Is PET MRI valuable in inflammation or fever of unknown aetiology?

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Authors

ROHAN Tomáš ANDRAŠINA Tomáš LITAVCOVÁ Alexandra JŮZA Tomáš ZAVADIL Jan RICHTER Svatopluk VÁLEK Vlastimil

Year of publication 2019
Type Conference abstract
MU Faculty or unit

Faculty of Medicine

Citation
Description Purpose: To evaluate the benefit of PET/MR imaging in diagnostic process of patients with inflammatory disease of unknown aetiology. Methods and Materials: 51 patients were selected for PET/MR imaging due to inflammation of unknown aetiology, these represent 2.5 % of all PET/MR examinations (total of 2056 examinations; Signa; GE) acquired in tertiary referral hospital since 7/2016. All patients underwent intensive investigation lasting at least 20 days (screening x-rays; abdominal ultrasound, dedicated CT or MRI focused in clinical suspect). Clinical (fever; artralgia; weight loss; night sweating) and laboratory (CRP, leukocytes) were monitored and correlated with PET/MR findings. Based on suspected aetiology patients were divided into 3 groups - fewer of unknown origin (26), unknown infection (13) and rheumatic disease (12). Patients were followed up until the aetiology was diagnosed or symptoms faded away. Results: In 26 (51%) patients diagnosis was proved, in 22 (43%) patients symptoms disappeared, in 3 patients symptoms persisted without explanation. PET/MR strongly supported or changed the diagnosis in 42% of cases (70% in subgroup of rheumatoid infections). As most important marker of conclusive PET/MR was shown artralgia and elevated level of CRP at the time of examination, which were present in 54% of diagnosed cases. PET/MR proved diagnosis of rheumatoid disease in 18 patients (50% without any clinical suspicion), overall sensitivity was up to 89% and specificity 100%, negative predictive value was 85%. Conclusion: PET-MRI is a useful tool in the evaluation of inflammatory disease of unknown aetiology especially in patients with suspected rheumatoid disease.
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