PET/CT helpful in diagnosing fever or inflammation of unknown origin: Study
Graz, Austria: A recent study in the journal Scientific Reports has shown the utility of F-18 FDG PET/CT for diagnosing fever or inflammation of unknown origin (FUO/IUO) in more than half of cases if other diagnostic tools fail.
In fever or inflammation of unknown origin, determining the cause has been challenging despite today's diagnostic modalities. Considering this, Friedrich Weitzer, Medical University of Graz, Auenbruggerplatz, Graz, Austria, and colleagues aimed to evaluate the value of F-18 FDG PET/CT in an unselected patient collective in a retrospective nonrandomized single-center study.
The study enrolled 300 male and female patients with FUO/IUO. The researchers compared PET/CT findings with final clinical outcomes to determine the specificity, sensitivity, etiological distribution of final diagnoses, clinical significance, impact on treatment, the role of white-blood-cell count (WBC), and C-reactive protein (CRP).
Based on the study, the researchers found the following:
- In 54.0% PET/CT was the decisive exanimation for establishing the final diagnosis, in 13.3% the findings were equivocal and indecisive, in 3.3% PET/CT findings were false positive, while in 29.3% a normal F-18 FDG pattern was present.
- Statistical analysis showed a sensitivity of 80.2% and a specificity of 89.8% for the contribution of PET/CT to the final diagnosis.
- CRP levels and WBC were not associated with PET/CT outcomes.
- PET/CT let to new treatment in 24.0%, treatment change in 18.0%, no treatment change in 49.6%, and in 8.3% no data was available.
"F-18 FDG PET/CT is a useful method in the diagnosis of FUO. Our study clearly showed an overall high specificity and sensitivity compared to several meta-analyses," wrote the authors. "Therefore, the early use of F-18 FDG PET/CT should be considered if other diagnostic means fail."
"The optimum timing for the performing as well as the standardization of F-18 FDG PET/CT as a first-line work-up in FUO/IUO patients however is still debatable," they concluded.
Reference:
Weitzer, F., Nazerani Hooshmand, T., Pernthaler, B. et al. Diagnostic value of F-18 FDG PET/CT in fever or inflammation of unknown origin in a large single-center retrospective study. Sci Rep 12, 1883 (2022). https://doi.org/10.1038/s41598-022-05911-7
