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ORIGINAL RESEARCH article

Front. Med.
Sec. Nuclear Medicine
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1511710
This article is part of the Research Topic Advances in PET-CT Imaging View all 12 articles

Diagnostic Efficacy and Necessity of 18F-FDG PET/CT in Fever of Unknown Origin: Insights from a Retrospective Cohort Study

Provisionally accepted
小曼 于 小曼 于 爽 王 爽 王 NA DU NA DU *海英 陈 海英 陈
  • First Affiliated Hospital of Jilin University, Changchun, China

The final, formatted version of the article will be published soon.

    Background: Despite advancements in medical examination equipment and techniques, fever of unknown origin (FUO) remains challenging in internal medicine. Purpose: This study evaluates the diagnostic efficacy and necessity of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with FUO. Methods: We retrospectively analyzed the results of 18F-FDG PET/CT in a cohort of 284 patients with FUO admitted to the Department of Infection at the First Hospital of Jilin University between January 2018 and March 2024. All patients received a final clinical diagnosis after various treatments, which helped determine the diagnostic relevance of identified lesions using 18F-FDG PET/CT. Additionally, univariate and multivariate logistic regression analyses were performed to evaluate the predictive value of relevant laboratory indices on the true-positive results of 18F-FDG PET/CT. The diagnostic performance for different etiologies of FUO was assessed by calculating the area under the receiver operating characteristic curve.Results: Of the 284 enrolled patients, infectious diseases were diagnosed in 53 (18.7%), non-infectious inflammatory diseases in 76 (26.8%), malignant tumors in 66 (23.2%), and 89 (31.3%) remained undiagnosed. The final diagnoses of 136 patients (47.9%) correlated with their 18F-FDG PET/CT results, yielding a sensitivity of 79.5%, specificity of 61.1%, positive predictive value of 75.6%, and negative predictive value of 66.3%. Furthermore, a correlation was found between localized pain, prolonged activated partial thromboplastin time, and true-positive 18F-FDG PET/CT results.The high diagnostic efficacy of 18F-FDG PET/CT in FUO suggests its potential as a routine imaging modality, which could enhance patient management and reduce the need for costly and unnecessary invasive procedures. The identification of clinical factors that are predictive of true-positive diagnosis could facilitate more effective allocation of PET/CT imaging.

    Keywords: Fever of unknown origin (FUO), 18F-FDG PET/CT, diagnostic value, image analysis, final diagnosis

    Received: 15 Oct 2024; Accepted: 16 Dec 2024.

    Copyright: © 2024 于, 王, DU and 陈. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: NA DU, First Affiliated Hospital of Jilin University, Changchun, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.