Real-world assessment of the clinical utility of whole body F-18-FDG PET/CT in the diagnosis of infection

Few studies have aimed to capture the full spectrum of (18)fluorodeoxyglucose-positron emission tomography/computed tomography (F-18-FDG PET/CT) use for evaluation of infections in a real-world context. We performed a retrospective chart review of hospitalized patients who underwent F-18-FDG PET/CT for the workup of infection between April, 2013 and September, 2019. The clinical indications for and impact of F-18-FDG PET/CT on diagnostic and antimicrobial management were evaluated across different infectious indications. Sixty-one patients met the inclusion criteria. The most common indication was identifying a source of a known infection (46%), followed by fever of unknown etiology (FUE)/fever of unknown origin (FUO) (38%), and other (16%). F-18-FDG PET/CT was determined to have had a diagnostic or management clinical impact for a total of 22 patients (36%) including 12/28 (43%) of patients with known infection, 7/23 (30%) of patients with FUE/FUO, and 3/10 (30%) of patients with other indications. F-18-FDG PET/CT confirmed suspected prosthetic endovascular infection for 6/16 (38%) patients. In this study,F-18-FDG PET/CT led to a clinical impact on diagnostic and treatment management of hospitalized patients across a variety of syndromes and particularly for source identification in the setting of known infection.