{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:15:17Z","timestamp":1780445717629,"version":"3.54.1"},"reference-count":36,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Fever of unknown origin (FUO) poses a diagnostic challenge, and 18-fluorodexoyglucose positron emission tomography with computed tomography (18FDG-PET\/CT) may identify the source. We aimed to evaluate the diagnostic yield of 18FDG-PET\/CT in the work-up of FUO. The records of patients admitted to Sheba Medical Center between January 2013 and January 2018 who underwent 18FDG-PET\/CT for the evaluation of FUO were reviewed. Following examination of available medical test results, 18FDG-PET\/CT findings were assessed to determine whether lesions identified proved diagnostic. Of 225 patients who underwent 18FDG-PET\/CT for FUO work-up, 128 (57%) met inclusion criteria. Eighty (62.5%) were males; mean age was 59 \u00b1 20.3 (range: 18\u201393). A final diagnosis was made in 95 (74%) patients. Of the 128 18FDG-PET\/CT tests conducted for the workup of FUO, 61 (48%) were true positive, 26 (20%) false positive, 26 (20%) true negative, and 15 (12%) false negative. In a multivariate analysis, weight loss and anemia were independently associated with having a contributary results of 18FDG-PET\/CT. The test yielded a sensitivity of 70%, specificity of 37%, positive predictive value of 70%, and negative predictive value of 37%. 18FDG-PET\/CT is a valuable tool in the diagnostic workup of FUO. It proved effective in diagnosing almost half the patients, especially in those with anemia and weight loss.<\/jats:p>","DOI":"10.3390\/ijerph18105360","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T06:01:33Z","timestamp":1621317693000},"page":"5360","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The Utility of 18FDG-PET\/CT in Diagnosing Fever of Unknown Origin: The Experience of a Large Tertiary Medical Center"],"prefix":"10.3390","volume":"18","author":[{"given":"Hussein","family":"Mahajna","sequence":"first","affiliation":[{"name":"Department of Medicine \u2018B\u2019, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel"},{"name":"Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keren","family":"Vaknin","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2018B\u2019, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1884-4925","authenticated-orcid":false,"given":"Jennifer","family":"Ben Shimol","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Department of Medicine, E. Wolfson Medical Center, Holon 5822012, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1404-8027","authenticated-orcid":false,"given":"Abdulla","family":"Watad","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2018B\u2019, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel"},{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS2 9JT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsalan","family":"Abu-Much","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2018B\u2019, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naim","family":"Mahroum","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2018B\u2019, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ora","family":"Shovman","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2018B\u2019, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehuda","family":"Shoenfeld","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel"},{"name":"Ministry of Health of the Russian Federation, Sechenov First Moscow State Medical University, Moscow 119991, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5406-7716","authenticated-orcid":false,"given":"Howard","family":"Amital","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2018B\u2019, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tima","family":"Davidson","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Department of Nuclear Medicine, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00005792-196102000-00001","article-title":"Fever of unexplained origin: Report on 100 cases","volume":"40","author":"Petersdorf","year":"1961","journal-title":"Medicine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/MD.0b013e31802fe858","article-title":"A prospective multicenter study on fever of unknown origin: The yield of a structured diagnostic protocol","volume":"86","author":"Vos","year":"2007","journal-title":"Medicine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.crad.2017.04.014","article-title":"Diagnostic yield of FDG-PET\/CT in fever of unknown origin: A systematic review, meta-analysis, and Delphi exercise","volume":"72","author":"Bharucha","year":"2017","journal-title":"Clin. Radiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3524","DOI":"10.1016\/j.ejrad.2012.05.025","article-title":"The role of 18F-FDG PET or PET\/CT in the detection of fever of unknown origin","volume":"81","author":"Qiu","year":"2012","journal-title":"Eur. J. Radiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1097\/00004728-198909000-00014","article-title":"High [18F]-fluorodeoxyglucose uptake in abdominal abscesses: A PET study","volume":"13","author":"Tahara","year":"1989","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/s12149-011-0521-z","article-title":"The molecular imaging approach to image infections and inflammation by nuclear medicine techniques","volume":"25","author":"Signore","year":"2011","journal-title":"Ann. Nucl. Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Glaudemans, A.W.J.M., De Vries, E.F.J., Galli, F., Dierckx, R.A.J.O., Slart, R.H.J.A., and Signore, A. (2013). The use of 18 F-FDG-PET\/CT for diagnosis and treatment monitoring of inflammatory and infectious diseases. Clin. Dev. Immunol., 2013.","DOI":"10.1155\/2013\/623036"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s10096-011-1440-6","article-title":"Place of (18)F-FDG-PET with computed tomography in the diagnostic algorithm of patients with fever of unknown origin","volume":"31","author":"Crouzet","year":"2012","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1097\/RLU.0b013e3181becfb1","article-title":"F-18 FDG PET\/CT in the diagnosis of fever of unknown origin","volume":"34","author":"Balink","year":"2009","journal-title":"Clin. Nucl. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1093\/qjmed\/hcu193","article-title":"[18F] FDG-PET\/CT for the diagnosis of patients with fever of unknown origin","volume":"108","author":"Raibman","year":"2015","journal-title":"QJM"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1136\/annrheumdis-2017-211687","article-title":"The value of 18F-FDG-PET\/CT in identifying the cause of fever of unknown origin (FUO) and inflammation of unknown origin (IUO): Data from a prospective study","volume":"77","author":"Vogel","year":"2018","journal-title":"Ann. Rheum. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1007\/s00259-015-3010-0","article-title":"18F-FDG PET\/CT in inflammation of unknown origin: A cost-effectiveness pilot-study","volume":"42","author":"Balink","year":"2015","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_13","first-page":"178","article-title":"An\u00e1lisis de costo-efectividad en el diagn\u00f3stico de fiebre de origen desconocido y el papel de la 18F-FDG PET-TC: Propuesta de algoritmo diagn\u00f3stico","volume":"31","year":"2012","journal-title":"Rev. Esp. Med. Nucl. Imagen Mol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2369","DOI":"10.1007\/s00261-017-1454-3","article-title":"Low rate of spleen involvement in sporadic Burkitt lymphoma at staging on PET-CT","volume":"43","author":"Davidson","year":"2018","journal-title":"Abdom. Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.1007\/s00330-017-5201-5","article-title":"Fat necrosis after abdominal surgery: A pitfall in interpretation of fdg-pet\/ct","volume":"28","author":"Davidson","year":"2018","journal-title":"Eur. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1080\/10428194.2017.1352096","article-title":"FDG PET-CT evaluation in neurolymphomatosis: Imaging characteristics and clinical outcomes","volume":"59","author":"Davidson","year":"2018","journal-title":"Leuk. Lymphoma"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1097\/MNM.0000000000000395","article-title":"Determinants of diagnostic performance of 18F-FDG PET\/CT in patients with fever of unknown origin","volume":"37","author":"Pereira","year":"2016","journal-title":"Nucl. Med. Commun."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1093\/ehjci\/jeaa299","article-title":"Procedural recommendations of cardiac PET\/ CT imaging: Standardization in inflammatory-, infective-, infiltrative-, and innervation- (4Is) related cardiovascular diseases: A joint collaboration of the EACVI and the EANM: Summary","volume":"21","author":"Slart","year":"2021","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.diii.2019.02.006","article-title":"18F-FDG PET\/CT imaging findings of extensive neurolymphomatosis as a relapse of diffuse large B cell lymphoma","volume":"100","author":"Chague","year":"2019","journal-title":"Diagn. Interv. Imaging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1007\/s11547-011-0649-x","article-title":"Role of integrated PET\/CT with [18F]-FDG in the management of patients with fever of unknown origin: A single-centre experience","volume":"116","author":"Pelosi","year":"2011","journal-title":"Radiol. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"18","DOI":"10.3109\/00365548.2011.603741","article-title":"Fever of unknown origin: A retrospective study of 52 cases with evaluation of the diagnostic utility of FDG-PET\/CT","volume":"44","author":"Pedersen","year":"2012","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1111\/j.1445-5994.2012.02828.x","article-title":"Diagnostic value of 18F-FDG PET\/CT in patients with fever of unknown origin","volume":"42","author":"Kim","year":"2012","journal-title":"Intern. Med. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ijid.2017.06.019","article-title":"The efficacy of18F-FDG PET\/CT and67Ga SPECT\/CT in diagnosing fever of unknown origin","volume":"62","author":"Hung","year":"2017","journal-title":"Int. J. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.2967\/jnumed.108.054692","article-title":"Fever of unknown origin: The role of 18F-FDG PET\/CT","volume":"49","author":"Keidar","year":"2008","journal-title":"J. Nucl. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1111\/j.1742-1241.2008.01774.x","article-title":"Value of (18)F-FDG-PET\/CT in patients with fever of unknown origin and unexplained prolonged inflammatory syndrome: A single centre analysis experience","volume":"64","author":"Federici","year":"2010","journal-title":"Int. J. Clin. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.ejrad.2008.12.014","article-title":"Fever of unknown origin: A value of (18)F-FDG-PET\/CT with integrated full diagnostic isotropic CT imaging","volume":"73","author":"Ferda","year":"2010","journal-title":"Eur. J. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1097\/MNM.0b013e32833d0281","article-title":"[18F] FDG PET\/CT in patients with fever of unknown origin: A local experience","volume":"31","author":"Kei","year":"2010","journal-title":"Nucl. Med. Commun."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.ejim.2010.09.015","article-title":"Diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography\/computed tomography in patients with fever of unknown origin","volume":"22","author":"Sheng","year":"2011","journal-title":"Eur. J. Intern. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1007\/s00259-016-3377-6","article-title":"Contribution of 18F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): A stratification-based meta-analysis","volume":"43","author":"Besson","year":"2016","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Georga, S., Exadaktylou, P., Petrou, I., Katsampoukas, D., Mpalaris, V., Moralidis, E.-I., Arvaniti, K., Papastergiou, C., and Arsos, G. (2020). Diagnostic Value of 18F-FDG-PET\/CT in Patients with FUO. J. Clin. Med., 9.","DOI":"10.3390\/jcm9072112"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1053\/j.semnuclmed.2013.04.005","article-title":"FDG-PET in Fever of Unknown Origin","volume":"43","author":"Kouijzer","year":"2013","journal-title":"Semin. Nucl. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.2967\/jnumed.116.174391","article-title":"Nuclear imaging for classic fever of unknown origin: Meta-analysis","volume":"57","author":"Takeuchi","year":"2016","journal-title":"J. Nucl. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.diii.2019.11.001","article-title":"18F-FDG PET\/CT in pancreatic adenocarcinoma: On the edge of a paradigm shift?","volume":"100","author":"Palmieri","year":"2019","journal-title":"Diagn. Interv. Imaging"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.ejim.2004.01.018","article-title":"Contribution of 18fluoro-deoxyglucose positron emission tomography to the work-up of patients with fever of unknown origin","volume":"15","author":"Buysschaert","year":"2004","journal-title":"Eur. J. Intern. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"19","DOI":"10.4274\/MIRT.20.04","article-title":"The Diagnostic Role of FDG PET\/CT in Patients with Fever of Unknown Origin","volume":"20","author":"Halac","year":"2011","journal-title":"Mol. Imaging Radionucl. Ther."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Vanderschueren, S., Knockaert, D., Adriaenssens, T., Demey, W., Durnez, A., Blockmans, D., and Bobbaers, H. (2003). From prolonged febrile illness to fever of unknown origin: The challenge continues. Arch. Intern. Med.","DOI":"10.1001\/archinte.163.9.1033"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/10\/5360\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:03:10Z","timestamp":1760162590000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/10\/5360"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,18]]},"references-count":36,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["ijerph18105360"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18105360","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,18]]}}}