Fever of unknown origin: prospective comparison of diagnostic value of 18F-FDG PET and 111In-granulocyte scintigraphy
Autor: | Annika Eigtved, Liselotte Højgaard, Anne-Mette Lebech, Andreas Kjaer |
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Rok vydání: | 2003 |
Předmět: |
Adult
Male medicine.medical_specialty Granulocyte Scintigraphy Fever of Unknown Origin Sensitivity and Specificity Fluorodeoxyglucose F18 Positive predicative value Medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Fever of unknown origin Prospective cohort study Aged Fluorodeoxyglucose Aged 80 and over medicine.diagnostic_test business.industry Indium Radioisotopes Reproducibility of Results General Medicine Middle Aged medicine.disease Confidence interval carbohydrates (lipids) medicine.anatomical_structure Positron emission tomography Positron-Emission Tomography Female Radiology Radiopharmaceuticals business medicine.drug Granulocytes |
Zdroj: | European journal of nuclear medicine and molecular imaging. 31(5) |
ISSN: | 1619-7070 |
Popis: | The diagnostic work-up in patients with fever of unknown origin (FUO) is often challenging and frequently includes nuclear medicine procedures. Whereas a role for leucocyte or granulocyte scintigraphy in FUO is generally accepted, a possible role of fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in these patients remains to be established. To study this, we compared prospectively, on a head-to-head basis, the diagnostic value of FDG-PET and indium-111 granulocyte scintigraphy in patients with FUO. Nineteen patients with FUO underwent both FDG-PET and (111)In-granulocyte scintigraphy within 1 week. FDG-PET scans and granulocyte scintigrams were reviewed by different doctors who were blinded to the result of the other investigation. The diagnostic values of FDG-PET and granulocyte scintigraphy were evaluated with regard to identification of a focal infectious/inflammatory or malignant cause of FUO. The sensitivity of granulocyte scintigraphy and FDG-PET were 71% [95% confidence interval (CI): 37-85%] and 50% (CI: 16-84%), respectively. The specificity of granulocyte scintigraphy was 92% (71-100%), which was significantly higher than that of FDG-PET, at 46% (34-62%). Positive and negative predictive values for granulocyte scintigraphy were both 85%. Positive and negative predictive values for FDG-PET were 30% and 67%, respectively. (111)In-granulocyte scintigraphy has a superior diagnostic performance compared to FDG-PET for detection of a localised infectious/inflammatory or neoplastic cause of FUO. The poorer performance of FDG-PET is in particular attributable to a high percentage of false positive scans, leading to low specificity. |
Databáze: | OpenAIRE |
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