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18F-FDGPET/CT in fever of unknown origin and inflammation of unknown origin: a Chinese multi-center study

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the clinical value of 18F-FDG-PET/CT for the diagnosis of fever of unknown origin (FUO) and inflammation of unknown origin (IUO) in Chinese population, as well as the characteristics of PET/CT in different category of etiological disease.

Methods

A total of 376 consecutive patients with FUO/IUO who underwent FDG-PET/CT at 12 hospitals were retrospectively studied. FDG uptake was quantitatively and visually evaluated, by using SUVmax and a 4-grade scale respectively. A questionnaire survey to the clinicians was used to evaluate the significance of PET/CT in diagnosing of FUO/IUO. Data analysis included the etiological distribution in the study population, image characteristics in different category of diseases, and clinical significance of PET/CT.

Results

In 376 studied patients, the infectious diseases accounted for 33.0% of patients, rheumatologic diseases for 32.4%, malignancies for 19.1%, miscellaneous causes for 6.6%, and cause unknown for 8.8%. However, the etiological distribution among hospitals was varied. In addition, the etiological disease composition ratio has changed over time in China. On PET/CT examinations, 358 (95.2%) of the patients had a positive finding. Within them, local high uptake lesion was found in 219 cases, and nonspecific abnormal uptake (NAU) was found in 187 cases. FDG uptake in malignant diseases was significantly higher than in other category diseases both on SUVmax and visual scores (t-value range from 4.098 to 5.612, all P value < 0.001). Based on a clinical questionnaire survey, PET/CT provided additional diagnostic information for 77.4% of patients, and 89.6% of patients benefited from PET/CT examination.

Conclusions

FDG PET/CT is a valuable tool for clinical diagnosis of FUO/IUO, and it is of great significance in further investigating the usefulness of PET/CT in non-neoplastic diseases.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Peking University People’s Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China

    Qian Wang & Yuan Li

  2. Department of Nuclear Medicine, The First Hospital of China Medical University, No.155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China

    Ya-Ming Li

  3. PET Center, Huashan Hospital, Fudan University, Shanghai, China

    Feng-Chun Hua

  4. PET Center, Nanfang Hospital, Southern Medical University, Guangzhou, China

    Quan-Shi Wang

  5. Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

    Xiao-Li Zhang

  6. Department of Nuclear Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China

    Chao Cheng

  7. Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital of the First Affiliated Hospital of Xiamen University, Xiamen, China

    Hua Wu

  8. Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Beijing, China

    Zhi-Ming Yao

  9. Department of Nuclear Medicine, Peking University Third Hospital, Beijing, China

    Wei-Fang Zhang

  10. PET Imaging Diagnostic Center, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China

    Qing-Yi Hou

  11. Department of Nuclear Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, China

    Wei-Bing Miao

  12. Department of Nuclear Medicine, Inner Mongolia Medical University Affiliated Hospital, Hohhot, China

    Xue-Mei Wang

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  1. Qian Wang
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  3. Yuan Li
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Correspondence to Qian Wang or Ya-Ming Li.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent does not apply as this is a review manuscript.

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Wang, Q., Li, YM., Li, Y. et al. 18F-FDGPET/CT in fever of unknown origin and inflammation of unknown origin: a Chinese multi-center study. Eur J Nucl Med Mol Imaging 46, 159–165 (2019). https://doi.org/10.1007/s00259-018-4121-1

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  • DOI: https://doi.org/10.1007/s00259-018-4121-1

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