Diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in fever of unknown origin / 北京大学学报(医学版)

ABSTRACT

Objective: To evaluate the diagnostic value of fluorine-18 fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography ( PET/CT) in fever of unknown origin ( FUO) in a Chinese hospital .Methods:The records of 51 patients with FUO (32 men and 19 women;mean age 54 years with a range between 3 and 81 years) were analyzed retrospectively .All the patients were examined by 18 F-FDG PET/CT scan and the results were compared with the final diagnosis which was established by additional procedures including pathology , laboratory examination , and clinical follow-up for more than 3 months.The t test was used for statistical analysis .Results: A final diagnosis was established for 48 patients , including 32 patients with infectious diseases , 9 with malignancies , and 7 with non-infectious inflammatory diseases .By FDG PET scan alone , the rates of true positive , false positive , false negative, and true negative were 52.9%, 27.5%, 17.6%, and 2.0%, respectively.By FDG PET/CT scan, the rates of true positive, false positive, false negative, and true negative were 70.6%, 27.5%, 2.0%, and 0, respectively.18F-PET/CT had a sensitivity of 97.3%(36/37), specificity of 0 (0/14), and accuracy of 70.6%(36/51) in FUO, especially a high sensitivity and accuracy of 100%(9/9) in the diagnosis of malignant tumor .Moreover , the maximum standardized uptake value ( SUVmax ) in tumor was significant higher than that in infection (3.7 ±2.7 vs.7.7 ±3.5, P=0.001, t=3.6), which implied that SUVmax might be useful in differential diagnosis in FUO .Conclusion:FDG PET/CT is a valuable imaging tool for the identification and location of the potential lesion in FUO and is helpful for the etiological diagnosis , especially in the diagnosis of malignant lesions .