Usefulness of 18F Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Infective Endocarditis in Daily Practice

Sánchez-Enrique, Cristina; Olmos, Carmen; Jiménez-Ballvé, A.; Fernández-Pérez, Cristina; Ferrera, Carlos; Pérez-Castejón, M.J.; Candil, A. Ortega; Delgado-Bolton, Roberto; Carnero, Manuel; Maroto, Luis; Carreras, José; Vilacosta, Isidre

doi:10.1016/j.jcmg.2018.06.011

Cited by 9 publications

(20 citation statements)

References 3 publications

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“…After full-text screening, six articles were excluded from the systematic review as well as from the meta-analysis, because of missing information to assess both sensitivity and specificity of 18 F-FDG PET/CT. Therefore, seven articles with a total of 351 episodes of suspected NVE were included in the qualitative (systematic review) as well as in the quantitative analysis (meta-analysis) [ 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Figure 1 summarizes the literature search results.…”

Section: Resultsmentioning

confidence: 99%

“…The articles were published between 2016 and 2020. Five studies included a total of 722 episodes with clinical suspicion of IE, with a subgroup of 209 episodes with suspected NVE [ 18 , 19 , 20 , 21 , 23 ]. Two studies were exclusively dedicated to assess the accuracy of 18 F-FDG PET/CT in 142 patients with clinical suspected NVE [ 17 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two studies were exclusively dedicated to assess the accuracy of 18 F-FDG PET/CT in 142 patients with clinical suspected NVE [ 17 , 22 ]. In six studies, the mean age of the patients ranged from 58 to 71 years with a proportion of 68.1% of males, whereas corresponding data could not be assessed in one study [ 23 ]. Two studies reported the percentage of positive echocardiographic findings, ranging from 19% to 42% [ 20 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic Performance of 18F-FDG PET/CT in Native Valve Endocarditis: Systematic Review and Bivariate Meta-Analysis

et al. 2020

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Background: Infectious endocarditis is a life-threatening disease, requiring prompt and accurate diagnosis. The aim of this article is to perform a systematic review and meta-analysis of the literature to estimate the performance of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for the diagnosis of native valve endocarditis (NVE). Methods: Selected articles evaluating the diagnostic accuracy of 18F-FDG PET/CT in patients with suspected NVE, resulting from a comprehensive literature search through the PubMed/MEDLINE and Cochrane library databases until April 2020, were included for the systematic review and meta-analysis. Results: Seven studies (351 episodes of suspected NVE) were included. 18F-FDG PET/CT yielded a pooled sensitivity of 36.3% and a pooled specificity of 99.1% for the diagnosis of NVE. The pooled positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 8.3, 0.6, and 15.3, respectively. The sensitivity increased using contemporary PET/CT device with state-of-the-art patient preparation as well as innovative image acquisitions or adding the results of 18F-FDG PET/CT in a multimodality strategy. Conclusions: In our systematic review and meta-analysis, 18F-FDG PET/CT yielded a poor pooled sensitivity with an otherwise excellent pooled specificity for the diagnosis of NVE; however, several factors may increase the sensitivity without affecting the specificity and these factors should be better evaluated in future studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Diagnostic Performance of 18F-FDG PET/CT in Native Valve Endocarditis: Systematic Review and Bivariate Meta-Analysis

et al. 2020

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“…The presence of echocardiographic features of IE is a major criterion in the diagnosis of IE in the modified Duke criteria but can be challenging in patients with prosthetic valves . Recent studies have shown that the addition of PET/CT increased both sensitivity and specificity in the diagnosis of IE in patients who do not clearly meet the modified Duke criteria …”

Section: Introductionmentioning

confidence: 99%

“…8 Recent studies have shown that the addition of PET/CT increased both sensitivity and specificity in the diagnosis of IE in patients who do not clearly meet the modified Duke criteria. [9][10][11] Surgical heart valves degenerate over time. Patients with failed or degenerative bioprosthetic valves are increasingly treated with valvein-valve (ViV) TAVR, which has become a viable alternative to reoperation.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of failed prosthetic valves in the valve‐in‐valve era: Potential for utilizing positron emission tomography/computed tomography to recognize infective endocarditis

Lam

Itani

Dvir

2019

Cathet Cardio Intervent

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Bioprosthetic valve dysfunction was treated in the past with redo open heart surgery. The need to identify occult leaflet infection was not an important requirement as all valve tissue was removed during surgery. With the dramatic growth in transcatheter aortic valve replacement (TAVR) valve‐in‐valve (ViV) therapy, identification of occult infection is of major significance. TAVR should be rarely performed in infected prosthetic valves and the optimal approach should include open heart surgery and removal of infected tissue. With surgical implants, it can be challenging to distinguish infection from degeneration. The use of advanced imaging modalities, including 18F‐fluorodeoxyglucose positron emission tomography/computed tomography, in the diagnosis of occult infection is emerging. We report the use of this imaging modality to identify or exclude endocarditis in patients with prosthetic valves who were candidates for ViV therapy.

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Diagnostic value of FDG PET/CT imaging in patients with surgically managed infective endocarditis: results of a retrospective analysis at a tertiary center

Sag

Menhart

Grosse

et al. 2022

Journal of Nuclear Cardiology

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Background We assessed the diagnostic value of FDG PET/CT in a real-world cohort of patients with surgically managed infective endocarditis (IE). Methods We performed a retrospective analysis of all patients hospitalized in a tertiary IE referral medical center from January 2014 to October 2018 fulfilling the following criteria: ICD-10 code for IE and OPS code for both, heart surgery and FDG PET/CT. Results Final analysis included 29 patients, whereof 28 patients had surgically proven IE. FDG PET/CT scan was true-positive in 15 patients (sensitivity (SEN) 56%) and false-negative in 12 patients. Combination of Duke criteria (DC) with FDG PET/CT scan resulted in gain of SEN for all patients with confirmed IE (SEN of DC 79% vs SEN of combination DC and FDG PET/CT 89%), driven by a relevant gain in PVE patients only (SEN of DC 78% vs SEN of combination DC and FDG PET/CT 94%). Interestingly, higher prosthesis age was observed in patients with false-negative scans. Conclusions We found a SEN of 56% for FDG PET/CT in a real-world cohort of patients with surgically proven IE which was associated with a 16% gain of IE diagnosis in patients with PVE when combined with DC.

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Usefulness of 18F Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Infective Endocarditis in Daily Practice

Cited by 9 publications

References 3 publications

Diagnostic Performance of 18F-FDG PET/CT in Native Valve Endocarditis: Systematic Review and Bivariate Meta-Analysis

Diagnostic Performance of 18F-FDG PET/CT in Native Valve Endocarditis: Systematic Review and Bivariate Meta-Analysis

Evaluation of failed prosthetic valves in the valve‐in‐valve era: Potential for utilizing positron emission tomography/computed tomography to recognize infective endocarditis

Diagnostic value of FDG PET/CT imaging in patients with surgically managed infective endocarditis: results of a retrospective analysis at a tertiary center

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