[F-18-FDG hybrid camera PET in patients with postoperative fever].
OBJECTIVE
Evaluation of F-18-FDG-hybrid-camera-PET imaging in patients with undetermined postoperative fever (POF).


METHODS
Prospective study of 18 patients (9 women, 9 men; age 23-85 years) suffering from POF with 2-fluoro-2'-deoxyglucose (F-18-FDG) using a dual headed coincidence camera (DHCC). Surgery had been performed 5-94 days prior to our investigation. 13 of the 18 patients received antibiotic therapy during the time of evaluation. Ten (55%) had an infectious and eight (45%) a non infectious cause of fever.


RESULTS
Increased F-18-FDG-uptake outside the surgical wound occurred in 13 regions (infection n = 11, malignancy n = 2). The sensitivity of F-18-FDG-hybrid-camera-PET in imaging infection in areas outside the surgical wound was 86% and the specificity 100%, respectively. Antibiotic therapy did not negatively influence the results of F-18-FDG-scanning. Increased F-18-FDG-uptake within the surgical wound was seen in 8 of 18 patients. The sensitivity of F-18-FDG-hybrid-camera-PET in imaging infection within the surgical wound was 100% and the specificity 56%, respectively. The interval between surgery and F-18-FDG-scanning was significantly shorter in patients with false positive results compared with patients showing true negative results (median 34 vs. 54 days; p = 0.038).


CONCLUSIONS
In POF-Patients, F-18-FDG transaxial tomography performed with a F-18-FDG-hybrid-camera-PET is sensitive in the diagnosis of inflammation and malignant disease within and outside the surgical wound. Because of the accumulation of the tracer both in granulation tissue and infection, the specificity in detecting the focus of fever within the surgical wound is poor.
Meller
J
J
Abteilung Nuklearmedizin, Georg August Universität, Göttingen, Deutschland. jmeller@med.uni-goettingen.de
Sahlmann
C O
CO
Lehmann
K
K
Siefker
U
U
Meyer
I
I
Schreiber
K
K
Altenvoerde
G
G
Becker
W
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005189:False Positive Reactions; D005260:Female; D005334:Fever / Q000000981:diagnostic imaging*; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006099:Granuloma / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D014018:Tissue Distribution; D014055:Tomography, Emission-Computed / Q000295:instrumentation* / Q000379:methods
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
F-18-FDG-Hybrid-Kamera-PET bei Patienten mit postoperativem Fieber.