Becerra Nakayo E M, García Vicente A M, Soriano Castrejón A M, Mendoza Narváez J A, Talavera Rubio M P, Poblete García V M, Cordero García J M
Servicio de Medicina Nuclear, Hospital General Universitario de Ciudad Real, Ciudad Real, España.
Rev Esp Med Nucl Imagen Mol. 2012 Jul-Aug;31(4):178-86. doi: 10.1016/j.remn.2011.08.007. Epub 2011 Dec 6.
To analyze the costs of Fever of Unknown Origin (FUO) prior to the PET-CT study. To determine the effectiveness of PET-CT in the diagnosis of FUO. A proposal of diagnostic algorithm.
A retrospective study was performed that included 20 patients who had been studied between January 2007 and January 2011, with a mean age of 57.75 years and FUO diagnosis. All underwent a PET-CT study with (18)F-FDG. Individual and mean costs of FUO in these patients were assessed, including hospitalization days and complementary tests prior to the PET-CT study. The effectiveness of the PET-CT study in the diagnosis of FUO was analyzed. Costs of the FUO process were determined, including those of the PET-CT study, and if it had been done earlier in the diagnostic process.
Mean hospital stay per patient until the PET-CT study was 28 days. The cost per hospitalization day was 342 €. Average cost per patient in complementary tests was 1395 €. Total cost of the FUO process until the PET-CT study was around 11167 € per patient. The PET-CT study showed a 78% sensitivity, 83% specificity, 92% PPV and 62% NPV. If PET-CT had been performed earlier in the FUO process, assuming the same effectiveness, 5471 € per patient would have been saved.
The PET-CT study could be cost-effective in the FUO process if used at an early stage, helping to establish an early diagnosis, reducing hospitalization days due to diagnostic purposes and the repetition of unnecessary tests.
分析在进行PET-CT检查之前不明原因发热（FUO）的费用。确定PET-CT在FUO诊断中的有效性。提出一种诊断算法。
进行一项回顾性研究，纳入20例在2007年1月至2011年1月期间接受检查的患者，平均年龄57.75岁，诊断为FUO。所有患者均接受了(18)F-FDG PET-CT检查。评估这些患者FUO的个体和平均费用，包括住院天数以及PET-CT检查之前的辅助检查。分析PET-CT检查在FUO诊断中的有效性。确定FUO诊疗过程的费用，包括PET-CT检查的费用，以及是否在诊断过程中更早进行该检查。
在进行PET-CT检查之前，每位患者的平均住院时间为28天。每日住院费用为342欧元。每位患者辅助检查的平均费用为1395欧元。在进行PET-CT检查之前，FUO诊疗过程的总费用约为每位患者11167欧元。PET-CT检查的敏感性为78%，特异性为83%，阳性预测值为92%，阴性预测值为62%。如果在FUO诊疗过程中更早进行PET-CT检查，假设有效性相同，则每位患者可节省5471欧元。
如果在早期阶段使用，PET-CT检查在FUO诊疗过程中可能具有成本效益，有助于早期诊断，减少因诊断目的导致的住院天数以及不必要检查的重复。
