A1 Refereed original research article in a scientific journal
18F-FDG positron emission tomography/computed tomography in infective endocarditis
Authors: Salomäki Soile Pauliina, Saraste Antti, Kemppainen Jukka, Bax Jeroen J, Knuuti Juhani, Nuutila Pirjo, Seppänen Marko, Roivainen Anne, Airaksinen Juhani, Pirilä Laura, Oksi Jarmo, Hohenthal Ulla
Publication year: 2017
Journal: Journal of Nuclear Cardiology
Volume: 24
Issue: 1
First page : 195
Last page: 206
Number of pages: 12
ISSN: 1071-3581
eISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-015-0325-y
Background
The diagnosis of infective endocarditis (IE), especially the diagnosis of prosthetic valve endocarditis (PVE) is challenging since echocardiographic findings are often scarce in the early phase of the disease. We studied the use of 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in IE.
Methods
Sixteen patients with suspected PVE and 7 patients with NVE underwent visual evaluation of 18F-FDG-PET/CT. 18F-FDG uptake was measured also semiquantitatively as maximum standardized uptake value (SUVmax) and target-to-background ratio (TBR). The modified Duke criteria were used as a reference.
Results
There was strong, focal 18F-FDG uptake in the area of the affected valve in all 6 cases of definite PVE, in 3 of 5 possible PVE cases, and in 2 of 5 rejected cases. In all patients with definite PVE, SUVmax of the affected valve was higher than 4 and TBR higher than 1.8. In contrast to PVE, only 1 of 7 patients with NVE had uptake of 18F-FDG by PET/CT in the valve area. Embolic infectious foci were detected in 58% of the patients with definite IE.
Conclusions
18F-FDG-PET/CT appears to be a sensitive method for the detection of paravalvular infection associated with PVE. Instead, the sensitivity of PET/CT is limited in NVE.
