Boulu X, Vaysse B, El Esper I, Meyer ME, Duhaut P, Salle V, Schmidt J. [Inflammatory syndrome of unknown origin and PET/CT: Economic and iatrogenic impacts of false positive].
Rev Med Interne 2023:S0248-8663(23)01275-4. [PMID:
38000918 DOI:
10.1016/j.revmed.2023.11.009]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/23/2023] [Accepted: 11/12/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION
PET/CT is regularly used to investigate inflammatory syndrome of unknown origin (IUO), but hypermetabolisms found are not always consistent with the final diagnosis. The objective of the study was to assess the cost attributed to the diagnostic work-up for these false positives.
MATERIALS AND METHODS
We conducted an ancillary study on a previous retrospective cohort from the internal medicine department at Amiens university hospital in patients who had a PET/CT scan between October 2004 and April 2017. Patients were included if PET/CT had been prescribed to investigate IUO. Among the 763 PET/CT performed, 144 met the inclusion criteria and a false-positive rate of 17.4% (n=25) was reported.
RESULTS
Among these 25 patients, 21 underwent further investigations. The most frequently found hypermetabolic territories were digestive (n=12, mean SUVmax 8 [±4.33]) and osteoarticular (n=11, mean SUVmax 4.33 [±1.15]). The total cost of the 13 prescribed consultations was €390, the total cost of the 40 additional tests was €4,476 (mainly digestive endoscopies and radiological tests) and the total cost of medical transport was €572. The total cost of the 35 days of hospitalization specifically required to investigate these false positives was €22,952. In 23.8% (n=5), these investigations led to the incidental discovery of tumor lesions.
CONCLUSION
The economic impact of false-positive PET/CT results does not appear to be negligible and merits a genuine prospective medico-economic study.
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