Journal of Peking University(Health Sciences) ›› 2015, Vol. 47 ›› Issue (1): 175-180.

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Diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in fever of unknown origin

KANG Lei1*, XU Xiao-jie2*, FAN Yan1△, WANG Rong-fu1△, MA Chao1, FU Zhan-li1, ZHANG Jian-hua1, ZHANG Xu-chu1   

  1. (1. Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China; 2. Department of Medical Molecular Biology, Institute of Biotechnology, Academy of Military Medical Sciences, Beijing 100850, China)
  • Online:2015-02-18 Published:2015-02-18

Abstract: Objective: To evaluate the diagnostic value of fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in fever of unknown origin (FUO) in a Chinese hospital.  Methods: The records of 51 patients with FUO (32 men and 19 women; mean age 54 years with a range between 3 and 81 years) were analyzed retrospectively. All the patients were examined by 18F-FDG PET/CT scan and the results were compared with the final diagnosis which was established by additional procedures including pathology, laboratory examination, and clinical followup for more than 3 months. The t test was used for statistical analysis. Results: A final diagnosis was established for 48 patients, including 32 patients with infectious diseases, 9 with malignancies, and 7 with non-infectious inflammatory diseases. By FDG PET scan alone, the rates of true positive, false positive, false negative, and true negative were 52.9%, 27.5%, 17.6%, and 2.0%, respectively. By FDG PET/CT scan, the rates of true positive, false positive, false negative, and true negative were 70.6%, 27.5%, 2.0%, and 0, respectively. 18F-PET/CT had a sensitivity of 97.3% (36/37), specificity of 0 (0/14), and accuracy of 70.6% (36/51) in FUO, especially a high sensitivity and accuracy of 100% (9/9) in the diagnosis of malignant tumor. Moreover, the maximum standardized uptake value (SUVmax) in tumor was significant higher than that in infection (3.7±2.7 vs. 7.7±3.5, P=0.001, t=3.6), which implied that SUVmax might be useful in differential diagnosis in FUO. Conclusion: FDG PET/CT is a valuable imaging tool for the identification and location of the potential lesion in FUO and is helpful for the etiological diagnosis, especially in the diagnosis of malignant lesions.

Key words: Fever of unknown origin, Fluorodeoxyglucose F18, Positron-emission tomography

[1] LIAO Xu-he,WANG Rong-fu,LIU Meng,CHEN Xue-qi,XIONG Yan,NONG Lin,YIN Lei,ZHANG Bing-ye,DU Yu-jing. Semiquantitative parameters of 18F-FDG PET/CT, gene mutation states of epidermal growth factor receptor and anaplastic lymphoma kinase in prognosis evaluation of patients with lung adenocarcinoma [J]. Journal of Peking University (Health Sciences), 2021, 53(2): 246-254.
[2] ZHENG Yi-Ming, SUN Wei, WANG Chao-Xia, ZHANG Wei, YUAN Yun. Leucine-rich glioma inactivated-1 protein antibody associated limbic encephalitis: one case report [J]. Journal of Peking University(Health Sciences), 2014, 46(4): 646-649.
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