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Combined clinical parameters improve the diagnostic efficacy of 18F-FDG PET/CT in patients with fever of unknown origin (FUO) and inflammation of unknown origin (IUO): A prospective study in China

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单位: [1]Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Infect Dis, Tongji Hosp, 1095 Jiefang Ave, Wuhan 430030, Peoples R China [2]Huazhong Univ Sci & Technol, Tongji Hosp, Dept Nucl Med, Tongji Med Coll, 1095 Jiefang Ave, Wuhan 430030, Peoples R China [3]Wuhan Univ, Dept Infect Dis, Renmin Hosp, 238 Jiefang Rd, Wuhan 430030, Peoples R China
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关键词: Fever of unknown origin (FUO) Inflammation of unknown origin (IUO) Clinical parameters F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) Diagnostic efficacy

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Objectives: To improve the diagnostic efficacy of F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for Chinese patients with fever of unknown origin (FUO) and inflammation of unknown origin (IUO), with combined clinical parameters. Materials and methods: FUO/IUO patients who underwent a standard diagnostic work-up and F-18-FDG PET/CT scanning were enrolled and divided into a local uptake lesion subgroup and a non-specific abnormal uptake subgroup. Beneficial clinical parameters for improving the diagnostic efficacy of PET/CT were identified. Results: From January 2014 to January 2019, 253 FUO/IUO patients were studied. In total, 147 patients had local uptake lesions and 106 patients had non-specific abnormal uptake. In the local uptake lesion group, the positioning accuracy of PET/CT was 37.2% in grades 1 and 2, and 66.3% in grades 3 and 4. With the following combination of clinical parameters, the positioning accuracy increased to 75.0% and 90.0%, respectively: time from admission to performing PET/CT scanning <6.5 days and C-reactive protein level >95 mg/l. In the non-specific abnormal uptake group, the combination of sex (male), bicytopenia, and lactic dehydrogenase improved the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for diagnosing malignancy from 64.3%, 69%, 60%, and 72.7%, respectively, to 83.3%, 81%, 81.4%, and 82.9%, respectively. With the combination of sex (male), white blood count, serum ferritin level, and hepatosplenomegaly, the infection prediction model had a sensitivity, specificity, PPV, and NPV of 78%, 76.2%, 76.6%, and 77.6%, respectively. Conclusions: Combined clinical parameters improved the localization diagnostic value of F-18-FDG PET/CT in the local uptake lesion subgroup and the etiological diagnostic value in the non-specific abnormal uptake subgroup. (C) 2020 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 3 区 传染病学
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 传染病学
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出版当年[2018]版:
Q2 INFECTIOUS DISEASES
最新[2023]版:
Q1 INFECTIOUS DISEASES

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第一作者单位: [1]Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Infect Dis, Tongji Hosp, 1095 Jiefang Ave, Wuhan 430030, Peoples R China
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