title: Value of 18F-FDG PET/CT in diagnosing chronic Q fever in patients with central vascular disease.
abstract: BACKGROUND
  The aim of this study is to describe the value of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in diagnosing chronic Q fever in patients with central vascular disease and the added value of 18F-FDG PET/CT in the diagnostic combination strategy as described in the Dutch consensus guideline for diagnosing chronic Q fever.
  
  
  METHODS
  18F-FDG PET/CT was performed in patients with an abdominal aortic aneurysm or aorto-iliac reconstruction and chronic Q fever, diagnosed by serology and positive PCR for Coxiella burnetii DNA in blood and/or tissue (PCR-positive study group). Patients with an abdominal aortic aneurysm or aorto-iliac reconstruction without clinical and serological findings indicating Q fever infection served as a control group. Patients with a serological profile of chronic Q fever and a negative PCR in blood were included in additional analyses (PCR-negative study group).
  
  
  RESULTS
  Thirteen patients were evaluated in the PCR-positive study group and 22 patients in the control group. 18F-FDG PET/CT indicated vascular infection in 6/13 patients in the PCR-positive study group and 2/22 patients in the control group. 18F-FDG PET/CT demonstrated a sensitivity of 46% (95% CI: 23-71%), specificity of 91% (95% CI: 71-99%), positive predictive value of 75% (95% CI:41-93%) and negative predictive value of 74% (95% CI: 55-87%). In the PCR-negative study group, 18F-FDG PET/CT was positive in 10/20 patients (50%).
  
  
  CONCLUSIONS
  The combination of 18F-FDG PET/CT, as an imaging tool for identifying a focus of infection, and Q fever serology is a valid diagnostic strategy for diagnosing chronic Q fever in patients with central vascular disease.
authors: Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
authors: J C J P
authors: JC
authors: Hagenaars
authors: P C
authors: PC
authors: Wever
authors: A W
authors: AW
authors: Vlake
authors: N H M
authors: NH
authors: Renders
authors: A S
authors: AS
authors: van Petersen
authors: M
authors: M
authors: Hilbink
authors: M G L
authors: MG
authors: de Jager-Leclercq
authors: F L
authors: FL
authors: Moll
authors: O H J
authors: OH
authors: Koning
authors: C J
authors: CJ
authors: Hoekstra
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000382:microbiology; D001018:Aortic Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000382:microbiology; D001807:Blood Vessel Prosthesis / Q000382:microbiology*; D016997:Coxiella burnetii / Q000235:genetics; D004269:DNA, Bacterial / Q000032:analysis; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000601:surgery; D016133:Polymerase Chain Reaction; D000072078:Positron Emission Tomography Computed Tomography; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000382:microbiology; D011778:Q Fever / Q000175:diagnosis / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014652:Vascular Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000382:microbiology
chemical_list: D004269:DNA, Bacterial; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18