Subscribe to RSS
DOI: 10.1055/s-0029-1241901
© Georg Thieme Verlag KG Stuttgart · New York
Diagnostik bei Fieber unklarer Genese (FUO)
Positronen-Emissions-Tomographie/Computer- tomographie (PET-CT) Diagnosis of fever of unknown origin (FUO) Positron emission tomography/computed tomography (PET-CT)Publication History
eingereicht: 10.11.2008
akzeptiert: 29.4.2009
Publication Date:
06 October 2009 (online)

Zusammenfassung
Nuklearmedizinische Entzündungsszintigraphien haben sich bei der septischen Entzündungsherdsuche bewährt. Unbefriedigend bleibt aber bislang die Anwendung nuklearmedizinischer sowie radiologischer, sonographischer Verfahren bei Patienten mit Fieber unklarer Genese (FUO). Im Gegensatz zu akut entzündlichen, septischen Prozessen leiden meist ältere Patienten mit FUO öfters an okkulten Tumoren, atypischen Pneumonien, Hämatoblastosen, malignen Lymphomen etc. Neuerdings erlaubt 18 F(Fluor-18)-Fluordeoxy(i)glukose-PET (18F-FDG PET) treffsicher das Auffinden okkulter Veränderungen und aktuelle Daten zeigen, dass eine diagnostisch wertvolle Einordnung dieser Veränderungen zu verschiedenen Krankheitsentitäten möglich ist.
Summary
Nuclear medicine imaging is now well accepted for the localization of septic foci. But in patients the results of infection scintigraphy, radiology and ultrasound remain unsatisfactory in the diagnosis of fever of unknown origin (FUO). In contrast to septic infections, patients with FUO – mostly in elderly patients – tend to have such conditions as occult tumours, atypical pneumonia, hematoblastosis, malignant lymphomas. 18F(Fluor-18)-Fluordeoxyglucose-PET (18F-FDG PET) has made it possible to localize symptomatically occult changes with a high diagnostic accuracy and to achieve differentiation between benign and malignant changes.
Schlüsselwörter
Fieber unklarer Genese - FUO - Entzündungsszintigraphie - PET
Keywords
Fever of unknown origin - FUO - imaging infection - PET
Literatur
- 1
Baldwin A L, Thurston G.
Mechanics
of endothelial cell architecture and vascular permeability.
Crit
Rev Biomed Eng.
2001;
29
247-278
MissingFormLabel
- 2
Barghouthi S, Everett K D, Speert D P.
Nonopsonic phagocytosis of Pseudomonas aeruginosa
requires facilitated transport of D-glucose by macrophages.
J
Immunol.
1995;
154
3420-3428
MissingFormLabel
- 3
Bleeker-Rovers C P, Corstens F H. et
al .
Fever of unknown origin: prospective comparison
of diagnostic value of (18)F-FDG PET and (111)In-granulocyte scintigraphy.
Eur J Nucl Med Mol Imaging.
2004;
31
622-626
MissingFormLabel
- 4
Bleeker-Rovers C P, Vos F J, Corstens F H, Oyen W J.
Imaging of infectious diseases using [18F] fluorodeoxyglucose
PET.
Q J Nucl Med Mol Imaging.
2008;
52
17-29
MissingFormLabel
- 5
Blockmans D, Knockaert D, Maes A. et al .
Clinical value of [(18)F]fluoro-deoxyglucose
positron emission tomography for patients with fever of unknown
origin.
Clin Infect Dis.
2001;
15,32
191-196
MissingFormLabel
- 6
Brown R S, Wahl R L.
Overexpression
of Glut-1 glucose transporter in human breast cancer. An immunohistochemical
study.
Cancer.
1993;
72
2979-2985
MissingFormLabel
- 7
Buonomo C, Treves S T.
Gallium scanning
in children with fever of unknown origin.
Pediatr Radiol.
1993;
23
307-310
MissingFormLabel
- 8
Buysschaert I, Vanderschueren S, Blockmans D. et al .
Contribution of (18)fluoro-deoxyglucose
positron emission tomography to the work-up of patients with fever
of unknown origin.
Eur J Intern Med.
2004;
15
151-156
MissingFormLabel
- 9
Chakrabarti R, Jung C Y, Lee T P. et al .
Changes in glucose transport
and transporter isoforms during the activation of human peripheral blood
lymphocytes by phytohemagglutinin.
J Immunol.
1994;
152
2660-2668
MissingFormLabel
- 10
Chung C J, Hicklin O A, Payan J M, Gordon L.
Indium-111-labeled
leukocyte scan in detection of synthetic vascular graft infection:
the effect of antibiotic treatment.
J Nucl Med.
1991;
32
13-15
MissingFormLabel
- 11
Davies S G, Garvie N W.
The role of
indium-labelled leukocyte imaging in pyrexia of unknown origin.
Br J Radiol.
1990;
63
850-854
MissingFormLabel
- 12
Durack D T, Street A C.
Fever of unknown
origin--reexamined and redefined.
Curr Clin Top Infect
Dis.
1991;
11
35-51
MissingFormLabel
- 13
Gratz S, Rennen H J, Boerman O C. et al .
99mTc-HMPAO-labeled autologous
versus heterologous leukocytes for imaging infection.
J
Nucl Med.
2002;
43
918-924
MissingFormLabel
- 14
Gratz S, Gotthardt M, Pfestroff A. et al .
Exogenous cell stimulation for imaging
infection.
The Open Medical Imaging Journal.
2008;
2
42-48
MissingFormLabel
- 15
Gratz S, Behr T M, Herrmann A. et al .
Immunoscintigraphy (BW 250/183)
in neonates and infants with fever of unknown origin.
Nucl Med
Commun.
1998;
19
1037-1045
MissingFormLabel
- 16
Keidar Z, Gurman-Balbir A, Gaitini D, Israel O.
Fever of Unknown Origin:
The Role of 18F-FDG PET/CT.
J Nucl Med.
2008;
49
1980-1985
MissingFormLabel
- 17
Kelly M J, Kalff V, Hicks R J. et al .
111In-oxine labelled leukocyte scintigraphy
in the detection and localization of active inflammation and sepsis.
Med J Aust.
1990;
152
352-357
MissingFormLabel
- 18
Knochel J Q, Koehler P R, Lee T G, Welch D M.
Diagnosis
of abdominal abscesses with computed tomography, ultrasound, and
111In leukocyte scans.
Radiology.
1980;
137
425-432
MissingFormLabel
- 19
Knockaert D C, Vanderschueren S, Blockmans D.
Fever of unknown origin in adults: 40 years on.
J
Intern Med.
2003;
253
263-275
MissingFormLabel
- 20
Kjaer A, Lebech A M, Eigtved A, Højgaard L.
Fever of unknown
origin: prospective comparison of diagnostic value of 18F-FDG PET
and 111In-granulocyte scintigraphy.
Eur J Nucl Med Mol
Imaging.
2004;
31
1342-31343
MissingFormLabel
- 21
Lorenzen J, Buchert R, Bohuslavizki K H.
Value of FDG PET in patients with fever
of unknown origin.
Nucl Med Commun.
2001;
22
779-783
MissingFormLabel
- 22
Majno G, Palade G E.
Studies on inflammation.
The effect of histamine and serotonin on vascular permeability:
an electron microscopic study.
J Biophys Biochem Cytol.
1961;
11
571-605
MissingFormLabel
- 23
Mamede M, Higashi T, Kitaichi M. et al .
[18F]FDG uptake and PCNA, Glut-1,
and Hexokinase-II expressions in cancers and inflammatory lesions
of the lung.
Neoplasia.
2005;
7
369-379
MissingFormLabel
- 24
Meller J, Ivancevic V, Conrad M.
Clinical value of immunoscintigraphy in patients with fever
of unknown origin.
J Nucl Med.
1998;
39
1248-1253
MissingFormLabel
- 25
Meller J, Altenvoerde G, Munzel U.
Fever of unknown origin: prospective comparison of [18F]FDG
imaging with a double-head coincidence camera and gallium-67 citrate
SPET.
Eur J Nucl Med.
2000;
27
1617-1625
MissingFormLabel
- 26
Peters A M.
Nuclear medicine imaging in fever of unknown origin.
Q
J Nucl Med.
1999;
43
61-73
MissingFormLabel
- 27
Petersdorf R G, Beeson P B.
Fever of unexplained
origin: report on 100 cases.
Medicine.
1961;
40
1-30
MissingFormLabel
- 28
Sørensen H T, Mellemkjaer L, Skriver M V. et al .
Fever of unknown
origin and cancer: a population-based study.
Lancet Oncol.
2005;
6
851-855
MissingFormLabel
Priv.-Doz. Dr. Dr. med. S. Gratz
Praxis für Nuklearmedizin
Seelbergstraße
11
70372 Stuttgart
Phone: 0711/5538241
Fax: 0711/5538246
Email: Nuklearmedizin-Gratz@gmx.net