Diagnostic Accuracy of ¹⁸F-FDG PET/CT in Infective Endocarditis and Implantable Cardiac Electronic Device Infection: A Cross-Sectional Study

Rol del PET/CT con 18FDG en patología no neoplásica

“…Sin embargo, en algunas series se reporta beneficio significativo de su uso para esta patología, con sensibilidad de un 82% y especificidad de un 96% 24 (Figura 1).…”

18F-FDG PET/CT now endorsed by guidelines across all types of CIED infection: Evidence limited but growing

“…15,18,22,[26][27][28][29][30][31] However, one caveat is that the majority of studies evaluating diagnostic accuracy in suspected CIED-GPI only include confirmed cases or those with medium-to-high pre-test probability. Paradoxically, patients at the opposite end of the spectrum (with a lower pre-test probability of infection at initial presentation) are generally considered to pose a greater diagnostic challenge and by comparison are relatively underrepresented in these studies; arguably, a novel non-invasive diagnostic tool would be most useful in this group of patients, and further studies assessing the performance of 18 F-FDG in this group are desirable.…”

“…Low-dose unfractionated heparin has also been postulated to suppress physiological myocardial uptake, and is therefore also included in patient preparation pathways by some centers. 22,23,25 CURRENT META-ANALYSIS…”

“…Contemporary studies have optimized patient preparation through use of dietary carbohydrate restriction, thereby reducing physiological myocardial 18 F-FDG uptake, making it easier to identify pathological uptake. [20][21][22][23][24][25] The current meta-analysis examined a subgroup of studies that utilized appropriate dietary preparation (?/-heparin) and show that the sensitivity of 18 F-FDG PET/CT for detecting CIED infection was substantially increased (to 92%) using this strategy. 15 This development represents a milestone in the advancement of metabolic imaging of cardiovascular infection and has possibly contributed to increasing clinician confidence in reporting on the extent of intracardiac extension of infection.…”

Predictive medicine: towards a multi-parametric imaging for a personal risk stratification

“…With a similar approach, dual properties of 18 F-FDG and an opportunity for whole-body imaging have been previously used to concomitantly explore other inflammatory diseases, such as infectious diseases, and cancer, for example for infective endocarditis, to detect both extra-cardiac embolisms [18], and associated tumours [19]. Moreover, multi-parametric PET imaging has been extended to dynamic and dual-phase acquisitions, to distinguish between tumour and inflammatory lesions [20], with a gradually increasing trend of 18 F-FDG uptake over time in malignant cells, and a decreasing or constant trend in inflammatory/infectious processes [21].…”