Experts publish updated guidance on nuclear imaging for fevers of unknown origin
Experts have just published new imaging criteria related to the use of nuclear medicine exams in cases of fevers of unknown origin (FUO).
The new appropriate use criteria (AUC), which are the result of collaborative efforts by the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the Infectious Diseases Society of America and the American College of Nuclear Medicine, detail six clinical scenarios that warrant the use of nuclear imaging for FUO cases.
FUO accounts for around 2% of hospitalizations and can present significant diagnostic challenges for providers. If the source of a patient’s fever is not determined quickly, which is not at least 50% of the time, it can result in numerous invasive procedures, prolonged hospital stays and a heightened risk of mortality. Given the complexity of determining the source of FUO, experts are hopeful that the new AUC can help guide more appropriate clinical decision-making and reduce the condition’s burden on providers.
“The intention of this AUC is to provide clinicians with scientifically based flexibility in their approach to clinical questions,” noted the authors of the JNM paper. “The integration and complementary use of nuclear and morphologic techniques may indeed provide the most appropriate strategy for what are often complex questions of extent and severity of disease.”
Here’s a rundown of some of new criteria highlights:
For adults, 18F-FDG PET and PET/CT are the recommended nuclear medicine tests of choice for FUO.
67Ga scintigraphy is recommended when 18F-FDG PET and PET/CT are not available.
When 18F-FDG PET and PET/CT are not available and there is high suspicion of infection, labeled leukocyte scintigraphy is recommended.
For pediatric patients, 18F-FDG PET and PET/CT are recommended, but 67Ga and labeled leukocyte scintigraphy are not recommended for this group.
The full criteria can be viewed in the Journal of Nuclear Medicine.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.