The value of 18F-FDG PET/CT in diagnosis and during follow-up in 273 patients with chronic Q fever

Ilse J.E. Kouijzer* (Corresponding Author), Linda M. Kampschreur, Peter C. Wever, Corneline Hoekstra, Marjo E.E. Van Kasteren, Monique G.L. De Jager-Leclercq, Marrigje H. Nabuurs-Franssen, Marjolijn C.A. Wegdam-Blans, Heidi S.M. Ammerlaan, Jacqueline Buijs, Lioe Fee de Geus-Oei, Wim J.G. Oyen, Chantal P. Bleeker-Rovers

*Corresponding author for this work

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In 1%–5% of all acute Q fever infections, chronic Q fever develops, mostly manifesting as endocarditis, infected aneurysms, or infected vascular prostheses. In this study, we investigated the diagnostic value of 18F-FDG PET/CT in chronic Q fever at diagnosis and during follow-up. Methods: All adult Dutch patients suspected of chronic Q fever who were diagnosed since 2007 were retrospectively included until March 2015, when at least one 18F-FDG PET/CT scan was obtained. Clinical data and results from 18F-FDG PET/CT at diagnosis and during follow-up were collected. 18F-FDG PET/CT scans were prospectively reevaluated by 3 nuclear medicine physicians using a structured scoring system. Results: In total, 273 patients with possible, probable, or proven chronic Q fever were included. Of all 18F-FDG PET/CT scans performed at diagnosis, 13.5% led to a change in diagnosis. Q fever–related mortality rate in patients with and without vascular infection based on 18F-FDG PET/CT was 23.8% and 2.1%, respectively (P 5 0.001). When 18F-FDG PET/CT was added as a major criterion to the modified Duke criteria, 17 patients (1.9-fold increase) had definite endocarditis. At diagnosis, 19.6% of 18F-FDG PET/CT scans led to treatment modification. During follow-up, 57.3% of 18F-FDG PET/CT scans resulted in treatment modification. Conclusion: 18F-FDG PET/CT is a valuable technique in diagnosis of chronic Q fever and during follow-up, often leading to a change in diagnosis or treatment modification and providing important prognostic information on patient survival.

Original languageEnglish
Pages (from-to)127-133
Number of pages7
JournalThe Journal of nuclear medicine
Issue number1
Publication statusPublished - 1 Jan 2018


  • 18F-FDG PET/CT
  • Endocarditis
  • Q fever
  • Vascular infection
  • n/a OA procedure


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