Clinical Value of Dual-phase 18F-FDG SPECT with Serum Procalcitonin for Identification of Etiology in Tumor Patients with Fever of Unknown Origin

Objective: The purpose of the study was to evaluate clinical value of dual-phase 18F-FDG SPECT withserum procalcitonin (PCT) in identifying cancers in patients with fever of unknown origin (FUO).
Methods:PCT test and dual-phase 18F-FDG SPECT were sequentially performed on 50 consecutive patients with FUO.Two radiologists evaluated all 18F-FDG SPECT data independently. A consensus was reached if any differenceof opinions existed. Final diagnosis was based on a comprehensive analysis of results for the PCT test, dualphase18F-FDG SPECT and bacterial cultivation, regarded as a gold standard.
Results: Among 50 patients, 34demonstrated PCT ≥ 0.5 μg/L. Coincidence imaging showed in 37 patients with inflammatory lesions, and 13 withmalignancy. Finally, 36 bacterial, 1 fungal and 1 viral infections, as well as 12 cancerous fevers were confirmed bydual-phase 18F-FDG SPECT with PCT, combined with bacterial cultivation and clinical follow-up.
Conclusion:Our study demonstrated that dual-phase 18F-FDG SPECT in association with PCT could be a valuable tool fordiagnosis in tumor patients with FUO.