Cited 26 times since 2015 (2.8 per year) source: EuropePMC Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, Volume 24, Issue 1, 9 2 2015, Pages 195-206 <sup>18</sup>F-FDG positron emission tomography/computed tomography in infective endocarditis. Salomäki SP, Saraste A, Kemppainen J, Bax JJ, Knuuti J, Nuutila P, Seppänen M, Roivainen A, Airaksinen J, Pirilä L, Oksi J, Hohenthal U

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.

J Nucl Cardiol. 2015 12;24(1):195-206