A combined whole body diffusion- and continous table movement STIR-protocol for the assessment of fever of unknown origin (FUO): first results

Purpose: Patients with fever of unknown origin (FUO) [1] are usually examined with many different modalities, such as conventional radiography of the lungs, CT of the abdomen and scintigraphy, however, in more than 50% without detection of the fever generating focus. Leucocyte scintigraphy is considered as the diagnostic standard [2], however, it is unspecific. F-FDG-PET [3] has been evaluated in some studies, and also MRI of the lungs and vessel system has been performed in single studies to rule out pulmonary infection [4] and vasculitis [5], however, there are no data on whole body (WB)-MRI using diffusion weighted imaging (DWI) and STIR imaging so far. Therefore the purpose of this study was to evaluate WB-MRI using DWI [6,7,8] and continuous table movement (CTM) [9] STIR sequences as a new specific modality for the etiologic workup of FUO without radiation exposure and with less technical effort compared to scintigraphy.