EANM consensus document on the use of [18F]FDG PET/CT in fever and inflammation of unknown origin

• DOI: 10.1007/s00259-024-06732-8
• Publication Date: 2024-04-27T07:03:00Z
• Authors: Søren Hess; Edel Noriega-Álvarez; Lucia Leccisotti; Giorgio Treglia; Domenico Albano; Anne Roivainen; Andor W.J.M. Glau...; Olivier Gheysens
• Keywords: Inflammation; Fever of unknown origin; Consensus; FDG; PET/CT; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography/standards; Humans; Inflammation/diagnostic imaging; Fever of Unknown Origin/diagnostic imaging; Consensus; Nuclear Medicine; Radiopharmaceuticals; FDG; FUO; Fever of unknown origin; IUO; Infection; Inflammation; Inflammation of unknown origin; PET/CT; Fever of Unknown Origin/diagnostic imaging; Fever of Unknown Origin; FUO; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Inflammation of unknown origin; Humans; Original Article; Positron Emission Tomography Computed Tomography/standards; Nuclear Medicine; Radiopharmaceuticals; Infection; IUO; Inflammation/diagnostic imaging

Abstract Purpose Patients with fever and inflammation of unknown origin (FUO/IUO) are clinically challenging due to variable clinical presentations nonspecific symptoms many differential diagnoses. Positron emission tomography/computed tomography (PET/CT) 2-deoxy-2-[ 18 F]fluoro-D-glucose ([ F]FDG) is increasingly used in FUO IUO, but the optimal diagnostic strategy remains controversial. This consensus document aims assist clinicians nuclear medicine specialists appropriate use [ F]FDG-PET/CT IUO based on current evidence. Methods A working group created by EANM infection committee performed a systematic literature search PICOs “patients FUO/IUO” as population, “[ F]FDG-PET/CT” intervention, several outcomes including pre-scan characteristics, scan protocol, yield, impact management, prognosis, cost-effectiveness. Results We included 68 articles published from 2001 2023: 9 reviews, 49 original papers general adult populations, 10 specific populations. All were analysed evidence-based recommendations. Conclusion challenge F]FDG PET/CT has definite role pathway an overall yield or helpfulness 50–60% patients. positive often contributory directly guiding treatment subsequent procedure. However, negative may be equally important excluding focal disease predicting favorable prognosis. Similar results obtained populations such ICU-patients, children HIV-patients.