To what extent does prior antimicrobial therapy affect the diagnostic performance of radiolabeled leukocyte scintigraphy in infective endocarditis?

Holcman, Katarzyna; Rubiś, Paweł; Ćmiel, Bogdan; Ząbek, Andrzej; Boczar, Krzysztof; Szot, Wojciech; Kalarus, Zuzanna; Graczyk, Katarzyna; Hanarz, Maksymilian; Małecka, Barbara; Podolec, Piotr; Kostkiewicz, Magdalena

doi:10.1007/s12350-022-03048-8

Cited by 8 publications

(9 citation statements)

References 24 publications

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“…Unfortunately, prior anti-microbial therapy appeared to be associated with a higher rate of false-negative HMPAO-SPECT/CT results (OR, 4.63; 95% CI, 1.41 to 15.23, p = 0.01) [87]. In this prospective study, the technique showed an accuracy of 81.95%, a specificity of 86.92%, a sensitivity of 73.33%, an NPV of 84.96%, and a PPV of 76.39% [87]. 18 F-FDG PET/CT is based on the accumulation of a radioactively labeled glucose analog ( 18 F-FDG) in cells with a large number of metabolically active glucose transporters expressed on their cell surface-activated inflammatory cells (macrophages, leukocytes, and lymphocytes) [88].…”

Section: Imaging Infective Endocarditis By Using Novel Techniquesmentioning

confidence: 99%

“…What is crucial is the fact that the 99m Tc-HMPAO-SPECT/CT examination is able to reliably exclude CDRIE in patients with fever, sepsis, or a suspicion of IE [85,86]. Unfortunately, prior anti-microbial therapy appeared to be associated with a higher rate of false-negative HMPAO-SPECT/CT results (OR, 4.63; 95% CI, 1.41 to 15.23, p = 0.01) [87]. In this prospective study, the technique showed an accuracy of 81.95%, a specificity of 86.92%, a sensitivity of 73.33%, an NPV of 84.96%, and a PPV of 76.39% [87].…”

Section: Imaging Infective Endocarditis By Using Novel Techniquesmentioning

confidence: 99%

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Novel Diagnostic Methods for Infective Endocarditis

Burban,

Słupik,

Reda

et al. 2024

IJMS

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Infective endocarditis (IE) remains a dangerous disease and continues to have a high mortality rate. Unfortunately, despite continuous improvements in diagnostic methods, in many cases, blood cultures remain negative, and the pathogen causing endocarditis is unknown. This makes targeted therapy and the selection of appropriate antibiotics impossible. Therefore, we present what methods can be used to identify the pathogen in infective endocarditis. These are mainly molecular methods, including PCR and MGS, as well as imaging methods using radiotracers, which offer more possibilities for diagnosing IE. However, they are still not widely used in the diagnosis of IE. The article summarizes in which cases we should choose them and what we are most hopeful about in further research into the diagnosis of IE. In addition, registered clinical trials that are currently underway for the diagnosis of IE are also presented.

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Section: Imaging Infective Endocarditis By Using Novel Techniquesmentioning

confidence: 99%

Section: Imaging Infective Endocarditis By Using Novel Techniquesmentioning

confidence: 99%

Novel Diagnostic Methods for Infective Endocarditis

Burban,

Słupik,

Reda

et al. 2024

IJMS

View full text Add to dashboard Cite

show abstract

“…In a prospective study assessing whether prior antimicrobial treatment impacts the diagnostic profile of this modality in IE diagnosis, this technique displayed 81.95% accuracy, 86.92% specificity, 73.33% sensitivity, 84.96% NPV, and 76.39% PPV [ 32 ]. Importantly, antimicrobial therapy was related to higher rates of false-negative 99m Tc-HMPAO-SPECT/CT results (OR, 4.63; 95% CI, 1.41 to 15.23, p = 0.01).…”

Section: 99m Tc-hmpao-spect/ctmentioning

confidence: 99%

“… Shows the proposed algorithm on how to interpret a negative 99m Tc-HMPAO-SPECT/CT results in patients with suspected infective endocarditis receiving antimicrobial therapy prior to examination. Adapted from Holcman, K.; et al To what extent does prior antimicrobial therapy affect the diagnostic performance of radiolabeled leukocyte scintigraphy in infective endocarditis [ 32 ]? …”

Section: Figurementioning

confidence: 99%

Advances in Molecular Imaging in Infective Endocarditis

et al. 2023

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Infective endocarditis (IE) is a growing epidemiological challenge. Appropriate diagnosis remains difficult due to heterogenous etiopathogenesis and clinical presentation. The disease may be followed by increased mortality and numerous diverse complications. Developing molecular imaging modalities may provide additional insights into ongoing infection and support an accurate diagnosis. We present the current evidence for the diagnostic performance and indications for utilization in current guidelines of the hybrid modalities: single photon emission tomography with technetium99m-hexamethylpropyleneamine oxime–labeled autologous leukocytes (99mTc-HMPAO-SPECT/CT) along with positron emission tomography with fluorodeoxyglucose (18F-FDG PET/CT). The role of molecular imaging in IE diagnostic work-up has been constantly growing due to technical improvements and the increasing evidence supporting its added diagnostic and prognostic value. The various underlying molecular processes of 99mTc-HMPAO-SPECT/CT as well as 18F-FDG PET/CT translate to different imaging properties, which should be considered in clinical practice. Both techniques provide additional diagnostic value in the assessment of patients at risk of IE. Nuclear imaging should be considered in the IE diagnostic algorithm, not only for the insights gained into ongoing infection at a molecular level, but also for the determination of the optimal clinical therapeutic strategies.

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“…WBC studies were performed in 205 consecutive adults with suspected IE followed for a mean period of 1 year. 19 Among the investigated group of patients, 63% had an implanted CIED and 55% had a prosthetic heart valve. Based on the modified Duke Criteria applied prior to performing the WBC scan 17.5% of patients had definite IE and 54% had possible cardiac device-related IE (CDRIE), while in 28% of cases there was a low probability of the disease.…”

mentioning

confidence: 97%