title: PET Index of Bone Glucose Metabolism (PIBGM) Classification of PET/CT Data for Fever of Unknown Origin Diagnosis.
abstract: OBJECTIVE
  Fever of unknown origin (FUO) remains a challenge in clinical practice. Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is helpful in diagnosing the etiology of FUO. This paper aims to develop a completely automatic classification method based on PET/CT data for the computer-assisted diagnosis of FUO.
  
  
  METHODS
  We retrospectively analyzed the FDG PET/CT scan of 175 FUO patients, 79 males and 96 females. The final diagnosis of all FUO patients was achieved through pathology or clinical evaluation, including 108 normal patients and 67 FUO patients. CT anatomic information was used to acquire bone functional information from PET images. The skeletal system of FUO patients was classified by analyzing the standardized uptake value (SUV) and the PET index of bone glucose metabolism (PIBGM). The SUV distributions in the bone marrow and the bone cortex were also studied in detail.
  
  
  RESULTS
  The SUV and PIBGM of the bone marrow only slightly differed between the FUO patients and normal people, whereas the SUV of whole bone structures and the PIBGM of the bone cortex significantly differed between the normal people and FUO patients. The method detected 43 patients from 67 FUO patients, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 64.18%, 95%, 93.48%, 72.73%, and 83.33%, respectively.
  
  
  CONCLUSIONS
  The experimental results demonstrate that the study can achieve automatic classification of FUO patients by the proposed novel biomarker of PIBGM, which has the potential to be utilized in clinical practice.
authors.affiliation: Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Electronics, Beijing Institute of Technology, Beijing, 100081, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.affiliation: Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Electronics, Beijing Institute of Technology, Beijing, 100081, China.
authors.forename: Xinxin
authors.initials: X
authors.lastname: Liu
authors.affiliation: Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Electronics, Beijing Institute of Technology, Beijing, 100081, China.
authors.forename: Danni
authors.initials: D
authors.lastname: Ai
authors.affiliation: Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Electronics, Beijing Institute of Technology, Beijing, 100081, China.
authors.forename: Jingfan
authors.initials: J
authors.lastname: Fan
authors.affiliation: Department of Nuclear Medicine, PET Center, Peking Union Medical College Hospital, Beijing, 100032, China.
authors.forename: Youjing
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Nuclear Medicine, PET Center, Peking Union Medical College Hospital, Beijing, 100032, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Nuclear Medicine, PET Center, Peking Union Medical College Hospital, Beijing, 100032, China.
authors.forename: Li
authors.initials: L
authors.lastname: Huo
authors.affiliation: Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Electronics, Beijing Institute of Technology, Beijing, 100081, China.
authors.forename: Yongtian
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001842:Bone and Bones / Q000378:metabolism*; D050260:Carbohydrate Metabolism; D003936:Diagnosis, Computer-Assisted; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis* / Q000378:metabolism*; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000378:metabolism; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose