Objectives: To assess the clinical utility of fluorodeoxyglucose (FDG) PET-CT in the early stage of fever of unknown origin and also compare the differences to patients with classical FUO. Material and Methods: The ambispective study evaluated 160 patients who presented with fever and underwent FDG PET to localize the focus of fever and assess the extent of disease. About 104 patients in the acute febrile illness category and 56 patients in the fever of unknown origin category were included in the study. The decision to perform PET-CT was made by the treating team after clinical examination and laboratory investigations (with or without anatomical imaging). Results: The diagnostic yield of FDG PET-CT is 76.8%. The etiological classification comprised infection (49.4%), inflammation (30%), and malignancy (10.6%). The cause of fever could not be detected in 16 patients (10%). Conclusion: This is the first study with such a large population to assess the role of FDG PET in patients with fever of duration <3 weeks. We found that there is no significant difference in the clinical utility of FDG PET-CT in patients with fever of duration more than 3 weeks and patients with fever of duration <3 weeks. We suggest that FDG PET can be used earlier in the workup of patients with FUO for early diagnosis and initiate appropriate management.
Angamuthu et al. (Tue,) studied this question.