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Appropriateness Criteria

Reference Study Type Patients/Events Study Objective(Purpose of Study) Study Results Study Quality
1. Arora R, Mahajan P. Evaluation of child with fever without source: review of literature and update. Pediatr Clin North Am. 2013;60(5):1049-1062. Review/Other-Dx N/A To review the literature on the evaluation and management of the febrile child, and comment on recent advances that may have potential to change the paradigm for detection of pathogens. The authors discuss evaluation of the febrile child in 2 age groups, febrile infants 3 months or younger and those between 3 and 36 months of age. No results stated in abstract. 4
2. Rose E. Pediatric Fever. Emerg Med Clin North Am 2021;39:627-39. Review/Other-Dx NA No purpose stated in abstract No results stated in abstract 4
3. Chan SS, Kotecha MK, Rigsby CK, et al. ACR Appropriateness Criteria® Pneumonia in the Immunocompetent Child. J Am Coll Radiol 2020;17:S215-S25. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for pneumonia in the immunocompetent child. No results stated in abstract. 4
4. Karmazyn BK, Alazraki AL, Anupindi SA, et al. ACR Appropriateness Criteria® Urinary Tract Infection-Child. J Am Coll Radiol 2017;14:S362-S71. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for urinary tract infection-child. No results stated in abstract. 4
5. Koberlein GC, Trout AT, Rigsby CK, et al. ACR Appropriateness Criteria® Suspected Appendicitis-Child. J Am Coll Radiol 2019;16:S252-S63. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for suspected appendicitis-child. No results stated in abstract. 4
6. Woll C, Neuman MI, Aronson PL. Management of the Febrile Young Infant: Update for the 21st Century. [Review]. Pediatric Emergency Care. 33(11):748-753, 2017 Nov. Review/Other-Dx NA No purpose stated in abstract No results stated in abstract 4
7. Greenhow TL, Hung YY, Herz AM, Losada E, Pantell RH. The changing epidemiology of serious bacterial infections in young infants. Pediatr Infect Dis J 2014;33:595-9. Review/Other-Dx 224,553 full-term infants To analyze all cultures of blood, urine, and cerebrospinal fluid obtained from full term infants for study of serious bacterial infections A total of 224,553 full-term infants were born during the study period. Of 5396 blood cultures, 129 bacteremic infants were identified (2%). Of 4599 urine cultures, 823 episodes of urinary tract infection (UTI) were documented in 778 infants (17%). Of 1796 CSF cultures, 16 infants had bacterial meningitis (0.9%). The incidence rate of serious bacterial infections (bacteremia, UTI and meningitis) and febrile serious bacterial infections was 3.75 and 3.1/1000 full-term births, respectively. Escherichia coli was the leading cause of bacteremia (78), UTI (719) and bacterial meningitis (7). There were 23 infants with Group B Streptococcus bacteremia including 6 cases of meningitis and no cases of Listeria infection. Nine percentage of infants had multiple sites of infection; 10% of UTIs were associated with bacteremia and 52% of bacteremia was associated with UTI. 4
8. Kuppermann N, Dayan PS, Levine DA, et al. A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMA Pediatrics. 173(4):342-351, 2019 04 01. Review/Other-Dx 913 infants To derive and validate a prediction rule to identify febrile infants 60 days and younger at low risk for SBIs. We derived the prediction rule on a random sample of 908 infants and validated it on 913 infants (mean age was 36 days, 765 were girls [42%], 781 were white and non-Hispanic [43%], 366 were black [20%], and 535 were Hispanic [29%]). Serious bacterial infections were present in 170 of 1821 infants (9.3%), including 26 (1.4%) with bacteremia, 151 (8.3%) with urinary tract infections, and 10 (0.5%) with bacterial meningitis; 16 (0.9%) had concurrent SBIs. The prediction rule identified infants at low risk of SBI using a negative urinalysis result, an ANC of 4090/µL or less (to convert to ×109 per liter, multiply by 0.001), and serum procalcitonin of 1.71 ng/mL or less. In the validation cohort, the rule sensitivity was 97.7% (95% CI, 91.3-99.6), specificity was 60.0% (95% CI, 56.6-63.3), negative predictive value was 99.6% (95% CI, 98.4-99.9), and negative likelihood ratio was 0.04 (95% CI, 0.01-0.15). One infant with bacteremia and 2 infants with urinary tract infections were misclassified. No patients with bacterial meningitis were missed by the rule. The rule performance was nearly identical when the outcome was restricted to bacteremia and/or bacterial meningitis, missing the same infant with bacteremia. 4
9. Mace AO, Martin AC, Ramsay J, Totterdell J, Marsh JA, Snelling T. FeBRILe3 Project: protocol for a prospective pragmatic, multisite observational study and safety evaluation assessing Fever, Blood cultures and Readiness for discharge in Infants Less than 3 months old. BMJ Open. 10(5):e035992, 2020 05 12. Review/Other-Dx N/A To assess the safety and impact of the introduction of a clinical practice guideline (CPG) recommending early discharge of infants with fever without source who are at low risk of serious bacterial infection (SBI) No results listed in abstract 4
10. Mercurio L, Hill R, Duffy S, Zonfrillo MR. Clinical Practice Guideline Reduces Evaluation and Treatment for Febrile Infants 0 to 56 Days of Age. Clinical Pediatrics. 59(9-10):893-901, 2020 09. Review/Other-Dx NA No purpose stated in abstract No results stated in abstract 4
11. Woll C, Neuman MI, Pruitt CM, et al. Epidemiology and Etiology of Invasive Bacterial Infection in Infants </=60 Days Old Treated in Emergency Departments. J Pediatr 2018;200:210-17 e1. Review/Other-Dx 442 infants To help guide empiric treatment of infants =60 days old with suspected invasive bacterial infection by describing pathogens and their antimicrobial susceptibilities. Of the 442 infants with invasive bacterial infection, 353 (79.9%) had bacteremia without meningitis, 64 (14.5%) had bacterial meningitis with bacteremia, and 25 (5.7%) had bacterial meningitis without bacteremia. The peak number of cases of invasive bacterial infection occurred in the second week of life; 364 (82.4%) infants were febrile. Group B streptococcus was the most common pathogen identified (36.7%), followed by Escherichia coli (30.8%), Staphylococcus aureus (9.7%), and Enterococcus spp (6.6%). Overall, 96.8% of pathogens were susceptible to ampicillin plus a third-generation cephalosporin, 96.0% to ampicillin plus gentamicin, and 89.2% to third-generation cephalosporins alone. 4
12. McCulloh RJ, McDaniel LM, Kerns E, Biondi EA. Prevalence of Invasive Bacterial Infections in Well-Appearing, Febrile Infants. Hospital Pediatrics. 11(9):e184-e188, 2021 09. Review/Other-Dx 10,618 febrile infants To determine current prevalence and epidemiology of IBI from a contemporary, national cohort of well-appearing, febrile infants at university-affiliated and community-based hospitals. A total of 10 618 febrile infants met inclusion criteria; cerebrospinal fluid and blood cultures were tested from 6747 and 10 581 infants, respectively. Overall, meningitis prevalence was 0.4% (95% confidence interval [CI]: 0.2-0.5); bacteremia prevalence was 2.4% (95% CI: 2.1-2.7). Neonates aged 7 to 30 days had significantly higher prevalence of bacteremia, as compared with infants in the second month of life. IBI prevalence did not differ between community-based and university-affiliated hospitals (2.7% [95% CI: 2.3-3.1] vs 2.1% [95% CI: 1.7-2.6]). Escherichia coli and Streptococcus agalactiae were the most commonly identified organisms. 4
13. Heulitt MJ, Ablow RC, Santos CC, O'Shea TM, Hilfer CL. Febrile infants less than 3 months old: value of chest radiography. Radiology. 1988;167(1):135-137. Observational-Dx 192 patients To evaluate the necessity of obtaining chest radiographs in febrile infant less than 3 months old. When chest radiography was considered the gold standard for the presence or absence of pneumonia, findings of respiratory distress on physical examination had a sensitivity of 58% and a specificity of 93% for the detection of pneumonia. 3
14. Ozcan A, Laskowski E, Sahai S, Levasseur K. Febrile infants without respiratory symptoms or sick contacts: are chest radiographs or RSV/influenza testing indicated?. BMC Infectious Diseases. 21(1):862, 2021 Aug 23. Observational-Dx 129 infants To determine the rate of positive CXR and RSV/flu results in febrile infants with no respiratory symptoms and no sick contacts. 129 infants met enrollment criteria. Of the 129 infants, 58 (45.0%) had no respiratory symptoms and no sick contacts. Of these 58, 36 (62.1%) received a CXR and none of them had any abnormal findings, 48 (82.8%) had RSV/flu testing, no patients tested positive for RSV and only one patient tested positive for flu. Costs of CXR and RSV/flu testing for this cohort was $19,788. 3
15. Biondi EA, Byington CL. Evaluation and Management of Febrile, Well-appearing Young Infants. [Review]. Infectious Disease Clinics of North America. 29(3):575-85, 2015 Sep. Review/Other-Dx NA To review the epidemiology of bacterial and viral infections in these infants. No results stated in abstract. 4
16. Pantell RH, Roberts KB, Adams WG, et al. Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old. Pediatrics. 148(2), 2021 08. Review/Other-Dx NA To address the evaluation and management of well-appearing, term infants, 8 to 60 days of age, with fever =38.0°C. No results stated in abstract. 4
17. Yaeger JP, Jones J, Ertefaie A, Caserta MT, van Wijngaarden E, Fiscella K. Refinement and Validation of a Clinical-Based Approach to Evaluate Young Febrile Infants. Hospital Pediatrics. 12(4):399-407, 2022 Apr 01. Observational-Dx 1419 febrile infants To refine and externally validate the predictive models. Of 1419 febrile infants (median age 53 days, interquartile range = 32-69), 99 (7%) had a bacterial infection. Areas-under-the-receiver operating characteristic curve of machine learning and regression models were 0.92 (95% confidence interval [CI] 0.89-0.94) and 0.90 (0.86-0.93) compared with 0.95 (0.91-0.98) and 0.96 (0.94-0.98) in the derivation study. Sensitivities and specificities of machine learning and regression models were 98.0% (94.7%-100%) and 54.2% (51.5%-56.9%) and 96.0% (91.5%-99.1%) and 50.0% (47.4%-52.7%). 3
18. Waterfield T, Lyttle MD, Munday C, et al. Validating clinical practice guidelines for the management of febrile infants presenting to the emergency department in the UK and Ireland. Archives of Disease in Childhood. 107(4):329-334, 2022 04. Observational-Dx 555 febrile infants To report the performance of clinical practice guidelines (CPG) in the diagnosis of serious/invasive bacterial infections (SBI/IBI) in infants presenting with a fever to emergency care in the UK and Ireland. 555 participants were included in the analysis. The median age was 53 days (IQR 32 to 70), 447 (81%) underwent blood testing and 421 (76%) received parenteral antibiotics. There were five participants with bacterial meningitis (1%), seven with bacteraemia (1%) and 66 (12%) with urinary tract infections. The NICE NG51 CPG was the most sensitive: 1.00 (95% CI 0.95 to 1.00). This was significantly more sensitive than NICE NG143: 0.91 (95% CI 0.82 to 0.96, p=0.0233) and BSAC: 0.82 (95% 0.72 to 0.90, p=0.0005). NICE NG51 was the least specific 0.0 (95% CI 0.0 to 0.01), and this was significantly lower than the NICE NG143: 0.09 (95% CI 0.07 to 0.12, p<0.0001) and BSAC: 0.14 (95% CI 0.1 to 0.17, p<0.0001). 3
19. Mintegi S, Bressan S, Gomez B, et al. Accuracy of a sequential approach to identify young febrile infants at low risk for invasive bacterial infection. Emergency Medicine Journal. 31(e1):e19-24, 2014 Oct. Observational-Dx 11123 infants To assess the value of a sequential approach ('step by step') to febrile young infants in order to identify patients at a low risk for invasive bacterial infections (IBI) who are suitable for outpatient management and compare it with other previously described strategies such as the Rochester criteria and the Lab-score. Of the 1123 infants (IBI 48; 4.2%), 488 (43.4%) were classified as low-risk criteria according to the step by step approach (vs 693 (61.7%) with the Lab-score and 458 (40.7%) with the Rochester criteria). The prevalence of IBI in the low-risk criteria patients was 0.2% (95% CI 0% to 0.6%) using the step by step approach; 0.7% (95% CI 0.1% to 1.3%) using the Lab-score; and 1.1% (95% CI 0.1% to 2%) using the Rochester criteria. Using the step by step approach, one patient with IBI was not correctly classified (2.0%, 95% CI 0% to 6.12%) versus five using the Lab-score or Rochester criteria (10.4%, 95% CI 1.76% to 19.04%). 3
20. Biondi EA, McCulloh R, Staggs VS, et al. Reducing Variability in the Infant Sepsis Evaluation (REVISE): A National Quality Initiative. Pediatrics 2019;144. Observational-Dx 20,570 infants To assess the impact of a national quality initiative on appropriate hospitalization and length of stay (LOS) in this population. In total, 124 hospitals from 38 states provided data on 20 570 infants. The median site improvement in percentages of infants who were evaluated and hospitalized appropriately and in those with appropriate LOS was 5.3% (interquartile range = -2.5% to 13.7%) and 15.5% (interquartile range = 2.9 to 31.3), respectively. Special cause variation toward the target was identified for both measures. There was no change in delayed treatment or missed bacterial infections (slope difference 0.1; 95% confidence interval, -8.3 to 9.1). 3
21. Cram EF BD, Bijur PE, Goldman HS. Is a Chest Radiograph Necessary in the of Every Febrile Infant Less Than 8 Evaluation Weeks of Age? Pediatrics 1991;88:821-24. Observational-Dx 242 patients To examine the relationship between respiratory signs and likelihood of having an abnormal chest radiograph in febrile infants <8 weeks of age and extent of abnormal radiographs in absence of respiratory findings. Of the 242 cases, 228 had chest radiographs available for interpretation. Of these, 27 chest radiographs (12%) were identified as abnormal, including 6 where there was initial disagreement as to the presence of an abnormality. Twenty-five (31%) of 80 infants with any respiratory signs had an abnormal chest radiograph, whereas only 2 (1%) of 148 asymptomatic infants did. The sensitivity of respiratory signs was 93% (confidence interval = 76% to 99%). These findings suggest that in the absence of respiratory signs, febrile infants are unlikely to have an abnormal chest radiograph. 1
22. Bramson RT, Meyer TL, Silbiger ML, Blickman JG, Halpern E. The futility of the chest radiograph in the febrile infant without respiratory symptoms. Pediatrics. 1993;92(4):524-526. Meta-analysis 617 patients To determine efficiency of chest radiograph in febrile infants. The combined group of infants had 361 infants who had no clinical evidence of pulmonary disease on history or physical examination. All 361 infants had normal chest radiograph. These results gave a 95% confidence interval that the chance of a positive chest radiograph in a patient with no pulmonary symptoms would occur less than 1.02% of the time. Inadequate
23. American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Pediatric Fever, Mace SE, Gemme SR, et al. Clinical Policy for Well-Appearing Infants and Children Younger Than 2 Years of Age Presenting to the Emergency Department With Fever. Annals of Emergency Medicine. 67(5):625-639.e13, 2016 May. Review/Other-Dx N/A To provide evidence-based recommendations for well-appearing infants and children younger than 2 years presenting to the emergency department with fever. No results stated in abstract. 4
24. Antoon JW, Potisek NM, Lohr JA. Pediatric Fever of Unknown Origin. Pediatr Rev 2015;36:380-90; quiz 91. Review/Other-Dx N/A To discuss a systematic approach to evaluation and management of fever of unknown origin in patients of various ages. No abstract available. 4
25. Besson FL, Chaumet-Riffaud P, Playe M, et al. Contribution of (18)F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): a stratification-based meta-analysis. [Review]. European Journal of Nuclear Medicine & Molecular Imaging. 43(10):1887-95, 2016 Sep. Meta-analysis 14 studies The aim of this study was to quantify the contribution of fluorodeoxyglucose (FDG)-positron emission tomography (PET) to the diagnostic assessment of fever of unknown origin (FUO), taking into account the diagnostic limitations resulting from the composite nature of this entity. A meta-analysis of the 14 included studies showed that normal PET findings led to an increase in the absolute final diagnostic rate of 36 % abnormal PET findings to an increase of 83 %, corresponding to a pooled OR of 8.94 (95 % CI 4.18 - 19.12, Z = 5.65; p < 0.00001). The design of the studies influenced the results (OR 2.92, 95 % CI 1.00 - 8.53 for prospective studies; OR 18,57, 95 % CI 7.57 - 45.59 for retrospective studies; p = 0.01), whereas devices (dedicated or hybrid), geographic area and follow-up period did not. Good
26. Williams-Smith JA, Fougere Y, Pauchard JY, Asner S, Gehri M, Crisinel PA. Risk factors for urinary tract infections in children aged 0-36months presenting with fever without source and evaluated for risk of serious bacterial infections. Archives de Pediatrie. 27(7):372-379, 2020 Oct. Observational-Dx 173 children To describe the epidemiology of SBI in children with FWS in our setting and to evaluate the performance of our management algorithm. Between October 2015 and September 2017, 173 children were recruited, with a median age of 4.4 months (2.1-1). Of these children, 166 (96%) were up to date with their vaccinations. A total of 47 children (27%) had a final diagnosis of SBI, which were all urinary tract infections (UTI). Presence of chills (odds ratio [OR] 5.6, 95% confidence interval [CI] 1.3-24.3), fever for>2 days (OR 29.1, 95% CI 3.5-243.5), and age<9 months (OR: 45.3, 95% CI: 4.9-415.7) were statistically significant predictors of UTI in a multivariate logistic regression. The sensitivity and specificity of our management algorithm were 100% (95% CI: 92.4-100%) and 21.4% (14.6-29.6%), respectively. 3
27. Hamilton JL, Evans SG, Bakshi M. Management of Fever in Infants and Young Children. American Family Physician. 101(12):721-729, 2020 06 15. Review/Other-Dx NA No purpose stated in abstract No results stated in abstract 4
28. Borensztajn D, Hagedoorn NN, Carrol E, et al. Characteristics and management of adolescents attending the ED with fever: a prospective multicentre study. BMJ Open. 12(1):e053451, 2022 01 19. Review/Other-Dx 2,577 patients To describe patient characteristics and management of febrile adolescents attending the emergency department (ED). 37,420 encounters were included, of which 2577 (6.9%) were adolescents. Adolescents were more often triaged as highly urgent (38.9% vs 34.5%) and described as ill appearing (23.1% vs 15.6%) than younger children. Increased work of breathing and a non-blanching rash were present less often in adolescents, while neurological signs were present more often (1% vs 0%). C reactive protein tests were performed more frequently in adolescents and were more often abnormal (adjusted OR (aOR) 1.7, 95% CI 1.5 to 1.9). Adolescents were more often diagnosed with SBI (OR 1.8, 95% CI 1.6 to 2.0) and sepsis/meningitis (OR 2.3, 95% CI 1.1 to 5.0) and were more frequently admitted (aOR 1.3, 95% CI 1.2 to 1.4) and treated with intravenous antibiotics (aOR 1.7, 95% CI 1.5 to 2.0). 4
29. Patterson RJ, Bisset GS, 3rd, Kirks DR, Vanness A. Chest radiographs in the evaluation of the febrile infant. AJR Am J Roentgenol. 1990;155(4):833-835. Observational-Dx 226: (105 retrospective121 prospective) To determine usefulness of chest radiographs in infants <24 months old with fever and no obvious cause. Chest radiographs in infants <3 months of age are of value only in those with clinical evidence of respiratory tract illness. 4
30. Lipsett SC, Hirsch AW, Monuteaux MC, Bachur RG, Neuman MI. Development of the Novel Pneumonia Risk Score to Predict Radiographic Pneumonia in Children. Pediatric Infectious Disease Journal. 41(1):24-30, 2022 01 01. Observational-Dx 206 children To derive and validate the novel Pneumonia Risk Score (PRS), a clinical tool utilizing signs and symptoms available to clinicians to determine a child’s risk of radiographic pneumonia. Among 1181 children included in the study, 206 (17%) had radiographic pneumonia. The PRS included age in years, triage oxygen saturation, presence of fever, presence of rales, and presence of wheeze. The area under the curve (AUC) of the PRS was 0.71 (95% confidence interval [CI]: 0.68-0.75), while the AUC of clinician judgment was 0.61 (95% CI: 0.56-0.66) (P < 0.001). Among 2132 children included in the validation cohort, the PRS demonstrated an AUC of 0.69 (95% CI: 0.65-0.73). 2
31. Ramgopal S, Ambroggio L, Lorenz D, Shah SS, Ruddy RM, Florin TA. A Prediction Model for Pediatric Radiographic Pneumonia. Pediatrics. 149(1), 2022 01 01. Observational-Dx 253 patients To construct a predictive model for radiographic community-acquired pneumonia (CAP) based on clinical features to decrease chest radiographs (CXRs) use. Radiographic CAP was identified in 253 (22.2%) of 1142 patients. In multivariable analysis, increasing age, prolonged fever duration, tachypnea, and focal decreased breath sounds were positively associated with CAP. Rhinorrhea and wheezing were negatively associated with CAP. The bootstrapped reduced model retained 3 variables: age, fever duration, and decreased breath sounds. The area under the receiver operating characteristic for the reduced model was 0.80 (95% confidence interval: 0.77-0.84). Of 229 children with a predicted risk of <4%, 13 (5.7%) had radiographic CAP (sensitivity of 94.9% at a 4% risk threshold). Conversely, of 229 children with a predicted risk of >39%, 140 (61.1%) had CAP (specificity of 90% at a 39% risk threshold). 3
32. Pulcini CD, Lentz S, Saladino RA, et al. Emergency management of fever and neutropenia in children with cancer: A review. [Review]. American Journal of Emergency Medicine. 50:693-698, 2021 12. Review/Other-Tx N/A This narrative review evaluates the management of pediatric patients with cancer and neutropenic fever and provides comparison with the care of the adult with neutropenic fever in the emergency department. When children with cancer and FN first present for care, stratification of risk is based on a thorough history and physical examination, baseline laboratory and radiologic studies and the clinical condition of the patient, much like that for the adult patient. Prompt evaluation and initiation of intravenous broad-spectrum antibiotics after cultures are drawn but before other studies are resulted is critically important and may represent a practice difference for some emergency physicians when compared with standardized adult care. Unlike adults, all high-risk and most low-risk children with FN undergoing chemotherapy require admission for parenteral antibiotics and monitoring. Oral antibiotic therapy with close, structured outpatient monitoring may be considered only for certain low-risk patients at pediatric centers equipped to pursue this treatment strategy. 4
33. Lehrnbecher T. Treatment of fever in neutropenia in pediatric oncology patients. [Review]. Current Opinion in Pediatrics. 31(1):35-40, 2019 02. Review/Other-Tx N/A To review a number of studies which have recently been performed to refine algorithms regarding initiation, modification, and termination of antimicrobial treatment and are the basis for international pediatric-specific guidelines for the treatment of fever and neutropenia in children with cancer. Although hospitalization and prompt initiation of intravenous broad-spectrum antibiotics remains the mainstay in the treatment of febrile neutropenic children with cancer, recent research has addressed a number of questions to optimize the management of these patients. Risk prediction rules have been evaluated to allow for individualized treatment intensity and to evaluate the safety of early discontinuation of empirical antibiotic therapy. In addition, the use of preemptive antifungal therapy has been evaluated to decrease the use of antifungal agents. 4
34. Lehrnbecher T, Robinson P, Fisher B, et al. Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update. [Review]. Journal of Clinical Oncology. 35(18):2082-2094, 2017 Jun 20. Review/Other-Tx N/A To update a clinical practice guideline (CPG) for the empirical management of fever and neutropenia (FN) in children with cancer and hematopoietic stem-cell transplantation recipients. Recommendations related to initial presentation, ongoing management, and empirical antifungal therapy of pediatric FN were reviewed; the most substantial changes were related to empirical antifungal therapy. Key differences from our 2012 FN CPG included the listing of a fourth-generation cephalosporin for empirical therapy in high-risk FN, refinement of risk stratification to define patients with high-risk invasive fungal disease (IFD), changes in recommended biomarkers and radiologic investigations for the evaluation of IFD in prolonged FN, and a weak recommendation to withhold empirical antifungal therapy in IFD low-risk patients with prolonged FN. 4
35. Rao AD, Sugar EA, Barrett N, Mahesh M, Arceci RJ. The utility of computed tomography in the management of fever and neutropenia in pediatric oncology. Pediatric Blood & Cancer. 62(10):1761-7, 2015 Oct. Observational-Dx 263 patients To examine the contribution of either the commonly employed pan-CT (computed tomography) (multiple anatomical locations) or targeted CT (single location) scanning to identify possible infectious etiologies in this challenging clinical scenario. Charts for 635 admissions for FN from 263 patients were reviewed. Overall, 139 (22%) admissions (93 individuals) had at least one scan. Of 188 scans, 103 (55%) were pan-scans. Changes in management were most strongly associated with the identification of evidence consistent with infection (OR=12.64, 95% CI: 5.05–31.60, P<0.001). Seventy-eight (41%) of all CT scans led to a change in clinical management, most commonly relating to use of antibiotic (N=41, 53%) or antifungal/antiviral medications (N=33, 42%). The odds of a change in clinical management did not differ for those receiving a pan-scan compared to those receiving a targeted scan (OR=1.23; 95% CI, 0.61–2.46; P=0.57). 3
36. Agrawal AK, Saini N, Gildengorin G, Feusner JH. Is routine computed tomographic scanning justified in the first week of persistent febrile neutropenia in children with malignancies? Pediatr Blood Cancer. 2011;57(4):620-624. Review/Other-Dx 52 patients To evaluate the diagnostic utility of CT obtained during prolonged fever and neutropenia in pediatric oncology patients. A secondary aim was to see if underlying diagnosis, symptomatology at time of CT, or length of febrile neutropenia prior to imaging predicted positive CT findings. 52 patients had 68 unique episodes of prolonged febrile neutropenia that resulted in CT imaging. Positive findings occurred in 18%, 12%, and 25% of initial chest, abdomen, and sinus CTs, respectively. There were no positive findings on initial pelvic CT. Only 2 of the initial positive CT scans led to a change in management (6.5% of positive scans, 0.8% of all initial scans). These were both scans of the chest. All patients with concern for occult fungal infection had findings on chest CT. Patients with clinically important infections had no statistical difference in days of fever or neutropenia or type of underlying malignancy compared with those without infection. Clinical symptomatology was most helpful for typhlitis. 4
37. Qiu KY, Liao XY, Huang K, et al. The early diagnostic value of serum galactomannan antigen test combined with chest computed tomography for invasive pulmonary aspergillosis in pediatric patients after hematopoietic stem cell transplantation. Clin Transplant 2019;33:e13641. Observational-Dx 141 patients 3
38. Chan SS, Coblentz A, Bhatia A, et al. Imaging of pediatric hematopoietic stem cell transplant recipients: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper. Pediatr Blood Cancer 2023;70 Suppl 4:e30013. Review/Other-Dx N/A To describe the various imaging modalities available with recommendations for which imaging study should be performed in specific complications. To provide select imaging protocols for different indications and modalities for the purpose of establishing a set minimal standard for imaging in these complex patients. No results in abstract. 4
39. Weitzer F, Nazerani Hooshmand T, Pernthaler B, Sorantin E, Aigner RM. Diagnostic value of F-18 FDG PET/CT in fever or inflammation of unknown origin in a large single-center retrospective study. Scientific Reports. 12(1):1883, 2022 02 03. Review/Other-Dx 300 patients To examine the clinical value of F-18 FDG PET/CT in FUO/IUO by comparing PET/CT with final clinical diagnoses, the impact on patient management and possibly treatment change. PET/CT findings were compared with final clinical outcomes to determine the sensitivity, specificity, clinical significance, etiological distribution of final diagnoses, impact on treatment, role of white-blood cell count (WBC), and C-reactive protein (CRP). In 54.0% (162/300) PET/CT was the decisive exanimation for establishing the final diagnosis, in 13.3% (40/300) the findings were equivocal and indecisive, in 3.3% (10/300) PET/CT findings were false positive, while in 29.3% (88/300) a normal F-18 FDG pattern was present. Statistical analysis showed a sensitivity of 80.2% and a specificity of 89.8% for the contribution of PET/CT to the final diagnosis. CRP levels and WBC were not associated with PET/CT outcome. PET/CT let to new treatment in 24.0% (72/300), treatment change in 18.0% (54/300), no treatment change in 49.6% (149/300), and in 8.3% (25/300) no data was available. Our study demonstrates the utility of F-18 FDG PET/CT for source finding in FUO/IUO if other diagnostic tools fail. 4
40. Wang SS, Mechinaud F, Thursky K, Cain T, Lau E, Haeusler GM. The clinical utility of fluorodeoxyglucose-positron emission tomography for investigation of fever in immunocompromised children. Journal of Paediatrics & Child Health. 54(5):487-492, 2018 May. Review/Other-Dx 14 patients To determine the clinical impact of fluorodeoxyglucose-positron emission tomography (FDG-PET) in combination with computed tomography (CT) in children with malignancy or following haematopoietic stem cell transplantation with prolonged or recurrent fever. Fourteen patients underwent an FDG-PET/CT for prolonged or recurrent fever. Median age was 11 years and 46% had diagnosis of acute lymphoblastic leukaemia. The median absolute neutrophil count on the day of FDG-PET/CT was 0.47 cells/µL. The clinical impact of FDG-PET/CT was 'high' in 11 (79%) patients, contributing to rationalisation of antimicrobials in three, and cessation of antimicrobials in five. Compared to conventional imaging, FDG PET/CT identified seven additional sites of clinically significant infection/inflammation in seven patients. Of the 10 patients who had a cause of fever identified, FDG-PET/CT contributed to the final diagnosis in six (60%). 4
41. Blokhuis GJ, Bleeker-Rovers CP, Diender MG, Oyen WJ, Draaisma JM, de Geus-Oei LF. Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression. Eur J Nucl Med Mol Imaging. 2014;41(10):1916-1923. Observational-Dx 31 children To investigate the diagnostic value of FDG-PET and FDG-PET/CT in children with FUO and in children with unexplained fever during immune suppression. FDG-PET/CT scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52%). Of the total number of scans, 32% were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80% and 78%, respectively. FDG-PET/CT scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in 9 patients (75%). Of the total number of these scans, 58% were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78% and 67%, respectively. 3
42. Yang J, Zhuang H. The role of 18F-FDG PET/CT in the evaluation of pediatric transplant patients. Hellenic Journal of Nuclear Medicine. 18(2):136-9, 2015 May-Aug. Review/Other-Dx 18 patients To evaluate the role of 18-fluoro-2-deoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in pediatric transplant patients. PET/CT scan showed development in 3 PTLD patients, improvement in 4 PTLD patients, development and improvement in 1 PTLD patient, new lesions in 1 PTLD patient, and no lesions in 2 PTLD patients. The scan demonstrated the cause of FUO in 2 patients but did not demonstrate the cause of FUO in 2 patients. The PET/CT was false positive in 1 FUO patient and did not show any new lesion(s) in 2 restaging patients. 4
43. Casali M, Lauri C, Altini C, et al. State of the art of (18)F-FDG PET/CT application in inflammation and infection: a guide for image acquisition and interpretation. Clin Transl Imaging 2021;9:299-339. Review/Other-Dx N/A The purpose of this paper is to achieve an Italian consensus document on [18F]FDG PET/CT or PET/MRI in inflammatory and infectious diseases, such as osteomyelitis (OM), prosthetic joint infections (PJI), infective endocarditis (IE), prosthetic valve endocarditis (PVE), cardiac implantable electronic device infections (CIEDI), systemic and cardiac sarcoidosis (SS/CS), diabetic foot (DF), fungal infections (FI), tuberculosis (TBC), fever and inflammation of unknown origin (FUO/IUO), pediatric infections (PI), inflammatory bowel diseases (IBD), spine infections (SI), vascular graft infections (VGI), large vessel vasculitis (LVV), retroperitoneal fibrosis (RF) and COVID-19 infections. Overall, we summarized 291 scientific papers and guidelines published between 1998 and 2021. Papers were divided in several sub-topics and summarized in the following paragraphs: clinical indications, image interpretation criteria, future perspectives and new trends (for each single disease), while patient preparation, image acquisition, possible pitfalls and reporting modalities were described afterwards. Moreover, a specific section was dedicated to pediatric and PET/MRI indications. A collection of images was described for each indication. 4
44. Korones DN HM, Gullace MA. Routine Chest Radiography of Children with Cancer Hospitalized for Fever and Neutropenia Is It Really Necessary? Cancer 1997;80:1160-64. Review/Other-Dx 42 studies To systematically review the test performance, diagnostic yield, and management decision impact of nuclear imaging tests in patients with classic fever of unknown origin (FUO). We included 42 studies with 2,058 patients. Studies were heterogeneous and had methodologic limitations. Diagnostic yield was higher in studies with higher prevalence of neoplasms and infections. Nonneoplastic causes, such as adult-onset Still's disease and polymyalgia rheumatica, were less successfully localized. Indirect evidence suggested that 18F-FDG PET/CT had the best test performance and diagnostic yield among the 4 imaging tests; summary sensitivity was 0.86 (95% confidence interval [CI], 0.81-0.90), specificity 0.52 (95% CI, 0.36-0.67), and diagnostic yield 0.58 (95% CI, 0.51-0.64). Evidence on direct comparisons of alternative imaging modalities or on the impact of tests on management decisions was limited. 4
45. Roberts SD, Wells GM, Gandhi NM, et al. Diagnostic value of routine chest radiography in febrile, neutropenic children for early detection of pneumonia and mould infections. Support Care Cancer 2012;20:2589-94. Observational-Dx 200 patients 4
46. Cox JA, DeMasi J, McCollom S, Jackson G, Scothorn D, Aquino VM. The diagnostic utility of routine chest radiography in the evaluation of the initial fever in patients undergoing hematopoietic stem cell. Pediatr Blood Cancer. 2011;57(4):666-668. Review/Other-Dx 81 patients Retrospective review of pediatric stem cell transplant recipients to determine if chest radiographs are useful in the evaluation of initial fever. 76 (94%) of the chest radiographs performed had no evidence of pulmonary infiltrate. Of the 5 children with positive radiographs, 3 had symptomatic respiratory infection and 2 (40%) were asymptomatic. 1 asymptomatic patient had a history of pulmonary infection with persistent stable infiltrates prior to transplantation. This patient did not have any evidence of pneumonia during the transplant. The second asymptomatic patient had subsequent resolution of the infiltrate with antibiotic administration. None of the patients had a change made in the empiric antibiotic regimen based upon the results of the chest film. 4
47. Tavakoli AA, Reichert M, Blank T, et al. Findings in whole body MRI and conventional imaging in patients with fever of unknown origin-a retrospective study. BMC Medical Imaging. 20(1):94, 2020 08 07. Review/Other-Dx 24 patients To analyse the influence of whole body (wb)-MRI on patient management compared to routine diagnostic tests in patients with fever of unknown origin (FUO). Wb-MRI yielded a correct diagnosis in 70% of the patients. In 46% the inflammatory focus was exclusively detected by wb-MRI. Focus detection by wb-MRI led to a subsequent change of the clinical management in 92% of the patients. In 6 patients both a wb-MRI and a PET-CT were performed yielding the correct diagnosis in the same 4 of 6 patients for both imaging modalities. 4
48. Takeuchi M, Dahabreh IJ, Nihashi T, Iwata M, Varghese GM, Terasawa T. Nuclear Imaging for Classic Fever of Unknown Origin: Meta-Analysis. Journal of Nuclear Medicine. 57(12):1913-1919, 2016 Dec. Meta-analysis 42 studies To systematically review the test performance, diagnostic yield, and management decision impact of nuclear imaging tests in patients with classic FUO. We included 42 studies with 2,058 patients. Studies were heterogeneous and had methodologic limitations. Diagnostic yield was higher in studies with higher prevalence of neoplasms and infections. Nonneoplastic causes, such as adult-onset Still's disease and polymyalgia rheumatica, were less successfully localized. Indirect evidence suggested that 18F-FDG PET/CT had the best test performance and diagnostic yield among the 4 imaging tests; summary sensitivity was 0.86 (95% confidence interval [CI], 0.81-0.90), specificity 0.52 (95% CI, 0.36-0.67), and diagnostic yield 0.58 (95% CI, 0.51-0.64). Evidence on direct comparisons of alternative imaging modalities or on the impact of tests on management decisions was limited. Not Assessed
49. Chamroonrat W. PET/Computed Tomography in the Evaluation of Fever of Unknown Origin and Infectious/Inflammatory Disease in Pediatric Patients. [Review]. Pet Clinics. 15(3):361-369, 2020 Jul. Review/Other-Dx N/A To discuss the use of PET/computed tomography in the evaluation of fever of unknown origin and infectious/inflammatory disease in the pediatric patient population. No results stated in the abstract. 4
50. Kan Y, Wang W, Liu J, Yang J, Wang Z. Contribution of 18F-FDG PET/CT in a case-mix of fever of unknown origin and inflammation of unknown origin: a meta-analysis. Acta Radiologica. 60(6):716-725, 2019 Jun. Meta-analysis 23 studies To systematically review and perform a meta-analysis of published data on the diagnostic performance of PET/CT in the diagnosis of FUO and IUO. Our meta-analysis included 23 studies, comprising a total sample size of 1927 patients. The pooled diagnosis performance was calculated with a per-patient-based analysis: sensitivity?=?0.84 (95% confidence interval [CI]?=?0.79-0.89), specificity?=?0.63 (95% CI?=?0.49-0.75), positive likelihood ratio?=?2.3 (95% CI?=?1.5-3.4), negative likelihood ratio?=?0.25 (95% CI?=?0.16-0.38), diagnostic odds ratio?=?9 (95% CI?=?4.0-20), and AUC?=?0.84 (95% CI?=?0.81-0.87). Not Assessed
51. Schonau V, Vogel K, Englbrecht M, et al. The value of 18F-FDG-PET/CT in identifying the cause of fever of unknown origin (FUO) and inflammation of unknown origin (IUO): data from a prospective study. Annals of the Rheumatic Diseases. 77(1):70-77, 2018 Jan. Observational-Dx 240 patients To determine if diagnosis of underlying disease may be improved by 18F-fluorodesoxyglucose positron emission tomography (18F-FDG-PET). 240 patients were enrolled, 72 with FUO, 142 with IUO and 26 had FUO or IUO previously (exFUO/IUO). Diagnosis was established in 190 patients (79.2%). The leading diagnoses were adult-onset Still's disease (15.3%) in the FUO group, large vessel vasculitis (21.1%) and polymyalgia rheumatica (18.3%) in the IUO group and IgG4-related disease (15.4%) in the exFUO/IUO group. In 136 patients (56.7% of all patients and 71.6% of patients with a diagnosis), 18F-FDG-PET/CT was positive and helpful in finding the diagnosis. Predictive markers for a diagnostic 18F-FDG-PET/CT were age over 50 years (p=0.019), C-reactive protein (CRP) level over 30 mg/L (p=0.002) and absence of fever (p=0.001). 2
52. Mulders-Manders CM, Kouijzer IJ, Janssen MJ, Oyen WJ, Simon A, Bleeker-Rovers CP. Optimal use of [18F]FDG-PET/CT in patients with fever or inflammation of unknown origin. The Quarterly Journal of Nuclear Medicine. 65(1):51-58, 2021 Mar. Observational-Dx 104 patients To study the contribution of elevated C-reactive protein (CRP), erythrocyte sedimentationrate (ESR), or the presence of fever on the outcome of [18F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT), as well as the contribution of repeated [18F]FDG-PET/CT in patients with fever of unknown origin (FUO) and inflammation of unknown origin (IUO). One hundred and four patients were identified, of whom 68 had a final diagnosis (65.4%). Mainly infections (30.8%) and non-infectious inflammatory diseases (30.8%). [18F]FDG-PET/CT contributed to the final diagnosis in 47 of the 68 patients (69.1%). In 21 patients [18F]FDG-PET/CT did not help making a diagnosis. In ten of these patients [18F]FDG-PET/CT was performed while body temperature, CRP and ESR were normal or unknown. Sixteen of 104 patients underwent repeated [18F]FDG-PET/CT. The second scan contributed to the final diagnosis in five of these patients. In two of these patients, the first scan retrospectively was truly non-contributory. In both patients the first [18F]FDG-PET/CT was made while CRP/ESR was low and fever was not present or not measured. A third or fourth scan never contributed to the final diagnosis when the second one did not. 3
53. Bharucha T, Rutherford A, Skeoch S, et al. Diagnostic yield of FDG-PET/CT in fever of unknown origin: a systematic review, meta-analysis, and Delphi exercise. [Review]. Clinical Radiology. 72(9):764-771, 2017 Sep. Meta-analysis 18 studies To perform a systematic review, meta-analysis and Delphi exercise to evaluate diagnostic yield of combined 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) positron-emission tomography and computed tomography (FDG-PET/CT) in fever of unknown origin (FUO). Pooled diagnostic yield was 56% (95% confidence interval [CI]: 50-61%, I2=61%) from 18 studies and 905 patients. Only five studies reported results of previous imaging, and subgroup analysis estimated diagnostic yield beyond conventional CT at 32% (95% CI: 22-44%; I2=66%). Consensus was established that FDG-PET/CT is increasingly available with an emerging role, but there is prevailing variability in practice. Good
54. Okuyucu K, Alagoz E, Demirbas S, et al. Evaluation of predictor variables of diagnostic [18F] FDG-PET/CT in fever of unknown origin. The Quarterly Journal of Nuclear Medicine. 62(3):313-320, 2018 Sep. Observational-Dx 76 patients The aim of the study is to evaluate the predictor variables effecting a contributory positron emission tomography-computed tomography scan (PET/CT) for the diagnosis. ESR (P=0.001), CRP (P=0.001), fibrinogen (P=0.009), lymphopenia (P<0.001), neutrophilia (P<0.001), ferritin (P<0.001), leukocytosis (P=0.003), duration of fever before PET/CT (<3 months) were found to be statistically significant for positive contribution of PET/CT results to the diagnosis. CONCLUSIONS: [18F]FDG-PET/CT is helpful and contributory for the diagnosis of FUO in patients having higher levels of CRP, ESR, ferritin, fibrinogen, leukocytosis, neutrophilia and shorter durations of fever (<3 months). 3
55. Wang WX, Cheng ZT, Zhu JL, et al. Combined clinical parameters improve the diagnostic efficacy of 18F-FDG PET/CT in patients with fever of unknown origin (FUO) and inflammation of unknown origin (IUO): A prospective study in China. International Journal of Infectious Diseases. 93:77-83, 2020 Apr. Observational-Dx 253 patients To improve the diagnostic efficacy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for Chinese patients with fever of unknown origin (FUO) and inflammation of unknown origin (IUO), with combined clinical parameters. From January 2014 to January 2019, 253 FUO/IUO patients were studied. In total, 147 patients had local uptake lesions and 106 patients had non-specific abnormal uptake. In the local uptake lesion group, the positioning accuracy of PET/CT was 37.2% in grades 1 and 2, and 66.3% in grades 3 and 4. With the following combination of clinical parameters, the positioning accuracy increased to 75.0% and 90.0%, respectively: time from admission to performing PET/CT scanning <6.5 days and C-reactive protein level >95 mg/l. In the non-specific abnormal uptake group, the combination of sex (male), bicytopenia, and lactic dehydrogenase improved the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for diagnosing malignancy from 64.3%, 69%, 60%, and 72.7%, respectively, to 83.3%, 81%, 81.4%, and 82.9%, respectively. With the combination of sex (male), white blood count, serum ferritin level, and hepatosplenomegaly, the infection prediction model had a sensitivity, specificity, PPV, and NPV of 78%, 76.2%, 76.6%, and 77.6%, respectively. 2
56. Takeuchi M, Nihashi T, Gafter-Gvili A, et al. Association of 18F-FDG PET or PET/CT results with spontaneous remission in classic fever of unknown origin: A systematic review and meta-analysis. [Review]. Medicine. 97(43):e12909, 2018 Oct. Meta-analysis 13 studies This systematic review and meta-analysis, we assessed the association of results of these imaging modalities with spontaneous remission in patients with classic fever of unknown origin (FUO). Nine studies of PET/CT results (418 patients) and 4 studies of standalone PET results (128 patients) were eligible. None explicitly specified the incidence of spontaneous remission as the primary or secondary outcomes of interest. The risk of bias was considered high in all studies because patients received subsequent diagnostic workup based on imaging results. Patients with negative PET/CT results were significantly more likely to present with spontaneous regression than those with positive results (summary RR = 5.6; 95% CI: 3.4-9.2; P < .001; I = 0%). In contrast, no significant association was found between standalone PET results and spontaneous remission. The random-effects study-level meta-regression found that PET/CT results [relative RR (rRR) = 7.4; 95% CI: 2.5-21.3; P = .002], compared with standalone PET results, and publication year (rRR = 1.2 per 1 year; 95% CI: 1.0-1.3; P = .013) were significantly associated with spontaneous remission. Not Assessed
57. del Rosal T, Goycochea WA, Mendez-Echevarria A, et al. (1)(8)F-FDG PET/CT in the diagnosis of occult bacterial infections in children. Eur J Pediatr. 2013;172(8):1111-1115. Review/Other-Dx 3 pediatric patients The authors communicate their experience regarding the role of FDG-PET/CT in the diagnosis and management of occult bacterial infections in children. 1 patient had streptococcal endocarditis and prolonged fever. FDG-PET/CT identified pneumonia and osteomyelitis, and was also used to monitor therapeutic response. Other patient had a cerebrospinal shunt fluid infection. FDG-PET/CT was used to determine the exact localization of infection and establish the best surgical approach. The last patient had FUO. FDG-PET/CT identified splenic abscesses, which were surgically treated. 4
58. Pijl JP, Kwee TC, Legger GE, et al. Role of FDG-PET/CT in children with fever of unknown origin. European Journal of Nuclear Medicine & Molecular Imaging. 47(6):1596-1604, 2020 06. Observational-Dx 110 children To determine the role of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET)/computed tomography (CT) in children with fever of unknown origin (FUO). In 53 out of 110 patients (48%), FDG-PET/CT identified a (true positive) cause of fever. Endocarditis (11%), systemic juvenile idiopathic arthritis (5%), and inflammatory bowel disorder (5%) were the most common causes of FUO. In 42 patients (38%), no cause of fever was found on FDG-PET/CT. In 58 out of 110 patients (53%), treatment modifications were made after FDG-PET/CT. FDG-PET/CT achieved a sensitivity of 85.5%, specificity of 79.2%, positive predictive value of 84.1%, and negative predictive value of 80.9%. On multivariate logistic regression, C-reactive protein was positively associated with finding a true positive focus of fever on FDG-PET/CT (OR = 1.01 (95% CI 1.00-1.02) per mg/L increase in CRP), while leukocyte count was negatively associated with finding a true positive focus of fever (OR = 0.91 (95% CI 0.85-0.97) per 109 leukocytes/L increase). 3
59. Purz S, Sabri O, Viehweger A, et al. Potential Pediatric Applications of PET/MR. J Nucl Med. 2014;55(Supplement 2):32S-39S. Review/Other-Dx N/A To review possible pediatric applications of PET/MR hybrid imaging, particularly pediatric oncology and neurology but also the diagnosis of infectious or inflammatory diseases. For noninvasive pediatric diagnostics, molecular imaging and WB-MRI have become important, especially in pediatric oncology. Because it has a lower radiation exposure than PET/CT, combined PET/MR is expected to be of special use in pediatric diagnostics. 4
60. Sethi I, Baum YS, Grady EE. Current Status of Molecular Imaging of Infection: A Primer. [Review]. AJR Am J Roentgenol. 213(2):300-308, 2019 08. Review/Other-Dx N/A This articles covers a number of infectious processes, including osteomyelitis, diabetic foot infections, periprosthetic infections, cardiovascular infections (including those due to implantable devices), abdominal infections, and fever of unknown origin. This article is aimed at informing the radiologist of scintigraphic methods that can be used in a variety of common adult infections. No results stated in the abstract. 4
61. Schaefer JF, Berthold LD, Hahn G, et al. Whole-Body MRI in Children and Adolescents - S1 Guideline. Rofo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin. 191(7):618-625, 2019 Jul. Review/Other-Dx N/A The goal of these guidelines is to specify the indications for which whole-body magnetic resonance imaging (MRI) can be recommended in children and adolescents and to describe the necessary technical requirements. No results stated in the abstract. 4
62. Korchi AM, Hanquinet S, Anooshiravani M, Merlini L. Whole-body magnetic resonance imaging: an essential tool for diagnosis and work up of non-oncological systemic diseases in children. Minerva Pediatrica. 66(3):169-76, 2014 Jun. Review/Other-Dx 42 children To determine the real impact of WB-MRI on diagnosis and management of non-oncological pediatric diseases remains unclear. The authors present their experience of pediatric WB-MRI in various pathologies. 21 children underwent general anesthesia. WB-MRI was a useful tool to provide correct diagnosis in chronic recurrent multifocal osteomyelitis, and to identify the origin of fever or arthralgia of unknown etiology. WB-MRI allowed to determine the extent of disease in juvenile idiopathic arthritis, chronic granulomatous disorder, enchondromatosis, Langerhans cell histiocytosis, and in the assessment of tumor burden in neurofibromatosis type I. For the battered child syndrome, the influence on management was rather minimal. For each of these pathologies we performed a review of recent literature. 4
63. Damasio MB, Magnaguagno F, Stagnaro G. Whole-body MRI: non-oncological applications in paediatrics. [Review]. Radiologia Medica. 121(5):454-61, 2016 May. Review/Other-Dx N/A To review whole-body magnetic resonance imaging (MRI) in non-oncological applications in paediatrics. No results stated in the abstract. 4
64. National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Committee on National Statistics; Committee on Measuring Sex, Gender Identity, and Sexual Orientation. Measuring Sex, Gender Identity, and Sexual Orientation. In: Becker T, Chin M, Bates N, eds. Measuring Sex, Gender Identity, and Sexual Orientation. Washington (DC): National Academies Press (US) Copyright 2022 by the National Academy of Sciences. All rights reserved.; 2022. Review/Other-Dx N/A Sex and gender are often conflated under the assumptions that they are mutually determined and do not differ from each other; however, the growing visibility of transgender and intersex populations, as well as efforts to improve the measurement of sex and gender across many scientific fields, has demonstrated the need to reconsider how sex, gender, and the relationship between them are conceptualized. No abstract available. 4
65. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. Review/Other-Dx N/A To provide evidence-based guidelines on exposure of patients to ionizing radiation. No abstract available. 4
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