Publication details

Význam18f-fdg-pet/mr při diagnostice horečky nejasné etiologie

Title in English Significance of18f-fdg-pet/mri in the diagnosis of the fever of unclear origin


Year of publication 2021
Type Article in Periodical
Magazine / Source Česká radiologie
MU Faculty or unit

Faculty of Medicine

Keywords Fever of unknown origin; Magnetic resonance imaging; Positron-emission tomography
Description Aim: To evaluate the contribution of18F-FDGPET/MRI in the diagnosis of Fever of Unknown Origin (FUO). Methods: The study included 57 consecutive patients in the period 7/2016 to 12/2019 who underwent18F-FDG-PET/MRI (Signa, GE) for FUO. Contrary to the official definition of FUO, the indication criteria have been extended to all patients with unclear temperatures above 37 °C. The sensitivity, specificity, predictive values and AUC of the PET/MRI finding in relation to the etiology of FUO were evaluated. A five-point Likert scale was used to semiquantitatively assess the probability of a cause of FUO based on PET/MRI finding (Likert 1 – PET/ MRI finding is not a cause of FUO, Likert 5 – PET/MRI finding is a certain cause of FUO). The Likert 3 to 5 finding was evaluated as positive PET/MRI. Furthermore, clinical (fever, arthralgia, weight loss, night sweats) and laboratory (CRP, leukocytes) parameters were monitored, which were correlated with the positivity rate of PET/MRI. Results:18F-FDG-PET/MRI achieved a sensitivity of 93%, specificity 65%, positive and negative predictive values of 78 and 87%, AUC 0.82 when determining the etiology of FUO. The cause of fever of unclear origin was determined in 27 patients (57%), of whom 17 (36%) had non-infectious inflammatory disease, 8 (17%) infectious inflammatory disease and 2 (4%) neoplasm. In 20 (43%) patients, FUO remained without a known etiology, while in 14 (30%) of them the symptoms resolved spontaneously and in 6 (13%) patients they persisted without explanation even after one year of follow-up. The increased level of CRP at the time of18F-FDG-PET/MRI examination showed up to 100% sensitivity and 100% negative predictive value for true positive PET/MRI, the specificity reached only 55%. Conclusion: Based on this pilot study, 18 F-FDG-PET/MRI is a suitable alternative to 18 F-FDG-PET/CT in the search for the etiology of the fever of unclear origin.
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