The Utility of 18FDG-PET/CT in Diagnosing Fever of Unknown Origin: The Experience of a Large Tertiary Medical Center

Hussein Mahajna, Keren Vaknin, Jennifer Ben Shimol, Abdulla Watad, Arsalan Abu-Much, Naim Mahroum, Ora Shovman, Yehuda Shoenfeld, Howard Amital and Tima Davidson
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Hussein Mahajna: Department of Medicine ‘B’, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
Keren Vaknin: Department of Medicine ‘B’, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
Jennifer Ben Shimol: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
Abdulla Watad: Department of Medicine ‘B’, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
Arsalan Abu-Much: Department of Medicine ‘B’, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
Naim Mahroum: Department of Medicine ‘B’, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
Ora Shovman: Department of Medicine ‘B’, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
Yehuda Shoenfeld: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
Howard Amital: Department of Medicine ‘B’, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
Tima Davidson: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel

IJERPH, 2021, vol. 18, issue 10, 1-14

Abstract: Fever of unknown origin (FUO) poses a diagnostic challenge, and 18-fluorodexoyglucose positron emission tomography with computed tomography (18FDG-PET/CT) may identify the source. We aimed to evaluate the diagnostic yield of 18FDG-PET/CT in the work-up of FUO. The records of patients admitted to Sheba Medical Center between January 2013 and January 2018 who underwent 18FDG-PET/CT for the evaluation of FUO were reviewed. Following examination of available medical test results, 18FDG-PET/CT findings were assessed to determine whether lesions identified proved diagnostic. Of 225 patients who underwent 18FDG-PET/CT for FUO work-up, 128 (57%) met inclusion criteria. Eighty (62.5%) were males; mean age was 59 ± 20.3 (range: 18–93). A final diagnosis was made in 95 (74%) patients. Of the 128 18FDG-PET/CT tests conducted for the workup of FUO, 61 (48%) were true positive, 26 (20%) false positive, 26 (20%) true negative, and 15 (12%) false negative. In a multivariate analysis, weight loss and anemia were independently associated with having a contributary results of 18FDG-PET/CT. The test yielded a sensitivity of 70%, specificity of 37%, positive predictive value of 70%, and negative predictive value of 37%. 18FDG-PET/CT is a valuable tool in the diagnostic workup of FUO. It proved effective in diagnosing almost half the patients, especially in those with anemia and weight loss.

Keywords: fever of unknown origin; FUO; positron emission tomography; 18FDG-PET/CT; nuclear imaging (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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