PT  - JOURNAL ARTICLE
AU  - Kouijzer, Ilse J.E.
AU  - Kampschreur, Linda M.
AU  - Wever, Peter C.
AU  - Hoekstra, Corneline
AU  - van Kasteren, Marjo E.E.
AU  - de Jager-Leclercq, Monique G.L.
AU  - Nabuurs-Franssen, Marrigje H.
AU  - Wegdam-Blans, Marjolijn C.A.
AU  - Ammerlaan, Heidi S.M.
AU  - Buijs, Jacqueline
AU  - Geus-Oei, Lioe-Fee de
AU  - Oyen, Wim J.G.
AU  - Bleeker-Rovers, Chantal P.
TI  - The Value of <sup>18</sup>F-FDG PET/CT in Diagnosis and During Follow-up in 273 Patients with Chronic Q Fever
AID  - 10.2967/jnumed.117.192492
DP  - 2018 Jan 01
TA  - Journal of Nuclear Medicine
PG  - 127--133
VI  - 59
IP  - 1
4099  - http://jnm.snmjournals.org/content/59/1/127.short
4100  - http://jnm.snmjournals.org/content/59/1/127.full
SO  - J Nucl Med2018 Jan 01; 59
AB  - In 1%–5% of all acute Q fever infections, chronic Q fever develops, mostly manifesting as endocarditis, infected aneurysms, or infected vascular prostheses. In this study, we investigated the diagnostic value of 18F-FDG PET/CT in chronic Q fever at diagnosis and during follow-up. Methods: All adult Dutch patients suspected of chronic Q fever who were diagnosed since 2007 were retrospectively included until March 2015, when at least one 18F-FDG PET/CT scan was obtained. Clinical data and results from 18F-FDG PET/CT at diagnosis and during follow-up were collected. 18F-FDG PET/CT scans were prospectively reevaluated by 3 nuclear medicine physicians using a structured scoring system. Results: In total, 273 patients with possible, probable, or proven chronic Q fever were included. Of all 18F-FDG PET/CT scans performed at diagnosis, 13.5% led to a change in diagnosis. Q fever–related mortality rate in patients with and without vascular infection based on 18F-FDG PET/CT was 23.8% and 2.1%, respectively (P = 0.001). When 18F-FDG PET/CT was added as a major criterion to the modified Duke criteria, 17 patients (1.9-fold increase) had definite endocarditis. At diagnosis, 19.6% of 18F-FDG PET/CT scans led to treatment modification. During follow-up, 57.3% of 18F-FDG PET/CT scans resulted in treatment modification. Conclusion: 18F-FDG PET/CT is a valuable technique in diagnosis of chronic Q fever and during follow-up, often leading to a change in diagnosis or treatment modification and providing important prognostic information on patient survival.