclusion: In patiens with fever of unknown origin, 18F-FDG-PET/CT might be an important tool in the detection of its cause.

Keywords: fluorodeoxyglucose, fever of unknown origin, PET, CT
Grants and funding:

Práce byla podpořena výzkumným záměrem MSM 0021620819.

Accepted: January 15, 2008; Published: March 1, 2008  Show citation

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Ferdova E, Záhlava J, Ferda J. Fever of unknown origin, a value of hybrid 18F-FDG PET/CT imaging. Ces radiol. 2008;62(1):23-33.
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