18-Fluoro-deoxyglucose-PET/Computed Tomography in Infection and Aseptic Inflammatory Disorders: Value to Patient Management

Fluorodeoxyglucose PET/Computed Tomography in Evaluation of Prosthetic Joints and Diabetic Foot: A Comparative Perspective with Other Functional Imaging Modalities

Infection imaging has been an important part of nuclear medicine practice. Infections in prosthetic joints and diabetic foot are associated with devastating complications, posing substantial challenge for both diagnosis and overall management. For many years, conventional nuclear medicine techniques have been used to frame a painful joint arthroplasty or diabetic foot infection. The various functional nuclear imaging modalities used include labeled leukocyte imaging, combined leukocyte-marrow scintigraphy, antigranulocyte antibody scintigraphy, 3-phase bone scintigraphy, and fluorodeoxyglucose PET/computed tomography, yet no single method has proved to be highly sensitive and specific and at the same time safe, simple, and time-effective.

Irritated seborrhoeic keratosis masquerading as malignancy on 18F-fluorodeoxyglucose positron emission tomography-computed tomography

Seborrhoeic keratosis is a common benign skin tumor and can have a variable presentation. Irritated seborrhoeic keratosis can clinically mimic cutaneous malignancy and often warrant biopsy. ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography-computed tomography (PET-CT) can give false-positive results in many cutaneous pathologies. We present an interesting case of irritated seborrhoeic keratosis masquerading as skin cancer, clinically as well as on¹⁸F-FDG PET-CT.

Fever of unknown origin - a literature review

Fever of undetermined origin (FUO) is a challenging entity with a striking presence in hospitals around the world and can be associated with a myriad of differential diagnoses. It is defined as axillary temperature ≥ 37.8 ° C on several occasions, lasting ≥ three weeks, in the absence of diagnosis after three days of hospital investigation or three outpatient visits. The main etiologies are: infectious, neoplastic, and rheumatic. The diagnosis is based on the detailed clinical history and physical examination of these patients, in order to direct the specific complementary tests to be performed in each case. Empirical therapy is not recommended (with few exceptions) in patients with prolonged fever, as it may disguise and delay the diagnosis and conduct to treat the specific etiology. The prognosis encompasses mortality of 12% - 35%, varying according to the underlying etiology. In this sense, the objective of this study is to review the main topics about fever of undetermined origin, bringing historical and scientific aspects, national and international.

Tumor Necrosis Factor-Alpha as Differential Diagnostic Marker for Patients with Fever of Unknown Origin

Febrile conditions of unidentified origin are still unknown in modern medicine despite the development of diagnostic procedures. There are various agents of long-term temperature encompassing numerous infectious or non-infectious diseases.

The aim of this study was to determine if there was a statistically significant difference in the values of proinflammatory cytokines (IL-1, TNFα, IL-6) in patients who meet the criteria for febrile conditions of unidentified origin, between the group of infectious, malignant, rheumatic, “other” diseases and undiagnosed patients.

The study was conducted in the Immunology laboratory of the Center for Molecular Medicine and Stem Cells Research of the Faculty of Medical Sciences in Kragujevac. Blood samples were taken from patients tested at the Clinic for Infectious Diseases, of the Clinical Center of Kragujevac, in the period from 2014 to 2016. The study included 70 patients.

The measured values of the level of TNFα showed significantly higher values in a group of malignant diseases than in the group of infectious diseases, while the values of IL-1 and IL-6 did not show statistical significance.

TNFα can improve diagnosing in case of patients with an unknown febrile condition, which can shorten the length of the hospital stay and reduce the volume of performance of diagnostic procedures.