Abstract | OBJECTIVES: PATIENTS AND METHODS: Individual data of 498 patients were retrieved from three retrospective studies. Receiver operating characteristic derived areas under the curve were used to assess (18)F-FDG PET/CT versus age, CRP, and ESR. The discriminative value of age, CRP, and ESR related to (18)F-FDG PET/CT was examined using the net reclassification improvement (NRI). RESULTS: A diagnosis was established in 331 patients; (18)F-FDG PET/CT had a diagnostic accuracy of 89%. (18)F-FDG PET/CT had the highest area under the curve (0.89, P<0.001). The addition of (18)F-FDG PET/CT to a diagnosis prediction model including age, CRP, and ESR resulted in an NRI of 42% (P<0.001). In the same model with CRP values below 20 mg/l or ESR values below 20 mm/h, the NRI was 64% (P<0.001) and 29% (P=0.059), respectively. In 30 of 91 patients with CRP less than 10 mg/l, a diagnosis could be established; (18)F-FDG PET/CT was 100% true negative only in patients with CRP levels less than 5 mg/l. CONCLUSION: In patients with fever of unknown origin or inflammation of unknown origin, compared with elevated ESR levels, elevated CRP levels more often indicate a true positive (18)F-FDG PET/CT outcome.In addition, (18)F-FDG PET/CT, compared with CRP and ESR, shows the highest discrimination of patients with possible disabling disease.
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Authors | Hans Balink, Nic J G M Veeger, Roel J Bennink, Riemer H J A Slart, Frits Holleman, Berthe L F van Eck-Smit, Hein J Verberne |
Journal | Nuclear medicine communications
(Nucl Med Commun)
Vol. 36
Issue 6
Pg. 604-9
(Jun 2015)
ISSN: 1473-5628 [Electronic] England |
PMID | 25738560
(Publication Type: Journal Article)
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Chemical References |
- Fluorodeoxyglucose F18
- C-Reactive Protein
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Topics |
- Adult
- Aged
- Blood Sedimentation
- C-Reactive Protein
(metabolism)
- Female
- Fever of Unknown Origin
(blood, diagnosis, diagnostic imaging, metabolism)
- Fluorodeoxyglucose F18
- Humans
- Inflammation
(blood, diagnostic imaging, metabolism)
- Male
- Middle Aged
- Multimodal Imaging
- Positron-Emission Tomography
- Predictive Value of Tests
- ROC Curve
- Retrospective Studies
- Tomography, X-Ray Computed
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