与不明原因发热相比，18F-FDG PET在不明原因炎症中的诊断率更高。
Higher diagnostic yield of 18F-FDG PET in inflammation of unknown origin compared to fever of unknown origin.
作者信息
Betrains Albrecht, Boeckxstaens Lennert, Moreel Lien, Wright William F, Blockmans Daniel, Van Laere Koen, Vanderschueren Steven
机构信息
Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium.
Department of Nuclear medicine and molecular imaging, University Hospitals Leuven, Leuven, Belgium.
出版信息
Eur J Intern Med. 2023 Apr;110:71-76. doi: 10.1016/j.ejim.2023.01.025. Epub 2023 Feb 2.
OBJECTIVE
18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) is an important imaging technique in the workup of fever of unknown origin (FUO) and inflammation of unknown origin (IUO). Studies comparing the diagnostic yield of 18F-FDG PET between both entities are lacking.
METHODS
Retrospective analysis of FUO/IUO patients who underwent 18F-FDG PET between 2000 and 2019 in the University Hospitals of Leuven (Belgium). 18F-FDG PET images were assessed for accuracy and contribution towards the final diagnosis. Logistic regression was performed to evaluate the association between meeting FUO or IUO criteria and diagnostic contribution of 18F-FDG PET with and without adjustment for confounders.
RESULTS
Out of 604 patients, 439 (73%, mean age 56 years, 43% female) underwent 18F-FDG PET imaging, including 349 (79%) classified as FUO and 90 (21%) as IUO. Noninfectious inflammatory disorders were significantly more frequent in the IUO group (37% versus 25%; P = 0.03). 18F-FDG PET imaging had a sensitivity of 93% (89-96%), a specificity of 35% (29-42%), and made a positive contribution to the final diagnosis in 25% (21-29%) of cases. IUO was significantly associated with contributive 18F-FDG PET imaging compared to FUO (aOR 2.21 [95% CI 1.31-3.72]; P = 0.003). Among those with contributive 18F-FDG PET imaging, giant cell arteritis (IUO 25% versus FUO 12%) and polymyalgia rheumatica (IUO 17% versus FUO 1%) were numerically more frequent in the IUO group.
CONCLUSION
The diagnostic contribution of 18F-FDG PET was higher among those with IUO, most likely due to differences in diagnostic spectrum.
目的
18F-氟脱氧葡萄糖正电子发射断层扫描（18F-FDG PET）是不明原因发热（FUO）和不明原因炎症（IUO）检查中的一项重要成像技术。目前缺乏比较这两种情况中18F-FDG PET诊断率的研究。
方法
对2000年至2019年在比利时鲁汶大学医院接受18F-FDG PET检查的FUO/IUO患者进行回顾性分析。评估18F-FDG PET图像的准确性及其对最终诊断的贡献。进行逻辑回归分析，以评估符合FUO或IUO标准与18F-FDG PET的诊断贡献之间的关联，分析时对混杂因素进行了调整和未调整。
结果
在604例患者中，439例（73%，平均年龄56岁，43%为女性）接受了18F-FDG PET成像，其中349例（79%）归类为FUO，90例（21%）归类为IUO。非感染性炎症性疾病在IUO组中明显更为常见（37%对25%；P = 0.03）。18F-FDG PET成像的敏感性为93%（89 - 96%），特异性为35%（29 - 42%），在25%（21 - 29%）的病例中对最终诊断有积极贡献。与FUO相比，IUO与有贡献的18F-FDG PET成像显著相关（调整后比值比2.21 [95%置信区间1.31 - 3.72]；P = 0.003）。在有贡献的18F-FDG PET成像的患者中，巨细胞动脉炎（IUO组为25%，FUO组为12%）和风湿性多肌痛（IUO组为17%，FUO组为1%）在IUO组中的数量上更为常见。
结论
18F-FDG PET在IUO患者中的诊断贡献更高，很可能是由于诊断谱的差异。
Zotero 插件