The efficacy of 18 F-FDG PET/CT and 67 Ga SPECT/CT in diagnosing fever of unknown origin

Fever of unknown origin (FUO) is a diagnostic challenge. This study aimed to assess the efficacy of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ( F-FDG PET/CT) and gallium-67 single-photon emission computed tomography/computed tomography ( Ga SPECT/CT) in diagnosi...

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Bibliographic Details
Published in:International journal of infectious diseases 2017-09, Vol.62, p.10-17
Main Authors: Hung, Bor-Tau, Wang, Pei-Wen, Su, Yu-Jih, Huang, Wen-Chi, Chang, Yen-Hsiang, Huang, Shu-Hua, Chang, Chiung-Chih
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Female
Fever of Unknown Origin - diagnosis
Fluorodeoxyglucose F18
Gallium Radioisotopes
Humans
Male
Middle Aged
Neoplasms - diagnosis
Noncommunicable Diseases
Positron Emission Tomography Computed Tomography
Radiopharmaceuticals
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed - methods
Young Adult
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Summary:Fever of unknown origin (FUO) is a diagnostic challenge. This study aimed to assess the efficacy of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ( F-FDG PET/CT) and gallium-67 single-photon emission computed tomography/computed tomography ( Ga SPECT/CT) in diagnosing FUO. A total of 68 patients with FUO underwent F-FDG PET/CT and Ga SPECT/CT from January 2013 through May 2016. Images were read independently. The imaging results were compared with the final diagnosis and categorized as helpful for diagnosis or non-contributory to diagnosis in the clinical setting. Associations between categorical variables were evaluated with the chi-square test or Fisher's exact test. Ten of the 68 patients were excluded. An infectious underlying disease was found in 23 patients. A malignant disorder was the cause of FUO in 10 patients. Non-infectious inflammatory disease was found in 11 patients. Adrenal insufficiency was the cause of FUO in two patients. The cause of FUO was not found for 12 patients. A high false-positive rate of 44% (7/16) was observed for F-FDG PET/CT, while a high false-negative rate of 55% (23/42) was observed for Ga SPECT/CT. F-FDG PET/CT studies depicted all Ga-avid lesions. The sensitivity (79% vs. 45%) and clinical contribution (72% vs. 55%) of F-FDG PET/CT in diagnosing FUO were significantly higher than those of Ga SPECT/CT (p
ISSN:1201-9712
1878-3511
DOI:10.1016/j.ijid.2017.06.019