Current situation and cost-effectiveness of 18 F-FDG PET/CT for the diagnosis of fever of unknown origin and inflammation of unknown origin: A single-center, large-sample study from China

• Published in: European journal of radiology 2022-03, Vol.148, p.110184
• Main Authors: Chen, Jin-Chuan, Wang, Qian, Li, Yuan, Zhao, Yun-Yun, Gao, Ping, Qiu, Li-Heng, Hao, Ke-Ji, Li, He-Bei, Yue, Ming-Gang, Zhou, Yun-Shan, Zhu, Ji-Hong, Gao, Yan, Gao, Zhan-Cheng
• Format: Article
• Language: English
• Subjects: Cost-Benefit Analysis; Fever of Unknown Origin - diagnostic imaging; Fever of Unknown Origin - etiology; Fluorodeoxyglucose F18; Humans; Inflammation - complications; Inflammation - diagnostic imaging; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiopharmaceuticals; Retrospective Studies
• ISSN: 1872-7727
• DOI: 10.1016/j.ejrad.2022.110184

F-FDG PET/CT has an important role in the evaluation of fever of unknown origin (FUO) and inflammation of unknown origin (IUO). Our study was to investigate the current status of the inclusion of F-FDG PET/CT within FUO/ IUO diagnostic work-up and evaluate the cost-effectiveness of it in China. A total of 741 FUO/IUO patients admitted to our hospital from January 2012 to December 2019 were retrospectively reviewed. The clinical characteristic, medical expenses to reach diagnosis and the proportion of definite etiological diagnosis achieved upon hospital discharge were compared between patients examined by F-FDG PET/CT ( F-FDG PET/CT group) and patients not examined by F-FDG PET/CT (non- F-FDG PET/CT group). The mean age, proportion of critically-ill patients, proportion of rheumatologic diseases, the number of examinations and hospitalisation days to reach diagnosis in the F-FDG PET/CT group were significantly higher than those in the non- F-FDG PET/CT group. The mean medical costs of F-FDG PET/CT group were significantly higher than those of non- F-FDG PET/CT group, whereas the proportion of definite etiological diagnosis achieved upon hospital discharge of F-FDG PET/CT group was significantly higher than that of non- F-FDG PET/CT group. The mean hospitalisation days and mean medical costs before diagnosis were significantly lower in patients who undertook F-FDG PET/CT ≤ 7 days after hospital admission than those in patients who undertook F-FDG PET/CT > 7 days after hospital admission. F-FDG PET/CT is mostly used in critically-ill and hard-to-diagnose FUO/IUO patients currently in China, which may conceal its cost-effective advantage. While the early use of F-FDG PET/CT according to patient characteristics and etiological clues could help to reduce hospitalization stay, limit medical costs, thus producing its diagnostic effect to the great extent.