67-Gallium SPECT/CT in febrile syndromes of unknown origin

Abstract Introduction and objective Febrile syndromes of unknown origin (FSUO) are complex processes in hospital practice. Their management includes an exhaustive medical history and examination, as well as an extensive number of biochemical tests. If these are inconclusive, diagnostic imaging techn...

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Published in:Revista Española de medicina nuclear e imagen molecular (English ed.) 2018-11, Vol.37 (6), p.354-358
Main Authors: Serrano Vicente, J, Parras Castañera, E, Infante Torre, J.R, Rayo Madrid, J.I, García Bernardo, L, Caballero Moreno, M, Martínez Esteve, A, Muñoz Sanz, A
Format: Article
Language:English
Subjects:
67-Gallium
Febrile syndrome
Fever of unknown origin
Fiebre de origen desconocido
Galio-67
Radiology
SPECT/CT
SPECT/TC
Síndrome febril
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Summary:Abstract Introduction and objective Febrile syndromes of unknown origin (FSUO) are complex processes in hospital practice. Their management includes an exhaustive medical history and examination, as well as an extensive number of biochemical tests. If these are inconclusive, diagnostic imaging techniques such as SPECT/CT with67 -Gallium Citrate (67 Ga-SPECT/CT) could play an important role. We evaluated its role in the management of FSUO in our healthcare area. Material and methods We reviewed 57 patients who underwent a67 Ga-SPECT/CT due to a FSUO (32 women and 25 men, age range: 32–83 years old) obtaining scintigraphic findings, previous treatments and final diagnosis. Values of sensitivity, specificity, positive predictive values (VPP) and negative predictive values (NPV) were obtained and compared with the results for PET/CT with18 Fluor-deoxy-glucose (18 F-FDG PET/CT) found in the literature. Results The diagnoses found were: infection in 27/57 (47%), inflammatory disease in 15/57 (26%), neoplasm in 1/57 (1.75%) and patients without final diagnosis in 14/57 (24%). The statistical values of67 Ga-SPECT/CT were: sensitivity, specificity, PPV and NPV of 67%, 93%, 97% y 48%, respectively which were slightly lower than those found for the18 F-FDG PET/CT (86%, 52%, 70% and 92%, respectively). The diagnostic yield was 73% which increased to 80% in the patients who lacked empirical treatment. Conclusion Despite the better results of18 F-FDG PET/CT,67 Ga-SPECT/CT behaved as a useful technique in the management of FSUO. It is advisable to use it if18 F-FDG PET/CT is not available.
ISSN:2253-8089
2253-8089
DOI:10.1016/j.remnie.2018.08.001