The efficacy of 18F-FDG PET/CT and 67Ga SPECT/CT in diagnosing fever of unknown origin
Objective: Fever of unknown origin (FUO) is a diagnostic challenge. This study aimed to assess the efficacy of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and gallium-67 single-photon emission computed tomography/computed tomography (67Ga SPECT/CT...
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doaj-d87c23fa4fa54bed9a047980b8acae2a2020-11-24T23:37:49ZengElsevierInternational Journal of Infectious Diseases1201-97121878-35112017-09-0162C101710.1016/j.ijid.2017.06.019The efficacy of 18F-FDG PET/CT and 67Ga SPECT/CT in diagnosing fever of unknown originBor-Tau Hung0Pei-Wen Wang1Yu-Jih Su2Wen-Chi Huang3Yen-Hsiang Chang4Shu-Hua Huang5Chiung-Chih Chang6Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Neurology, Cognitive and Aging Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanObjective: Fever of unknown origin (FUO) is a diagnostic challenge. This study aimed to assess the efficacy of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and gallium-67 single-photon emission computed tomography/computed tomography (67Ga SPECT/CT) in diagnosing FUO. Methods: A total of 68 patients with FUO underwent 18F-FDG PET/CT and 67Ga SPECT/CT from January 2013 through May 2016. Images were read independently. The imaging results were compared with the final diagnosis and categorized as helpful for diagnosis or non-contributory to diagnosis in the clinical setting. Associations between categorical variables were evaluated with the chi-square test or Fisher’s exact test. Results: Ten of the 68 patients were excluded. An infectious underlying disease was found in 23 patients. A malignant disorder was the cause of FUO in 10 patients. Non-infectious inflammatory disease was found in 11 patients. Adrenal insufficiency was the cause of FUO in two patients. The cause of FUO was not found for 12 patients. A high false-positive rate of 44% (7/16) was observed for 18F-FDG PET/CT, while a high false-negative rate of 55% (23/42) was observed for 67Ga SPECT/CT. 18F-FDG PET/CT studies depicted all 67Ga-avid lesions. The sensitivity (79% vs. 45%) and clinical contribution (72% vs. 55%) of 18F-FDG PET/CT in diagnosing FUO were significantly higher than those of 67Ga SPECT/CT (p < 0.05). Conclusions: On the basis of this study, the diagnostic performance of 18F-FDG PET/CT is superior to 67Ga SPECT/CT in the work-up of patients with FUO. With its rapid results and superior sensitivity, 18F-FDG PET/CT may replace 67Ga SPECT/CT where this technique is available.http://www.sciencedirect.com/science/article/pii/S120197121730173X18F-FDG PET/CT67Ga SPECT/CTFever of unknown origin |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Bor-Tau Hung Pei-Wen Wang Yu-Jih Su Wen-Chi Huang Yen-Hsiang Chang Shu-Hua Huang Chiung-Chih Chang |
spellingShingle |
Bor-Tau Hung Pei-Wen Wang Yu-Jih Su Wen-Chi Huang Yen-Hsiang Chang Shu-Hua Huang Chiung-Chih Chang The efficacy of 18F-FDG PET/CT and 67Ga SPECT/CT in diagnosing fever of unknown origin International Journal of Infectious Diseases 18F-FDG PET/CT 67Ga SPECT/CT Fever of unknown origin |
author_facet |
Bor-Tau Hung Pei-Wen Wang Yu-Jih Su Wen-Chi Huang Yen-Hsiang Chang Shu-Hua Huang Chiung-Chih Chang |
author_sort |
Bor-Tau Hung |
title |
The efficacy of 18F-FDG PET/CT and 67Ga SPECT/CT in diagnosing fever of unknown origin |
title_short |
The efficacy of 18F-FDG PET/CT and 67Ga SPECT/CT in diagnosing fever of unknown origin |
title_full |
The efficacy of 18F-FDG PET/CT and 67Ga SPECT/CT in diagnosing fever of unknown origin |
title_fullStr |
The efficacy of 18F-FDG PET/CT and 67Ga SPECT/CT in diagnosing fever of unknown origin |
title_full_unstemmed |
The efficacy of 18F-FDG PET/CT and 67Ga SPECT/CT in diagnosing fever of unknown origin |
title_sort |
efficacy of 18f-fdg pet/ct and 67ga spect/ct in diagnosing fever of unknown origin |
publisher |
Elsevier |
series |
International Journal of Infectious Diseases |
issn |
1201-9712 1878-3511 |
publishDate |
2017-09-01 |
description |
Objective: Fever of unknown origin (FUO) is a diagnostic challenge. This study aimed to assess the efficacy of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and gallium-67 single-photon emission computed tomography/computed tomography (67Ga SPECT/CT) in diagnosing FUO.
Methods: A total of 68 patients with FUO underwent 18F-FDG PET/CT and 67Ga SPECT/CT from January 2013 through May 2016. Images were read independently. The imaging results were compared with the final diagnosis and categorized as helpful for diagnosis or non-contributory to diagnosis in the clinical setting. Associations between categorical variables were evaluated with the chi-square test or Fisher’s exact test.
Results: Ten of the 68 patients were excluded. An infectious underlying disease was found in 23 patients. A malignant disorder was the cause of FUO in 10 patients. Non-infectious inflammatory disease was found in 11 patients. Adrenal insufficiency was the cause of FUO in two patients. The cause of FUO was not found for 12 patients. A high false-positive rate of 44% (7/16) was observed for 18F-FDG PET/CT, while a high false-negative rate of 55% (23/42) was observed for 67Ga SPECT/CT. 18F-FDG PET/CT studies depicted all 67Ga-avid lesions. The sensitivity (79% vs. 45%) and clinical contribution (72% vs. 55%) of 18F-FDG PET/CT in diagnosing FUO were significantly higher than those of 67Ga SPECT/CT (p < 0.05).
Conclusions: On the basis of this study, the diagnostic performance of 18F-FDG PET/CT is superior to 67Ga SPECT/CT in the work-up of patients with FUO. With its rapid results and superior sensitivity, 18F-FDG PET/CT may replace 67Ga SPECT/CT where this technique is available. |
topic |
18F-FDG PET/CT 67Ga SPECT/CT Fever of unknown origin |
url |
http://www.sciencedirect.com/science/article/pii/S120197121730173X |
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