Clin Infect Dis. 2020 Aug 23:ciaa1220. doi: 10.1093/cid/ciaa1220. Online ahead of print.
Growing evidence suggests 2-deoxy-2-[18F]fluoro-D-glucose (18FDG)-positron emission tomography/computed tomography (PET/CT) is a useful imaging technique for the evaluation of fever of unknown origin (FUO). This imaging technique allows for accurate localization of foci of hypermetabolism based on 18FDG uptake in glycolytically-active cells that may represent inflammation, infection, or neoplasia. The presence of abnormal uptake can help direct further investigation that may yield a final diagnosis. A lack of abnormal uptake can be reasonably reassuring that these conditions are not present, thereby avoiding unnecessary additional testing. Insurers have not routinely covered outpatient 18FDG-PET/CT for the indication of FUO in the United States; however, data published since 2007 suggest early use in FUO diagnostic evaluations improves diagnostic efficiency and saves costs. Clinicians and insurers should consider 18FDG-PET/CTas a useful tool when preliminary studies are unrevealing.