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Int J Infect Dis. 2014 Nov;28:219-24. doi: 10.1016/j.ijid.2014.04.028. Epub 2014 Aug 2.

18-Fluoro-2-deoxyglucose positron emission tomography-computed tomography: an additional tool in the diagnosis of prosthetic valve endocarditis.

Author information

1
Clinical Infectious Diseases, Tor Vergata University, V. Montpellier 1, 00133, Rome, Italy.
2
Department of Virology, Royal Free London NHS Foundation Trust, London, UK.
3
Department of Biopathology and Diagnostic Imaging, Tor Vergata University, Rome, Italy.
4
Cardiac Surgery Unit, Tor Vergata University, Rome, Italy.
5
Clinical Infectious Diseases, Tor Vergata University, V. Montpellier 1, 00133, Rome, Italy. Electronic address: sarmati@med.uniroma2.it.

Abstract

OBJECTIVES:

To evaluate the role of 18-fluoro-2-deoxyglucose positron emission tomography-computed tomography ((18)F-FDG-PET-CT) in the diagnosis of infectious endocarditis (IE).

METHODS:

We retrospectively examined 27 consecutive patients who were admitted to the Infectious Diseases Department of Tor Vergata University Hospital between 2009 and 2013 with a suspicion of IE. The final IE diagnosis was defined according to the modified Duke criteria, and the microbiological and diagnostic results were collected for each patient.

RESULTS:

Twenty out of 27 patients had a suspected prosthetic valve endocarditis (PVE) and seven had a suspected native valve endocarditis (NVE). Twenty-five out of 27 patients (92%) had a confirmed diagnosis of IE (18/25 PVE and 7/25 NVE); 16 had a positive echocardiography evaluation and 16 had positive (18)F-FDG-PET-CT findings. Echocardiography showed a higher sensitivity as a diagnostic tool for the detection of IE compared to (18)F-FDG-PET-CT (80% vs. 55%). However, a greater number of PVE had positive (18)F-FDG-PET-CT results compared to those with positive echocardiography findings (11/13 vs. 9/13), and overall 89% (16/18) of confirmed PVE resulted (18)F-FDG-PET-CT positive. Analyzing only the cases who underwent transoesophageal echocardiography, (18)F-FDG-PET-CT showed a sensitivity of 85% in PVE (vs. 69% for echocardiography and 77% for the Duke criteria). All seven patients with NVE had a positive echocardiography and negative (18)F-FDG-PET-CT findings (p<0.001).

CONCLUSIONS:

The results of this study further highlight the limitations of echocardiography in the diagnosis of PVE and the potential advantages of (18)F-FDG-PET-CT in these cases.

KEYWORDS:

(18)F-FDG-PET–CT; Cardiac imaging; Echocardiography; Infective endocarditis; Prosthetic valve endocarditis

PMID:
25093540
DOI:
10.1016/j.ijid.2014.04.028
[Indexed for MEDLINE]
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