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F-18 FDG-PET/CT in evaluation of patients with fever of unknown origin

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Abstract

Objectives

This study was carried out to evaluate the diagnostic utility of FDG-PET/CT in patients with fever of unknown origin (FUO).

Methods

Medical records of 103 patients who underwent FDG-PET/CT and anatomic imaging as a part of FUO workup were analyzed. Final diagnosis of the cause of FUO was reached based on serologic assays, cultures, biopsy, surgery or 6 months of clinical follow-up.

Results

The definite cause of fever was established in 69/103 patients. Abnormal FDG uptake was found in 63/103 patients and contributed to the final diagnosis (TP) in 62 patients (98.48 %). Of the remaining 40 patients with negative PET/CT, the final definite cause of fever (FN) could be determined only in seven patients (17.5 %). PET/CT had a sensitivity, specificity, positive predictive value and negative predictive value of 90, 97, 98.4 and 82.5 % compared to 43.5, 67.6, 73.2 and 37.1 %, respectively, for anatomic imaging. FDG-PET/CT had a higher accuracy (92.2 vs. 51.5 %; p = 0.003) compared to anatomic imaging for suggesting a cause of FUO.

Conclusions

PET/CT showed high sensitivity and specificity in suggesting a definite diagnosis in the evaluation of FUO.

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Authors and Affiliations

  1. Department of Nuclear Medicine & PET, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India

    Kuruva Manohar, Bhagwant Rai Mittal & Anish Bhattacharya

  2. Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Sanjay Jain, Aman Sharma & Subhash Varma

  3. Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Naveen Kalra

Authors
  1. Kuruva Manohar
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  2. Bhagwant Rai Mittal
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  3. Sanjay Jain
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  4. Aman Sharma
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  7. Subhash Varma
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Correspondence to Bhagwant Rai Mittal.

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Manohar, K., Mittal, B.R., Jain, S. et al. F-18 FDG-PET/CT in evaluation of patients with fever of unknown origin. Jpn J Radiol 31, 320–327 (2013). https://doi.org/10.1007/s11604-013-0190-z

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  • DOI: https://doi.org/10.1007/s11604-013-0190-z

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