Skip to main content
SpringerLink
Log in

Role of FDG-PET and PET/CT in the diagnosis of prolonged febrile states

  • Original article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The role of FDG-PET and PET/CT in patients whose main symptom is prolonged fever has not yet been defined. We addressed this topic in a retrospective study.

Methods

A total of 124 patients (referred between May 2001 and December 2004) with fever of unknown origin or prolonged fever due to a suspected infection of a joint or vascular prosthesis were included in the study. The patients underwent either FDG-PET or FDG-PET/CT scanning. Sixty-seven patients had a negative focal FDG-PET finding; in this group the method was regarded as unhelpful in determining a diagnosis, and no further investigation was pursued. We tried to obtain clinical confirmation for all patients with positive PET findings.

Results

Fifty-seven (46%) patients had positive FDG-PET findings. In six of them no further clinical information was available. Fifty-one patients with positive PET findings and 118 patients in total were subsequently evaluated. Systemic connective tissue disease was confirmed in 17 patients, lymphoma in three patients, inflammatory bowel disease in two patients, vascular prosthesis infection in seven patients, infection of a hip or knee replacement in seven patients, mycotic aneurysm in two patients, abscess in four patients and AIDS in one patient. In eight (16%) patients the finding was falsely positive.

Conclusion

FDG-PET or PET/CT contributed to establishing a final diagnosis in 84% of the 51 patients with positive PET findings and in 36% of all 118 evaluated patients with prolonged fever.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3 a, b
Fig. 3 a, b

Similar content being viewed by others

References

  1. Alavi A, Zhuang H. PET Imaging in infectious diseases. In: Valk PE, Bailey DL, Townsend DW, Maisey MN, editors. Positron emission tomography. Lonodon: Springer; 2003. p. 727–39

    Google Scholar 

  2. Petersdorf RG, Beeson PB. Fever of unexplained origin: report on 100 cases. Medicine (Baltimore) 1961;40:1–30

    Article  CAS  Google Scholar 

  3. Wong SY, Lam MS. Pyrexia of unknown origin—approach to management. Singapore Med J 1995;36(2):204–8

    PubMed  CAS  Google Scholar 

  4. Knockaert DC, Dujardin KS, Bobbaers HJ. Long-term follow up of patients with undiagnosed fever of unknown origin. Arch Intern Med 1996;156(6):618–20

    Article  PubMed  CAS  Google Scholar 

  5. Buysschaert I, Vanderchueren S, Blockmans D, Mortelmans L, Knockaert D. Contribution of (18) fluoro-deoxyglucose positron emission tomography to the work-up of patients with fever of unknown origin. Eur J Intern Med 2004;15(3):151–6

    Article  PubMed  Google Scholar 

  6. Bleeker-Rovers CP, de Klein EMHA, Corstens FHM, van der Meer JWM, Oyen WJG. Clinical value of FDG-PET in patients with fever of unknown origin and patients suspected of focal infection or inflammation. Eur J Nucl Med Mol Imaging 2004;31(1):29–37

    Article  PubMed  Google Scholar 

  7. Webb M, Chambers A, AL-Nahhas A, Mason JC, Maudlin L, Rahman L, et al. The role of 18F-FDG PET in characterising disease activity in Takayasu arteritis. Eur J Nucl Med Mol Imaging 2004;31(5):627–34

    Article  PubMed  Google Scholar 

  8. Brodmann M, Lipp RW, Passath A. The role of 2-F-18-fluoro-2-deoxy-D-glucose positron emission tomography in the diagnosis of giant cell arteritis of the temporal arteries. Rheumatology 2004;43:241–2

    Article  PubMed  CAS  Google Scholar 

  9. Mochizuki Y, Fujii H, Yasuda S, Nakahara T, Takahashi W, Ide M, et al. FDG accumulation in aortic walls. Clin Nucl Med 2001;26(1):68–9

    Article  PubMed  CAS  Google Scholar 

  10. Yun M, Yeh D, Araujo LI, Jang S, Newberg A, Alavi A. F-18 FDG uptake in the large arteries: a new observation. Clin Nucl Med 2001;26(4):314–9

    Article  PubMed  CAS  Google Scholar 

  11. de Kleijn EM, Vandenbroucke JP, ven der Meer JW. Fever of unknown origin (FUO). I. A. prospective multicenter study of 167 patients with FUO using fixed epidemiologic entry criteria. The Netherlands FUO Study Group. Medicine (Baltimore) 1997;76(6):392–400

    Article  Google Scholar 

  12. Belohlavek O, Votrubova J, Skopalova M, Fencl P. The detection of aortic valve infection by FDG-PET/CT in a patient with infection following total knee replacement. Eur J Nucl Med Mol Imaging 2005;32(4):518

    Article  PubMed  CAS  Google Scholar 

  13. Love C, Marwin SE, Tomas MB, Krauss EX, Tronco GG, Bhargava KK, et al. Diagnosing infection in the failed joint replacement: a comparison of coincidence detection 18F-FDG and 111In-labeled leukocyte/99Tc-sulfur colloid marrow imaging. J Nucl Med 2004;45(11):1864–71

    PubMed  Google Scholar 

  14. Vanquikenborne B, Maes A, Nuyts J, Van Acker F, Stuyck J, Mulier M, et al. The value of 18FDG-PET for the detection of infected hip prosthesis. Eur J Nucl Med Mol Imaging 2003;30(5):705–15

    Article  PubMed  CAS  Google Scholar 

  15. Meller J, Sahlmann CO. F-18-FDG hybrid camera PET in patients with postoperative fever. Nuklearmedizin 2002;41(1):22–9

    PubMed  CAS  Google Scholar 

  16. De Winter F, Gemmel F. 18-Fluorine fluorodeoxyglucose positron emission tomography for the diagnosis of infection in the postoperative spine. Spine 2003;28(12):1314–9

    Article  PubMed  Google Scholar 

  17. Zhuang H, Chacko TH, Hickeson M, Stevenson K, Feng Q, Ponzo F, et al. Persistent non-specific FDG uptake on PET imaging following hip arthroplasty. Eur J Nucl Med Mol Imaging 2002;29(10):1328–33

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. PET Center, Na Homolce Hospital, Roentgenova 2, 150 30, Prague 5, Czech Republic

    M. Jaruskova & O. Belohlavek

Authors
  1. M. Jaruskova
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. O. Belohlavek
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Jaruskova.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jaruskova, M., Belohlavek, O. Role of FDG-PET and PET/CT in the diagnosis of prolonged febrile states. Eur J Nucl Med Mol Imaging 33, 913–918 (2006). https://doi.org/10.1007/s00259-006-0064-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-006-0064-z

Keywords

Search

Navigation