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Hypermetabolism of the spleen or bone marrow is an additional albeit indirect sign of infective endocarditis at FDG-PET

  • ORIGINAL ARTICLE
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Journal of Nuclear Cardiology Aims and scope

Abstract

Purpose

This study aimed at determining the diagnostic implications of indirect signs of infection at FDG-PET—i.e., hypermetabolisms of the spleen and/or bone marrow (HSBM)—when documented in patients with known or suspected infective endocarditis (IE).

Methods

HSBM were defined by higher mean standardized uptake values comparatively to that of the liver on FDG-PET images from patients with a high likelihood of IE and prospectively included in a multicenter study.

Results

Among the 129 included patients, IE was ultimately deemed as definite in 88 cases. HSBM was a predictor of definite IE (P = 0.014; odds ratio (OR) 3.2), independently of the criterion of an abnormal cardiac FDG uptake (P = 0.0007; OR 9.68), and a definite IE was documented in 97% (29/30) of patients showing both HSBM and abnormal cardiac uptake, 78% (7/9) of patients with only abnormal cardiac uptake, 67% (42/63) of patients with only HSBM, and 37% (10/27) of patients with neither one.

Conclusion

In this cohort with a high likelihood of IE, HSBM is an additional albeit indirect sign of IE, independently of the criterion of an abnormal cardiac uptake, and could reinforce the suspicion of IE in the absence of any other infectious, inflammatory, or malignant disease.

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Abbreviations

BM:

Bone marrow

FDG:

18F-fluorodeoxyglucose

HSBM:

hypermetabolisms of the spleen and/or bone marrow

IE:

infective endocarditis

PET:

positron emission tomography

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Acknowledgements

The French Ministry of Health for financial support (PHRC Grant).

AEPEI TEPvENDO study group: Principal investigator: DUVAL Xavier. Steering Committee: HOEN Bruno, IUNG Bernard, ROUZET Francois, TUBIANA Sarah. Clinical centers: Besançon: ALBAYRAK Tubanur, BERNARD Yvette, BOULAHDOUR Hatem, BRIAND Florent, CHIROUZE Catherine, FAUCHER Jean-François, GUIGNIER Alexandre, HUSTACHE-MATHIEU Laurent, ILLES-HAJNAL, Gabriela, MOREAU Joséphine, MOREL Olivier, SERONDE Marie-France, Dijon BEHECHTI Niloufar, BLOT Mathieu, BUISSON Marielle, COCHET Alexandre, EICHER Jean-Christophe, HUMBERT Olivier, LECLUSE-BARTH Julien, MAHY Sophie, PIROTH Lionel, ANDRE Philippe; Lyon: BOIBIEUX André, DELAHAYE François, DELAHAYE Armelle, Grégoire Bastien; Montpellier: BOURDON Aurélie, CADE Stéphane, CASANOVA Marie-Laure, CERUTTI Diane, DE VERBIZIER Delphine, LE MOING Vincent, MARTINEZ Angelina, MORQUIN David, SOLECKI Kamila; Nancy: BONAY Stéphanie, CHEVALIER Elodie, CLAUDIN Marine, DJABALLAH Wassila, GOEHRINGER François, HUTTIN Olivier, JEANMAIRE Eliette, MARIE Pierre-Yves, MIDENET Véronique, ROCH Véronique, SELTON-SUTY Christine, VAUTHIER Sandrine, VENNER Clément; Nantes: ASSERAY Nathalie, BIRON Charlotte, BOUTOILLE David, BROCHARD-LIBOIS Julia, CAVELLEC Morgane, CUEFF Caroline, DELARUE Sandrine, DI PRIZIO Catherine DINC Levent, FELLAH Imen, GUIJARRO Damien, LACHAUD Mathias, LE GLOAN Laurianne, LE TOURNEAU Thierry, LECOMPTE Anne-Sophie, LEFEBVRE Maeva, LUÇON Adrien, MATHIEU Cédric, ORAIN Jérémie, PALLARDY Amandine, PIRIOU Nicolas, POILANE Maxime, SASSIER Jérôme; Paris: BEN ALI Khadija, BROCHET Eric, BURDET Charles, CELESTIN Bettia, CIMADEVILLA Claire, DUVAL Xavier, HIAFYL Fabien, ILIC-HABENSUS Emila, IUNG Bernard, LACHATRE Marie, LEPAGE Laurent, LESCURE Xavier, ROUZET François, VINDRIOS William, WOLFF Michel, YAZDAPANAH Yazdan; Rennes: DEVILLERS Anne, DONAL Erwan, LACROIX Adèle, LELONG Bernard, REVEST Matthieu, TATTEVIN Pierre, THEBAULT Elise. Coordination and statistical analyses (Clinical trial unit, Hôpitaux Universitaires Paris Nord Val de Seine, AP-HP, Paris): COUFFIGNAL Camille, ESPOSITO-FARESE Marina, LAOUENAN Cédric, MAKLOUF Sonia, MENTRE France, PREVAULT Margot, ROGIER Ophélie.

Disclosure

Dr. Boursier, Dr. Duval, Dr. Mahida, Dr. Hoen, Dr. Goehringer, Dr. Selton-Suty, Dr. Chevalier, Mrs Roch, Mrs Lamiral, Dr. Bourdon, Dr. Piriou, Dr. Pallardy, Dr. Morel, Dr. Rouzet and Dr. Marie have nothing to disclose.

Author information

Authors and Affiliations

  1. Université de Lorraine, 54000, Nancy, France

    Caroline Boursier MD, Bruno Hoen MD, PhD & Pierre-Yves Marie MD, PhD

  2. Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, 54000, Nancy, France

    Caroline Boursier MD, Elodie Chevalier MD, Véronique Roch MSc & Pierre-Yves Marie MD, PhD

  3. Université Paris Diderot, INSERM, UMR 1137 (IAME), 75000, Paris, France

    Xavier Duval MD, PhD

  4. INSERM, CIC 1425, AP-HP, Hôpital Bichat Claude Bernard, 75000, Paris, France

    Xavier Duval MD, PhD

  5. Department of Infectious Diseases, AP-HP, Hôpital Bichat Claude Bernard, 75000, Paris, France

    Xavier Duval MD, PhD

  6. Department of Nuclear Medicine, AP-HP, Hôpital Bichat Claude Bernard, 75000, Paris, France

    Besma Mahida MD & François Rouzet MD, PhD

  7. Department of Infectious Diseases, CHRU-Nancy, 54000, Nancy, France

    Bruno Hoen MD, PhD & François Goehringer MD

  8. Department of Cardiology, CHRU-Nancy, 54000, Nancy, France

    Christine Selton-Suty MD

  9. Université de Lorraine, CHRU-Nancy, INSERM, CIC 1433, 54000, Nancy, France

    Zohra Lamiral MSc

  10. Department of Nuclear Medicine, Montpellier University Hospital, 34000, Montpellier, France

    Aurélie Bourdon MD

  11. Department of Nuclear Medicine, CHU de Nantes, 44000, Nantes, France

    Nicolas Piriou MD & Amandine Pallardy MD

  12. CHU-Besançon, Université de Franche-Comté, Service de Médecine Nucléaire, 25000, Besançon, France

    Olivier Morel MD

  13. Université Paris Diderot, INSERM, UMR 1148 (LVTS), 75000, Paris, France

    François Rouzet MD, PhD

  14. Université de Lorraine, INSERM, UMR 1116, 54000, Nancy, France

    Pierre-Yves Marie MD, PhD

Authors
  1. Caroline Boursier MD
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  2. Xavier Duval MD, PhD
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  3. Besma Mahida MD
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  8. Véronique Roch MSc
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  9. Zohra Lamiral MSc
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  15. Pierre-Yves Marie MD, PhD
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the AEPEI-TEPvENDO Study Group

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Correspondence to Caroline Boursier MD.

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Boursier, C., Duval, X., Mahida, B. et al. Hypermetabolism of the spleen or bone marrow is an additional albeit indirect sign of infective endocarditis at FDG-PET. J. Nucl. Cardiol. 28, 2533–2542 (2021). https://doi.org/10.1007/s12350-020-02050-2

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