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18F-FDG PET and PET/CT in Fever of Unknown Origin*

Johannes Meller1, Carsten-Oliver Sahlmann1 and Alexander Konrad Scheel2

1 Department of Nuclear Medicine, University of Göttingen, Göttingen, Germany; and 2 Department of Nephrology and Rheumatology, University of Göttingen, Göttingen, Germany


Figure 1
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  		FIGURE 1.  18F-FDG PET (from left to right: coronal, sagittal, and transversal slices) of 65-y-old patient with long-standing FUO 6 y after revision of aortic aneurism, which was replaced by vascular graft. PET scan demonstrates elevated uptake in graft extending to adjacent tissue. Infection of graft was subsequently proven during diagnostic work-up.

 

Figure 2
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  		FIGURE 2.  18F-FDG PET (from left to right: coronal, sagittal, and transversal slices) of 52-y-old patient with FUO. PET demonstrated elevated uptake in wall of thoracic aorta and supraaortal branches. Atypical GCA was diagnosed subsequently. After medication with glucocorticoids had begun, fever resolved and systemic signs of inflammation normalized.

 

Figure 3
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  		FIGURE 3.  18F-FDG PET (from left to right: coronal, sagittal, and transversal slices) of 45-y-old patient with FUO (coronal view). High uptake in thyroid (maximum standardized uptake value, 14.3) was found. Subacute, painless granulomatous thyroiditis was subsequently proven cytologically. After glucocorticoid medication had begun, fever disappeared within 2 d.

 

Figure 4
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  		FIGURE 4.  18F-FDG PET (from left to right: coronal, sagittal, and transversal slices) of 62-y-old patient with long-standing FUO. PET revealed accumulation of tracer in right colonic flexura. During diagnostic work-up, adenocarcinoma in this location was diagnosed. Fever disappeared after surgery.

 

Figure 5
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  		FIGURE 5.  18F-FDG PET (from left to right: coronal, sagittal, and transversal slices) of 52-y-old patient with FUO caused by uterine rhabdomyosarcoma. Ringlike supravesical 18F-FDG uptake (maximum standardized uptake value, 15.8) was clearly higher than usually seen in benign uterine leiomyoma, which had been clinically suggested until PET evaluation was performed. Body temperature normalized after surgery. In addition, right hemispheric uptake in brain was reduced because of vascular stroke 4 y previously.

 




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