The role of PET-CT-scan in patients with elevated inflammatory markers without fever?
S.M. Popma, E. Bons, M. Vincken, A.S.M. Dofferhoff
Voorzitter(s): prof. dr. Y. Smulders, VUmc, Amsterdam & dr. Y.W.J. Sijpkens, Bronovo Ziekenhuis, Den Haag
Woensdag 22 april 2015
15:00 - 16:00u
Categorieën: parallelsessie (case reports/research)
Parallel sessie: Parallelsessie 2: Case reports/research
Background:
A PET-CT-scan is often used in the diagnostic work-up in fever of unknown origin. Less is known about patients with elevated inflammatory markers without fever. The aim of this study is to determine the role of PET-CT-scanning in the diagnostic process of patients with elevated inflammatory markers without fever.
Methods:
We retrospectively analysed the data of patients with elevated CRP and/or ESR who underwent a PET-CT-scan between 01-01-2011 and 31-12-2012. Exclusion criterion was fever.
Results:
49 patients were included in the study (26 male, 23 female). Age ranged from 31-86 (mean: 64,5) years. In 25 patients (51%) the PET-CT-scan showed a significant abnormality. 12 (24%) patients were diagnosed with a non-infectious inflammatory disease (NIID) (vasculitis (7), PMR (3) and rheumatoid arthritis (2)), all treated successfully with prednisone. 9 (18%) patients were diagnosed with a neoplasm, one benign tumor, 8 extensive malignancies not eligible for curative treatment. In 4 (8%) patients an infection was found, three were cured, one suffered from a fatal inoperable mycotic aneurysm. In 16 patients (neoplasm (3), infection (2), NIID (11)) the diagnosis would not have been found without performing a PET-CT-scan, 12 had a curable disease. So in every 4 PET-CT-scans made, 1 patient has a treatable condition, probably not to be found by other diagnostic tests.
Conclusion:
In our study PET-CT-scanning in patients with elevated inflammatory markers without fever has a high yield for detection of clinically relevant diagnoses (51%). We found a number needed to diagnose, to find a treatable cause, of 4.
