title: Value of (18)F-FDG-PET/CT in patients with fever of unknown origin and unexplained prolonged inflammatory syndrome: a single centre analysis experience.
abstract: OBJECTIVE
  The aim of our study was to evaluate the diagnostic contribution of (18)F-fluoro-deoxyglucose ((18)F-FDG)-positron emission tomography (PET)/computed tomography (CT) in patients with fever of unknown origin (FUO) or unexplained prolonged inflammatory syndrome (UPIS) in real life.
  
  
  METHODS
  We performed a retrospective study including 14 patients with FUO or UPIS hospitalised in our institution (Strasbourg University Hospital, France) between January 2005 and July 2006. (18)F-FDG-PET/CT was considered helpful when abnormal results allowed an accurate diagnosis.
  
  
  RESULTS
  (18)F-FDG-PET/CT was helpful in half the patients (7/14) for final diagnosis. A diagnosis was reached in 87.5% of the patients (7/8) with an abnormal (18)F-FDG-PET/CT but only in 50% of the patients (3/6) with a normal (18)F-FDG-PET/CT. Conventional chest and abdominal CT was performed in 13 patients before ordering (18)F-FDG-PET/CT. We considered that (18)F-FDG-PET/CT was essential to establish the final diagnosis in only 23% of the patients (3/13) since neither chest nor abdominal CT identified abnormalities consistent with the final diagnosis. However, among the three patients, two were diagnosed with large vessel vasculitis and one patient with local prosthetic infection.
  
  
  CONCLUSIONS
  Our study supports the potential interest of (18)F-FDG-PET/CT in the diagnostic workup of FUO and UPIS as it helped establish a fine diagnosis in half of the cases. However, (18)F-FDG-PET/CT appeared to be essential to the final diagnosis in only 23% of the cases. In our opinion, this protocol should be performed as a second level test, especially when conventional CT is normal or is unable to discriminate between active and silent lesions.
authors.affiliation: Department of Internal Medicine, Medical Clinic B, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: L
authors.initials: L
authors.lastname: Federici
authors.forename: C
authors.initials: C
authors.lastname: Blondet
authors.forename: A
authors.initials: A
authors.lastname: Imperiale
authors.forename: J
authors.initials: J
authors.lastname: Sibilia
authors.forename: J-L
authors.initials: JL
authors.lastname: Pasquali
authors.forename: F
authors.initials: F
authors.lastname: Pflumio
authors.forename: B
authors.initials: B
authors.lastname: Goichot
authors.forename: G
authors.initials: G
authors.lastname: Blaison
authors.forename: J-C
authors.initials: JC
authors.lastname: Weber
authors.forename: D
authors.initials: D
authors.lastname: Christmann
authors.forename: A
authors.initials: A
authors.lastname: Constantinesco
authors.forename: E
authors.initials: E
authors.lastname: Andrès
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007249:Inflammation / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013577:Syndrome; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18