Utility of fluorine-18 fluorodeoxyglucose positron emission tomography in the etiological diagnosis of unexplained inflammatory syndromes: A retrospective study of 25 cases
Positron emission tomography integrated with computed tomography using 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG PET/CT) plays a critical role in the localization, diagnosis, and management of infectious diseases and inflammatory disorders. This hybrid imaging modality provides morpho-metabolic information that aids in defining the etiology of unexplained inflammatory syndromes and assessing treatment response. A key advantage of 18F-FDG PET/CT is its ability to provide a comprehensive, “all in one” diagnostic solution, particularly in cases where localizing symptoms are absent, facilitating the identification of metastatic and/or septic foci. Recently, there has been increasing recognition among clinicians of its potential in diagnosing, characterizing, and assessing inflammatory disorders. This study evaluates the clinical utility of 18F-FDG PET/CT in identifying the etiology of inflammatory syndromes by analyzing 25 patients with unexplained inflammatory disorders. The findings highlight the high reproducibility, sensitivity, and specificity of this imaging modality in this context.
- Kubota R, Yamada S, Kubota K, Ishiwata K, Tamahashi N, Ido T. Intratumoral distribution of fluorine-18- fluorodeoxyglucose in vivo: High accumulation in macrophages and granulation tissues studied by microautoradiography. J Nucl Med. 1992;33(11):1972-80.
- Mochizuki T, Tsukamoto E, Kuge Y, et al. FDG uptake and glucose transporter subtype expressions in experimental tumor and inflammation models. J Nucl Med. 2001;42(10):1551-1555.
- Prabhakar HB, Rabinowitz CB, Gibbons FK, O’Donnell WJ, Shepard JA, Aquino SL. Imaging features of sarcoidosis on MDCT, FDG PET, and PET/CT. AJR Am J Roentgenol. 2008;190(3 Suppl):S1-S6. doi: 10.2214/AJR.07.7001
- Zhuang H, Alavi A. 18-fluorodeoxyglucose positron emission tomographic imaging in the detection and monitoring of infection and inflammation. Semin Nucl Med. 2002;32(1):47-59. doi: 10.1053/snuc.2002.29278
- Dumarey N, Egrise D, Blocklet D, et al. Imaging infection with 18F-FDG-labeled leukocyte PET/CT: Initial experience in 21 patients. J Nucl Med. 2006;47(4):625-632.
- Rini JN, Palestro CJ. Imaging of infection and inflammation with 18F-FDG-labeled leukocytes. Q J Nucl Med Mol Imaging. 2006;50(2):143-146.
- Park IN, Ryu JS, Shim TS. Evaluation of therapeutic response of tuberculoma using F-18 FDG positron emission tomography. Clin Nucl Med. 2008;33(1):1-3. doi: 10.1097/RLU.0b013e31815c5128
- Bleeker-Rovers CP, Vos FJ, Corstens FH, Oyen WJ. Imaging of infectious diseases using [18F] fluorodeoxyglucose PET. Q J Nucl Med Mol Imaging. 2008;52(1):17-29.
- Bleeker-Rovers CP, Vos FJ, Wanten GJ, et al. 18F-FDG PET in detecting metastatic infectious disease. J Nucl Med. 2005;46(12):2014-2019.
- Jamar F, Buscombe J, Chiti A, et al. EANM/SNMMI guideline for 18F-FDG use in inflammation and infection. J Nucl Med. 2013;54(4):647-658. doi: 10.2967/jnumed.112.112524
- Salomäki SP, Saraste A, Kemppainen J, et al. 18F-FDG positron emission tomography/computed tomography in infective endocarditis. J Nucl Cardiol. 2017;24(1):195-206. doi: 10.1007/s12350-015-0325-y
- Bleeker-Rovers CP, De Kleijn EM, Corstens FH, Van der Meer JW, Oyen WJ. Clinical value of FDG PET in patients with fever of unknown origin and patients suspected of focal infection or inflammation. Eur J Nucl Med Mol Imaging. 2004;31(1):29-37. doi: 10.1007/s00259-003-1338-3
- Meller J, Sahlmann CO, Scheel AK. 18F-FDG PET and PET/CT in fever of unknown origin. J Nucl Med. 2007;48(1):35-45.
- Blockmans D, Knockaert D, Maes A, et al. Clinical value of [(18)F]fluoro-deoxyglucose positron emission tomography for patients with fever of unknown origin. Clin Infect Dis. 2001;32(2):191-196. doi: 10.1086/318480
- Hao R, Yuan L, Kan Y, Li C, Yang J. Diagnostic performance of 18F-FDG PET/CT in patients with fever of unknown origin: A meta-analysis. Nucl Med Commun. 2013;34(7):682-688. doi: 10.1097/MNM.0b013e328361cd0e