The utility of 18fdg-pet/ct in diagnosing fever of unknown origin: The experience of a large tertiary medical center

Hussein Mahajna, Keren Vaknin, Jennifer Ben Shimol, Abdulla Watad, Arsalan Abu-Much, Naim Mahroum, Ora Shovman, Yehuda Shoenfeld, Howard Amital, Tima Davidson

Research output: Contribution to journalArticlepeer-review

Abstract

Fever of unknown origin (FUO) poses a diagnostic challenge, and 18-fluorodexoyglucose positron emission tomography with computed tomography (18FDG-PET/CT) may identify the source. We aimed to evaluate the diagnostic yield of 18FDG-PET/CT in the work-up of FUO. The records of patients admitted to Sheba Medical Center between January 2013 and January 2018 who underwent 18FDG-PET/CT for the evaluation of FUO were reviewed. Following examination of available medical test results, 18FDG-PET/CT findings were assessed to determine whether lesions identified proved diagnostic. Of 225 patients who underwent 18FDG-PET/CT for FUO work-up, 128 (57%) met inclusion criteria. Eighty (62.5%) were males; mean age was 59 ± 20.3 (range: 18–93). A final diagnosis was made in 95 (74%) patients. Of the 128 18FDG-PET/CT tests conducted for the workup of FUO, 61 (48%) were true positive, 26 (20%) false positive, 26 (20%) true negative, and 15 (12%) false negative. In a multivariate analysis, weight loss and anemia were independently associated with having a contributary results of 18FDG-PET/CT. The test yielded a sensitivity of 70%, specificity of 37%, positive predictive value of 70%, and negative predictive value of 37%. 18FDG-PET/CT is a valuable tool in the diagnostic workup of FUO. It proved effective in diagnosing almost half the patients, especially in those with anemia and weight loss.

Original languageEnglish
Article number5360
JournalInternational Journal of Environmental Research and Public Health
Volume18
Issue number10
DOIs
StatePublished - 2 May 2021

Keywords

  • 18FDG-PET/CT
  • FUO
  • Fever of unknown origin
  • Nuclear imaging
  • Positron emission tomography

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