A prospective multi-centre study of the value of FDG-PET as part of a structured diagnostic protocol in patients with fever of unknown origin

  • Chantal P. Bleeker-Rovers
  • Fidel J. Vos
  • Aart H. Mudde
  • Anton S. M. Dofferhoff
  • Lioe-Fee de Geus-Oei
  • Anton J. Rijnders
  • Paul F. M. Krabbe
  • Frans H. M. Corstens
  • Jos W. M. van der Meer
  • Wim J. G. Oyen
Original Article

Abstract

Purpose

Since 18F-fluorodeoxyglucose (FDG) accumulates in neoplastic cells and in activated inflammatory cells, positron emission tomography (PET) with FDG could be valuable in diagnosing patients with fever of unknown origin (FUO). The aim of this study was to validate the use of FDG-PET as part of a structured diagnostic protocol in the general patient population with FUO.

Methods

From December 2003 to July 2005, 70 patients with FUO were recruited from one university hospital (n=38) and five community hospitals (n=32). A structured diagnostic protocol including FDG-PET was used. A dedicated, full-ring PET scanner was used for data acquisition. FDG-PET scans were interpreted by two staff members of the department of nuclear medicine without further clinical information. The final clinical diagnosis was used for comparison with the FDG-PET results.

Results

Of all scans, 33% were clinically helpful. The contribution of FDG-PET to the final diagnosis did not differ significantly between patients diagnosed in the university hospital and patients diagnosed in the community hospitals. FDG-PET contributed significantly more often to the final diagnosis in patients with continuous fever than in patients with periodic fever. FDG-PET was not helpful in any of the patients with normal erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).

Conclusion

FDG-PET is a valuable imaging technique as part of a diagnostic protocol in the general patient population with FUO and a raised ESR or CRP.

Keywords

18F-fluorodeoxyglucose PET Fever of unknown origin Infection Inflammation Diagnosis 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Chantal P. Bleeker-Rovers
    • 1
    • 2
    • 3
  • Fidel J. Vos
    • 2
    • 3
  • Aart H. Mudde
    • 4
  • Anton S. M. Dofferhoff
    • 5
  • Lioe-Fee de Geus-Oei
    • 1
  • Anton J. Rijnders
    • 6
  • Paul F. M. Krabbe
    • 7
  • Frans H. M. Corstens
    • 1
    • 3
  • Jos W. M. van der Meer
    • 2
    • 3
  • Wim J. G. Oyen
    • 1
    • 3
  1. 1.Department of Nuclear MedicineRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
  2. 2.Department of Internal MedicineRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
  3. 3.Nijmegen University Centre for Infectious DiseasesNijmegenThe Netherlands
  4. 4.Department of Internal MedicineSlingeland HospitalDoetinchemThe Netherlands
  5. 5.Department of Internal MedicineCanisius-Wilhelmina HospitalNijmegenThe Netherlands
  6. 6.Department of Nuclear MedicineRijnstate HospitalArnhemThe Netherlands
  7. 7.Department of Medical Technology AssessmentRadboud University Nijmegen Medical CentreNijmegenThe Netherlands

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