Molecular Imaging for the diagnosis of infective endocarditis: A systematic literature review and meta-analysis

Guidelines in review: Comparison of ESC and AHA guidance for the diagnosis and management of infective endocarditis in adults. Are the differences clinically relevant? The European perspective

“…10 The same meta-analysis found that the diagnostic performance of WBC SPECT/ CT was even better than that of 18 F-FDG PET/CT (sensitivity 86%, specificity 97%). 10 However, disadvantages of WBC SPECT/CT include the need for manipulation of blood products for labeling and a more time-consuming protocol. 8,10 Additional benefit of nuclear imaging is that extracardiac complications, such as septic emboli and metastatic infection, are commonly detected by 18 F-FDG PET/CT or WBC SPECT/CT that can contribute to the diagnosis of IE and have therapeutic implications.…”

“…Several reports have shown promising results for 18 F-FDG PET/CT and WBC SPECT/CT imaging in IE. 8,10 When 18 F-FDG PET/CT is used to diagnose cardiac infection, patient preparation is very important in order to suppress physiological tracer uptake in the myocardium. These measures include high-fat low carbohydrate diet, prolonged fasting, and heparin injection prior to the scan.…”

“…The overall pooled specificity was 90%, and 81% when only PVE was considered. 10 Notably, studies have included mainly patients with suspected PVE. 10 The same meta-analysis found that the diagnostic performance of WBC SPECT/ CT was even better than that of 18 F-FDG PET/CT (sensitivity 86%, specificity 97%).…”

“…10 Notably, studies have included mainly patients with suspected PVE. 10 The same meta-analysis found that the diagnostic performance of WBC SPECT/ CT was even better than that of 18 F-FDG PET/CT (sensitivity 86%, specificity 97%). 10 However, disadvantages of WBC SPECT/CT include the need for manipulation of blood products for labeling and a more time-consuming protocol.…”

“…10 However, disadvantages of WBC SPECT/CT include the need for manipulation of blood products for labeling and a more time-consuming protocol. 8,10 Additional benefit of nuclear imaging is that extracardiac complications, such as septic emboli and metastatic infection, are commonly detected by 18 F-FDG PET/CT or WBC SPECT/CT that can contribute to the diagnosis of IE and have therapeutic implications. 8,10 In one study, extracardiac findings were seen in 60% of patients, and in 15% these lesions were previously unknown and considered of clinical relevance.…”