METHODS: A working group created by the EANM infection and inflammation committee performed a systematic literature search based on PICOs with \"patients with FUO/IUO\" as population, \"[18F]FDG-PET/CT\" as intervention, and several outcomes including pre-scan characteristics, scan protocol, diagnostic yield, impact on management, prognosis, and cost-effectiveness.
RESULTS: We included 68 articles published from 2001 to 2023: 9 systematic reviews, 49 original papers on general adult populations, and 10 original papers on specific populations. All papers were analysed and included in the evidence-based recommendations.
CONCLUSIONS: FUO and IUO remains a clinical challenge and [18F]FDG PET/CT has a definite role in the diagnostic pathway with an overall diagnostic yield or helpfulness in 50-60% of patients. A positive scan is often contributory by directly guiding treatment or subsequent diagnostic procedure. However, a negative scan may be equally important by excluding focal disease and predicting a favorable prognosis. Similar results are obtained in specific populations such as ICU-patients, children and HIV-patients.
方法:由EANM感染和炎症委员会创建的工作组基于以“FUO/IUO患者”为人群的PICOs进行了系统的文献检索,“[18F]FDG-PET/CT”作为干预措施,和几个结果,包括预扫描特征,扫描协议,诊断产量,对管理的影响,预后,和成本效益。
结果:我们纳入了2001年至2023年发表的68篇文章:9篇系统综述,49篇关于一般成年人的原始论文,和10篇关于特定人群的原创论文。对所有论文进行了分析,并将其纳入基于证据的建议中。
结论:FUO和IUO仍然是一个临床挑战,[18F]FDGPET/CT在诊断途径中具有明确的作用,在50-60%的患者中具有整体诊断效果或帮助。阳性扫描通常通过直接指导治疗或随后的诊断程序而起作用。然而,通过排除局灶性疾病和预测良好的预后,阴性扫描可能同样重要.在特定人群中获得了类似的结果,例如ICU患者,儿童和艾滋病毒患者。