title: Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression.
abstract: OBJECTIVE
  Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression.
  
  
  METHODS
  All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis.
  
  
  RESULTS
  FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively.
  
  
  CONCLUSIONS
  FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value.
authors.affiliation: Department of Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Gijsbert J
authors.initials: GJ
authors.lastname: Blokhuis
authors.forename: Chantal P
authors.initials: CP
authors.lastname: Bleeker-Rovers
authors.forename: Marije G
authors.initials: MG
authors.lastname: Diender
authors.forename: Wim J G
authors.initials: WJ
authors.lastname: Oyen
authors.forename: Jos M Th
authors.initials: JM
authors.lastname: Draaisma
authors.forename: Lioe-Fee
authors.initials: LF
authors.lastname: de Geus-Oei
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005335:Fever of Unknown Origin / Q000000981:diagnostic imaging*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D008297:Male; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18