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Title: FDG-PET/CT for investigation of pyrexia of unknown origin: a cost of illness analysis.
Austin Authors: Liu, Bonnia ;Ma, Ronald ;Shum, Evonne;Hormiz, Maria;Lee, Sze Ting ;Poon, Aurora M T ;Scott, Andrew M 
Affiliation: Molecular Imaging and Therapy
Department of Finance, Austin Health, Melbourne, VIC, Australia.
General Medicine
University of Melbourne, Melbourne, VIC, Australia.
University of Melbourne, Melbourne, VIC, Australia.
Olivia Newton-John Cancer Research Institute
La Trobe University, Melbourne, VIC, Australia.
La Trobe University, Melbourne, VIC, Australia.
Department of Nuclear Medicine, Royal Melbourne Hospital, 300 Grattan St, Melbourne, VIC, Australia.
Issue Date: 7-Dec-2023
Date: 2023
Publication information: European Journal of Nuclear Medicine and Molecular Imaging 2023-12-07
Abstract: Our study aims to explore the current utilisation of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the diagnostic pathway of pyrexia of unknown origin (PUO) and associated cost of illness in a large tertiary teaching hospital in Australia. 1257 febrile patients between June 2016 and September 2022 were retrospectively reviewed. There were 57 patients who met the inclusion criteria of "classical PUO", of which FDG-PET/CT was performed in 31 inpatients, 15 outpatients and 11 inpatients did not have an FDG-PET/CT scan. The patient demographics, clinical characteristics and inpatient cost were analysed, together with the diagnostic performance of FDG-PET/CT and impact on clinical management. The mean age, length of stay and total cost of admission were higher for inpatients who received FDG-PET/CT versus those who did not. The median cost per patient-bed-day did not differ between the two groups. Inpatients who received earlier FDG-PET/CTs (≤ 7 days from admission) had shorter length of stays and lower total cost compared to those who received a later scan. A negative FDG-PET/CT scan, demonstrating no serious or life-threatening abnormalities resulted in subsequent discharge from hospital or outpatient clinic in 7/10 (70%) patients. There were 11/40 (28%) scans where ancillary abnormalities were identified, requiring further evaluation. FDG-PET/CT showed high diagnostic accuracy and significant impact on patient management in patients with PUO. FDG-PET/CT performed earlier in admission for PUO was associated with shorter length of stay and lower total cost.
DOI: 10.1007/s00259-023-06548-y
ORCID: 0000-0001-6796-7134
Journal: European Journal of Nuclear Medicine and Molecular Imaging
PubMed URL: 38057651
ISSN: 1619-7089
Type: Journal Article
Subjects: Cost of Illness
Fever of unknown origin
Pyrexia of unknown origin
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