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Place of 18F-FDG-PET with computed tomography in the diagnostic algorithm of patients with fever of unknown origin

  • J. Crouzet
  • V. Boudousq
  • C. Lechiche
  • J. P. Pouget
  • P. O. Kotzki
  • L. Collombier
  • J. P. Lavigne
  • A. Sotto
Article

Abstract

There is evidence for the interest of 18F-fluoro-deoxyglucose positron emission tomography with computed tomography (18F-FDG-PET/CT) in fever of unknown origin (FUO) clinical investigation. However, little and conflicting data exist about its place in the investigation procedure. The aim of this work was to evaluate the clinical value of 18F-FDG-PET/CT in patients with FUO and identify patients who need early 18F-FDG-PET/CT rather than a last-resort procedure. We performed a 2-year retrospective cohort study at the Nîmes University Hospital, France. A total of 79 patients (36 men, 43 women, mean age 54.0 ± 16.2 years) with FUO underwent 18F-FDG-PET/CT. A final diagnosis was established in 61 (77.2 %) cases. Aetiologies of FUO were determined using 18F-FDG-PET/CT findings in 45 (73.8 % of patients with diagnosis) cases. The sensibility and specificity value were 98 % and 87 %, respectively. The presence of adenopathy, low haemoglobin and increased C-reactive protein (CRP) were predictors of high-yield 18F-FDG-PET/CT. 18F-FDG-PET/CT may help to detect most causes of FUO. The predictors of high-yield 18F-FDG-PET/CT found in this study can help identify patients likely to benefit from specific and early imaging techniques.

Keywords

Final Diagnosis Giant Cell Arteritis Compute Tomography Slice Periodic Fever Temporal Artery Biopsy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

None.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • J. Crouzet
    • 1
  • V. Boudousq
    • 2
    • 3
  • C. Lechiche
    • 1
  • J. P. Pouget
    • 2
    • 4
  • P. O. Kotzki
    • 2
  • L. Collombier
    • 2
  • J. P. Lavigne
    • 5
    • 6
  • A. Sotto
    • 1
    • 5
  1. 1.Service des Maladies Infectieuses et TropicalesCHU CaremeauNîmes cedexFrance
  2. 2.Service de Médecine NucléaireCHU CaremeauNîmesFrance
  3. 3.INSERM, U896 Université Montpellier 1NîmesFrance
  4. 4.Direction de la Radioprotection de l’HommeIRSNFontenay-aux-RosesFrance
  5. 5.UFR de MédecineINSERM, U0147, Université Montpellier 1NîmesFrance
  6. 6.Laboratoire de BactériologieCHU CaremeauNîmesFrance

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