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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., (Copyright © 2023 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.)

Le TEP/CT est un examen régulièrement utilisé dans la stratégie diagnostique du syndrome inflammatoire inexpliqué (SII), mais les hypermétabolismes retrouvés ne sont pas toujours concordants avec le diagnostic final. Notre objectif était d'évaluer l'impact clinique et financier de ces faux positifs. Nous avons mené une étude ancillaire sur une précédente cohorte rétrospective du service de médecine interne du centre hospitalier universitaire d'Amiens chez les patients ayant eu un TEP/CT entre octobre 2004 et avril 2017. Les patients étaient inclus si le TEP/CT avait été prescrit pour investiguer un SII. Sur les 763 TEP/CT réalisés, 144 patients satisfaisaient les critères d'inclusion et il était rapporté un taux de faux positifs de 17,4 % (n = 25). Parmi ces 25 patients, les résultats du TEP/CT ont entraîné des investigations complémentaires chez 21 d'entre eux. Les territoires hypermétaboliques les plus fréquemment retrouvés étaient digestifs (n = 12, SUVmax moyen 8 [± 4,33]) et ostéo-articulaires (n = 11, SUVmax moyen 4,33 [± 1,15]). Le coût total des 13 consultations prescrites était de 390 €, le coût total des 40 investigations paracliniques était de 4476€ (essentiellement des endoscopies digestives et de l'imagerie) et le coût total des transports médicaux était de 572€. Le coût total des 35 jours d'hospitalisation nécessaires pour explorer ces faux positifs était estimé à 22 952 €. Chez 23,8 % des patients (n = 5), ces investigations ont fait découvrir fortuitement des lésions tumorales. L'impact économique des investigations prescrites pour étudier les hypermétabolismes faux positifs du TEP/CT ne semble pas négligeable et mériterait une véritable étude prospective médico-économique. 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. 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. 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. The economic impact of false-positive PET/CT results does not appear to be negligible and merits a genuine prospective medico-economic study. [ABSTRACT FROM AUTHOR]