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Nuklearmedizin 2023; 62(01): 27-33
DOI: 10.1055/a-1976-1765
Original Article

Diagnostic value of FDG-PET/CT in the diagnostic work-up of inflammation of unknown origin

Wertigkeit der PET/CT im Rahmen der Entzündungsherddiagnostik mit F-18-FDG
Luisa Maria Knappe
1   Department of Nuclear Medicine, University Hospital Gießen-Marburg, Marburg, Germany
2   Nuklearmedizin, Inselspital Universitatsspital Bern, Bern, Switzerland (Ringgold ID: RIN27252)
,
Frederik Anton Verburg
1   Department of Nuclear Medicine, University Hospital Gießen-Marburg, Marburg, Germany
3   Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands (Ringgold ID: RIN6993)
,
Luca Giovanella
4   Nuclear Medicine, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland
,
Markus Luster
1   Department of Nuclear Medicine, University Hospital Gießen-Marburg, Marburg, Germany
,
Damiano Librizzi
1   Department of Nuclear Medicine, University Hospital Gießen-Marburg, Marburg, Germany
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Abstract

Introduction The present study aims to evaluate the clinical diagnostic value of FDG-PET/CT in patients with inflammation of unknown origin. Material and methods We retrospectively analyzed data of 130 patients who presented general inflammatory symptoms and/or elevated level of CRP and underwent FDG-PET/CT for the purpose of identifying unknown foci of inflammation. The accuracy of PET/CT findings was assessed against the standard of eventual clinical diagnosis e.g. results of pathology, microbiology or other imaging methods. Results In 99/130 patients (76 %) a final diagnosis was established, FDG-PET/CT showed a sensitivity and specificity of each 93 %. A decreased pseudocholinesterase is associated with a higher SUVmax value and with a higher CRP value whereas no significant relationship was found between elevated CRP values and the SUVmax, although higher CRP values are associated significantly with a true positive PET/CT result. Conclusion FDG-PET/CT is a highly sensitive, specific and accurate method for the detection of foci of inflammation of unknown origin. The combination of decreased pseudocholinesterase and increased CRP levels may be a useful tool to select patients for FDG PET/CT.

Keywords

Inflammation of unknown origin - fever of unknown origin - FDG-PET - pseudocholinesterase


Publikationsverlauf

Eingereicht: 12. Oktober 2022

Angenommen: 08. November 2022

Artikel online veröffentlicht:
09. Januar 2023

© 2023. Thieme. All rights reserved.

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