title: Clinical value of dual-phase 18F-FDG SPECT with serum procalcitonin for identification of etiology in tumor patients with fever of unknown origin.
abstract: OBJECTIVE
  The purpose of the study was to evaluate clinical value of dual-phase 18F-FDG SPECT with serum procalcitonin (PCT) in identifying cancers in patients with fever of unknown origin (FUO).
  
  
  METHODS
  PCT test and dual-phase 18F-FDG SPECT were sequentially performed on 50 consecutive patients with FUO. Two radiologists evaluated all 18F-FDG SPECT data independently. A consensus was reached if any difference of opinions existed. Final diagnosis was based on a comprehensive analysis of results for the PCT test, dual- phase 18F-FDG SPECT and bacterial cultivation, regarded as a gold standard.
  
  
  RESULTS
  Among 50 patients, 34 demonstrated PCT ≥ 0.5 μg/L. Coincidence imaging showed in 37 patients with inflammatory lesions, and 13 with malignancy. Finally, 36 bacterial, 1 fungal and 1 viral infections, as well as 12 cancerous fevers were confirmed by dual-phase 18F-FDG SPECT with PCT, combined with bacterial cultivation and clinical follow-up.
  
  
  CONCLUSIONS
  Our study demonstrated that dual-phase 18F-FDG SPECT in association with PCT could be a valuable tool for diagnosis in tumor patients with FUO.
authors.affiliation: Division of Infectious Diseases, Affiliated Zhongda Hospital of Southeast University, Nanjing, China E-mail : slim888@163.com, huangxinen06@aliyun.com.
authors.forename: Qun
authors.initials: Q
authors.lastname: Zhang
authors.forename: Chun
authors.initials: C
authors.lastname: Shan
authors.forename: Pei
authors.initials: P
authors.lastname: Wu
authors.forename: Xin-En
authors.initials: XE
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D005335:Fever of Unknown Origin / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D049268:Positron-Emission Tomography; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; C000606589:CALCA protein, human; D011498:Protein Precursors; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide