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Diagnostic value of [18F]-FDG PET/CT in children with fever of unknown origin or unexplained signs of inflammation

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Fever of unknown origin (FUO) and unexplained signs of inflammation are challenging medical problems especially in children and predominantly caused by infections, malignancies or noninfectious inflammatory diseases. The aim of this study was to assess the diagnostic value of 18F-FDG PET and PET/CT in the diagnostic work-up in paediatric patients.

Methods

In this retrospective study, 47 FDG PET and 30 PET/CT scans from 69 children (median age 8.1 years, range 0.2–18.1 years, 36 male, 33 female) were analysed. The diagnostic value of PET investigations in paediatric patients presenting with FUO (44 scans) or unexplained signs of inflammation without fever (33 scans) was analysed.

Results

A diagnosis in paediatric patients with FUO or unexplained signs of inflammation could be established in 32 patients (54%). Of all scans, 63 (82%) were abnormal, and of the total number of 77 PET and PET/CT scans 35 (45%) were clinically helpful. In patients with a final diagnosis, scans were found to have contributed to the diagnosis in 73%. Laboratory, demographic or clinical parameters of the children did not predict the usefulness of FDG PET scans.

Conclusion

This is the first larger study demonstrating that FDG PET and PET/CT may be valuable diagnostic tools for the evaluation of children with FUO and unexplained signs of inflammation. Depicting inflammation in the whole body, while not being traumatic, it is attractive for use especially in children. The combination of PET with CT seems to be superior, since the site of inflammation can be localized more accurately.

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Authors and Affiliations

  1. Department of Pediatrics, University of Muenster, Albert-Schweitzer-Str. 33, 48149, Muenster, Germany

    Niklas Jasper, Jan Däbritz, Michael Frosch & Dirk Foell

  2. Department of Nuclear Medicine, University of Muenster, Albert-Schweitzer-Str. 33, 48149, Muenster, Germany

    Markus Loeffler & Matthias Weckesser

  3. Department of Radiology, Clemenshospital, Düesbergweg 124, 48153, Muenster, Germany

    Markus Loeffler

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  1. Niklas Jasper
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  2. Jan Däbritz
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Correspondence to Dirk Foell.

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Each author listed has seen and approved the submission of this version of the article and takes full responsibility for its content.

-There are no prior publications or submissions with any information overlapping that provided in this article.

-This article contains original unpublished work and has not been and will not be submitted for publication elsewhere.

The study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Jasper, N., Däbritz, J., Frosch, M. et al. Diagnostic value of [18F]-FDG PET/CT in children with fever of unknown origin or unexplained signs of inflammation. Eur J Nucl Med Mol Imaging 37, 136–145 (2010). https://doi.org/10.1007/s00259-009-1185-y

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  • DOI: https://doi.org/10.1007/s00259-009-1185-y

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