Contribution of 18fluoro-deoxyglucose PET/CT for the diagnosis of infectious diseases

Med Mal Infect. 2014 Jun;44(6):251-60. doi: 10.1016/j.medmal.2014.04.007. Epub 2014 May 18.

Abstract

The diagnosis of some infectious diseases is sometimes difficult to make and new diagnostic tools have been regularly assessed to that end. 18fluoro-deoxyglucose ((18)FDG) positron-emission tomography (PET) coupled with computed tomography (CT) is one of these new procedures. It has been evaluated for numerous infectious diseases with uneven results. A literature review allowed drawing some conclusions. First, (18)FDG-PET/CT is not currently a first-line procedure for infectious diseases. Second, it has proved useful for the evaluation of patients presenting with fever of unknown origin (FUO). Its negative predictive value is 100%: the symptoms of patients experiencing FUO with negative first-line investigations and a negative (18)FDG-PET/CT will almost always spontaneously disappear. Third, (18)FDG-PET/CT also seems to be contributive for the diagnosis of vascular prosthesis infections or osteomyelitis. Fourth, it has promising results for patients presenting with infective endocarditis, especially for secondary infectious foci, or for patients presenting with suspected infection of pacemakers or implanted defibrillator; but results are still preliminary and must be confirmed. Finally(18)FDG-PET/CT cannot be recommended yet for other infectious diseases due to lack of published data.

Keywords: (18)FDG-PET/CT; Endocardite infectieuse; Fever of unknown origin; Fièvre d’origine indéterminée; Infection de prothèse vasculaire; Infective endocarditis; Osteomyelitis; Ostéomyélite; Vascular prosthesis infection.

Publication types

  • Review

MeSH terms

  • Bacteremia / diagnostic imaging
  • Defibrillators, Implantable / adverse effects
  • Diabetic Foot / diagnostic imaging
  • Discitis / diagnostic imaging
  • Early Diagnosis
  • Endocarditis / diagnostic imaging
  • Fever of Unknown Origin / diagnostic imaging
  • Fluorine Radioisotopes*
  • Fluorodeoxyglucose F18*
  • Humans
  • Infections / diagnostic imaging*
  • Inflammation / diagnostic imaging
  • Meta-Analysis as Topic
  • Multimodal Imaging*
  • Osteomyelitis / diagnostic imaging
  • Pacemaker, Artificial / adverse effects
  • Positron-Emission Tomography*
  • Predictive Value of Tests
  • Prosthesis-Related Infections / diagnostic imaging
  • Radiopharmaceuticals*
  • Tomography, X-Ray Computed*

Substances

  • Fluorine Radioisotopes
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18