What is the most rational diagnostic imaging tool in patient with FUO?

Abstract

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Learning Objectives: 1. Definition and classification of FUO. 2. Clinical diagnostic procedure in the detection of cause of FUO. 3. Role of imaging modalities in the evaluation of FUO - clinical utilities and limitations of various imaging modalities. 4. Advantage of FDG-PET/CT and MRI (diffusion weighted images) in the detection of FUO.

Abstract Body: Classical fever of unknown origin (FUO) can be caused by numerous diseases; infections, tumors, and collagen disease and so on. Therefore, the diagnosis of FUO is usually difficult in many cases. Several studies have established the value of FDG-PET in the diagnosis of inflammatory or infectious disease. The increased FDG uptake can be observed in cells with high metabolic requirements, such as inflammatory and tumor cells. FDG cannot leave the cell once it is taken up, and therefore it can be expected to be a useful radiopharmaceutical in the evaluation of patients with FUO. Usually, we select plain radiograph and ultrasound as the initial diagnostic imaging tool, but these can not detect the focus in many cases. Then we tend to choose CT in the next step. It is certain that the detectability of contrast enhanced CT is high. However, much radiation exposure is expected in the whole body scanning. FDG-PET/CT and MRI (diffusion weighted images) should be recommended as the most suitable tool in various imaging modalities, because these can scan for whole body screening at a time and be easy to diagnose by simple visual finding such as the high accumulation and high signal intensity. In this exhibit we consider the usefulness and the demerit of each diagnostic imaging tool for FUO.