Department of Nuclear Medicine, All India Institute of Medical Sciences, .
Maulana Azad Medical College, New Delhi, .
Nucl Med Commun. 2024 Aug 1;45(8):702-709. doi: 10.1097/MNM.0000000000001855. Epub 2024 May 17.
This study aimed to evaluate the potential role of 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) in providing a targeted approach for diagnosing the etiology of Pyrexia of Unknown Origin (PUO).
A total of 573 PUO patients were included in this ambispective study, with a mean age of 39.40 ± 4.6 years. Patients underwent FDG PET/CT scans using dedicated hybrid scanners. PET/CT data were interpreted by experienced nuclear medicine physicians. The study analyzed the guidance provided by FDG PET/CT for appropriate biopsy sites and assessed concordance between PET/CT findings and histopathological examination.
Out of the 573 patients, a final diagnosis was reached for 219 patients, including malignancy, infectious causes, noninfectious inflammatory causes (NIID), and precancerous conditions. FDG PET/CT played a crucial role in guiding clinicians to appropriate biopsy sites, contributing to a higher diagnostic yield. Concordance between PET/CT findings and histopathological examination emphasized the noninvasive diagnostic potential of PET/CT in identifying underlying causes of PUO. Overall, FDG PET/CT contributed to guiding the appropriate site of biopsy or concordance of the first differential diagnosis with the final diagnosis in 50.05% of cases.
This study highlights the valuable role of FDG PET/CT in providing a targeted approach for diagnosing PUO, showcasing its potential in guiding clinicians towards appropriate biopsy sites and improving the diagnostic yield. The findings underscore the importance of integrating FDG PET/CT into the diagnostic pathway for PUO, ultimately enhancing patient management and outcomes. Further prospective studies are necessary to validate these results and refine the integration of FDG PET/CT in the diagnosis of PUO.
本研究旨在评估 18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）在为不明原因发热（PUO）的病因诊断提供靶向方法方面的潜在作用。
这项前瞻性和回顾性研究共纳入 573 例 PUO 患者，平均年龄为 39.40±4.6 岁。患者接受了专用的混合扫描仪的 FDG PET/CT 扫描。核医学医师对 PET/CT 数据进行了解读。该研究分析了 FDG PET/CT 对适当活检部位的指导作用，并评估了 PET/CT 结果与组织病理学检查之间的一致性。
在 573 例患者中，219 例患者确定了最终诊断，包括恶性肿瘤、感染性病因、非感染性炎症性病因（NIID）和癌前病变。FDG PET/CT 在指导临床医生选择适当的活检部位方面发挥了关键作用，提高了诊断的阳性率。PET/CT 结果与组织病理学检查之间的一致性强调了 PET/CT 在识别 PUO 潜在病因方面的非侵入性诊断潜力。总的来说，FDG PET/CT 有助于指导适当的活检部位，或者首次鉴别诊断与最终诊断的一致性，在 50.05%的病例中发挥了作用。
本研究强调了 FDG PET/CT 在为 PUO 提供靶向诊断方法方面的重要作用，展示了其在指导临床医生选择适当活检部位和提高诊断阳性率方面的潜力。这些发现强调了将 FDG PET/CT 纳入 PUO 诊断途径的重要性，最终改善了患者的管理和结局。需要进一步的前瞻性研究来验证这些结果，并完善 FDG PET/CT 在 PUO 诊断中的应用。
