Title |
18F-FDG positron emission tomography/computed tomography in infective endocarditis
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Published in |
Journal of Nuclear Cardiology, December 2015
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DOI | 10.1007/s12350-015-0325-y |
Pubmed ID | |
Authors |
Soile Pauliina Salomäki, Antti Saraste, Jukka Kemppainen, Jeroen J Bax, Juhani Knuuti, Pirjo Nuutila, Marko Seppänen, Anne Roivainen, Juhani Airaksinen, Laura Pirilä, Jarmo Oksi, Ulla Hohenthal |
Abstract |
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-[(18)F]fluoro-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) in IE. Sixteen patients with suspected PVE and 7 patients with NVE underwent visual evaluation of (18)F-FDG-PET/CT. (18)F-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. There was strong, focal (18)F-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 (18)F-FDG by PET/CT in the valve area. Embolic infectious foci were detected in 58% of the patients with definite IE. (18)F-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. |
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