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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-09-2016 | Review Article

Contribution of ¹⁸F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): a stratification-based meta-analysis

Authors: Florent L. Besson, Philippe Chaumet-Riffaud, Margot Playe, Nicolas Noel, Olivier Lambotte, Cécile Goujard, Alain Prigent, Emmanuel Durand

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2016

Abstract

Purpose

The aim of this study was to quantify the contribution of FDG PET to the diagnostic assessment of fever of unknown origin (FUO), taking into account the diagnostic limitations resulting from the composite nature of this entity.

Methods

The PubMed/MEDLINE database was searched from 2000 to September 2015. Original articles fulfilling the following criteria were included: (1) FUO as the initial diagnosis, (2) no immunosuppressed or nosocomial condition, (3) final diagnosis not based on PET, (4) a follow-up period specified, (5) adult population, and (6) availability of adapted data for calculation of odds ratios (ORs). ORs were computed for each study and then pooled using a random effects model. Stratification-based sensitivity analyses were finally performed using the following prespecified criteria: (a) study design, (b) PET device, (c) geographic area, and (d) follow-up period.

Results

A meta-analysis of the 14 included studies showed that normal PET findings led to an increase in the absolute final diagnostic rate of 36 % abnormal PET findings to an increase of 83 %, corresponding to a pooled OR of 8.94 (95 % CI 4.18 – 19.12, Z = 5.65; p < 0.00001). The design of the studies influenced the results (OR 2.92, 95 % CI 1.00 – 8.53 for prospective studies; OR 18,57, 95 % CI 7.57 – 45.59 for retrospective studies; p = 0.01), whereas devices (dedicated or hybrid), geographic area and follow-up period did not.

Conclusion

Abnormal PET findings are associated with a substantially increased final diagnostic rate in FUO. Consequently, FDG PET could be considered for inclusion in the first-line diagnostic work-up of FUO. Further randomized prospective studies with standardized FDG PET procedures are warranted to confirm this first-line position.

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Title: Contribution of 18F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): a stratification-based meta-analysis
Authors: Florent L. Besson
Philippe Chaumet-Riffaud
Margot Playe
Nicolas Noel
Olivier Lambotte
Cécile Goujard
Alain Prigent
Emmanuel Durand
Publication date: 01-09-2016
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2016
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-016-3377-6

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Contribution of ¹⁸F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): a stratification-based meta-analysis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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