Fevers of unknown origin (FUO) present a daunting challenge for clinicians, as they account for approximately 2% of hospitalizations and require extensive diagnostic efforts to identify their often elusive causes. The publication of new imaging criteria, developed collaboratively by the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the Infectious Diseases Society of America, and the American College of Nuclear Medicine, aims to address these diagnostic challenges. These criteria provide a comprehensive framework for clinicians to make informed decisions, reduce diagnostic complexity, and mitigate the risks associated with FUO.
The new criteria recommend specific nuclear imaging tests based on patient demographics and available resources. For adults, 18F-FDG PET and PET/CT are the preferred imaging tests due to their superior diagnostic accuracy and ability to detect a wide range of pathological processes. When these tests are unavailable, alternative methods like 67Ga scintigraphy or labeled leukocyte scintigraphy (if infection is strongly suspected) can be employed. For pediatric patients, the guidelines also favor 18F-FDG PET and PET/CT, while advising against the use of 67Ga and labeled leukocyte scintigraphy due to their lower efficacy and potential risks in younger patients.
By guiding clinicians toward the most appropriate imaging techniques for different patient groups, the criteria aim to improve diagnostic precision, reduce the need for invasive procedures, and shorten the duration of hospital stays. Effective use of these advanced imaging methods helps in identifying the underlying causes of FUO, thereby decreasing mortality associated with undiagnosed fevers. The guidelines emphasize the integration of nuclear and morphologic imaging techniques, reflecting a thorough understanding of the complex nature of FUO and the diverse clinical scenarios encountered in practice.
Overall, the new imaging criteria underscore the importance of selecting appropriate imaging tests based on patient age and available technology. By streamlining the utilization of these techniques, the guidelines contribute to enhanced care quality and operational efficiency within healthcare settings. The collaborative effort behind these recommendations ensures their relevance and applicability, providing clinicians with a robust tool to address the diagnostic challenges posed by FUO comprehensively. As healthcare practitioners adopt these guidelines, the potential for improved outcomes and reduced diagnostic uncertainty in FUO cases is considerable.
