Fever
Conditions
Keywords
FDG-PET/CT, FUO, Chronic Inflammatory syndrome, Fever of unknown origin
Brief summary
Fever of unknown origin (FUO) and chronic inflammatory syndrome could be seen in many affections. The diagnostic process is still a challenge and could not be specified yet after several clinical studies performed by trained teams using two levels diagnostic procedures. For this reason, the diagnosis involves many additional and expensive tests such as computed tomography (CT scan), scintigraphic imaging, endoscopy, biopsy. There is no evidence-based recommendation for the diagnostic work-up of FUO or chronic inflammatory syndrome. Positron emission tomography with 2-\[18F\] fluoro-2-deoxy-D-glucose combined with CT scan (FDG-PET/CT) is widely used in malignant diseases and seems to be promising for the diagnosis of inflammatory disorders. Its role has not been yet clearly defined in the investigation of FUO and chronic inflammatory syndrome.
Detailed description
All patients with FUO and chronic inflammatory syndrome will undergo FDG-PET/CT and conventional morphologic imaging modalities. Results of these two diagnostic procedures in identifying diagnostic clues will be compared. We assume FDG-PET/CT could be safer and more helpful to reach early final diagnosis in patients with FUO and chronic inflammatory syndrome than conventional morphologic imaging modalities
Interventions
PROCEDURETEP
Intravenous injection of glucose labeled Fluor 18. The patient remains fasted at least 6 hours before the start of the examination. The review lasted 1 hour, during wich the patient should not move.
Sponsors
University Hospital, Limoges
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient with FUO criteria: Fever since 3 weeks, Temperature \> 38.3°C, No diagnostic after 3 days of hospitalization. * Patient with periodic fever criteria: Fever with criteria like FUO, Fever-free intervals, and apparent remission of the underlying disease, At least 3 febrile episodes. * Inflammatory syndrome without any clinical sign, Important inflammatory syndrome: Erythrocyte sedimentation rate ≥ 50 at the first hour, and elevation of at least one another inflammatory parameter (haptoglobin, orosomucoïd, fibrinogen or C-reactive protein), Evolution since more than 3 weeks, No diagnostic orientation after clinical examination and history-taking, No diagnostic clue after 3 days of hospitalisation. * Oral informed consent obtained.
Exclusion criteria
* Demented patient or unable to receive information on the protocol and to give informed consent. * Pregnant women, or without contraception. * Contraindication to iodine examination, gallium scintigraphy or 18FDG TEP-scan. * Immunodeficient patient. * Know HIV infection, neutropenic patient and nosocomial fever.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To assess the contribution of FDG-PET/CT in the early diagnostic work-up of patients with FUO or chronic inflammatory syndrome | 3 month |
Secondary
| Measure | Time frame |
|---|---|
| To establish the role of FGD PET in reaching final diagnosis compared to conventional morphologic imaging modalities including computer tomography and gallium-67 citrate scintigraphy. | 3 months |
| To evaluate sensitivity and specificity of this diagnostic procedure | 3 months |
| To analyse the cost effectiveness of this diagnostic approach | 3 months |
Countries
France
Outcome results
None listed