Mycotic aneurysm of the superior mesenteric artery and other sequelae of prosthetic valve endocarditis on 18F-FDG PET/CT

18F-FDG PET/CT Detection of a Popliteal Mycotic Aneurysm Complicating Staphylococcus aureus Bacteremia

“…There is increasing evidence of the usefulness of 18 F-FDG PET/CT in the management of infectious diseases, 4–6 given its ability to detect metastatic infectious foci in a context of high-risk bacteremia 7 . If most of septic grafts have been described all along the vascular tree, 8–10 recent preliminary study found that in the setting of suspected infective endocarditis, MAs were most likely located in the arteries of the lower limbs 11 . These data, along with our case, highlight the importance of including lower limbs in 18 F-FDG PET/CT acquisition in case of suspicion of septic emboli.…”

Current controversies in infective endocarditis

“…A focus of fludeoxyglucose- 18 F ( 18 F-FDG) uptake (arrow) can be seen at the site of a prosthetic aortic valve, separate from the myocardium, consistent with prosthetic valve IE. Adapted from Teoh et al 34 .…”

“…18 F-FDG-PET/CT (fludeoxyglucose- 18 F/positron emission tomography/CT)—which shows uptake of radiolabelled glucose by metabolically active tissues—can visualise the infected vegetations of IE and has been successfully used in patients with suspected prosthetic valve IE or CDI, in which interpretation of TOE can be challenging ( Figure 1D ) 32 – 34 . In a recently published study of 92 patients with suspected prosthetic valve IE or CDI, hybrid PET-CT enabled reclassification of 90% of patients (45 out of 50) with possible IE by Duke criteria and provided a conclusive diagnosis (definite/rejected) in 95% of cases 35 .…”

State of the art in nuclear cardiology

“…The sensitivity for the identification of PVE rose from 70% to 97% when FDG-PET was added to their diagnostic algorithm. Figure 3 demonstrates the use of FDG-PET in a diagnostically difficult PVE case, and found it very useful to identify the extracardiac sources of infection 43. Radiolabelled leucocyte SPECT imaging has also been shown to have an excellent specificity regarding PVE 44…”