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Detection of Native and Prosthetic Valve Endocarditis: Incremental Attributes of Functional FDG PET/CT over Morphologic Imaging

  • Nuclear Cardiology (V Dilsizian, Section Editor)
  • Published:
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Abstract

Purpose of Review

The clinical and incremental value of functional imaging with 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG PET/CT) for the diagnosis and management of patients with suspected native and prosthetic valve infective endocarditis (IE).

Recent Findings

The diagnosis of IE is challenging because of the highly variable clinical presentations, especially in the case of prosthetic valve endocarditis (PVE). FDG PET/CT has been shown to play an important role for the diagnosis of PVE as a major Duke criterion. Whether FDG PET/CT could play a similar role in patients with suspected native valve endocarditis (NVE) is less well established. It is increasingly recognized that IE is a multisystem disorder, and identification of extra-cardiac manifestations on whole-body FDG PET/CT impacts management and prognosis of patients with IE. Finally, FDG PET/CT provides incremental prognostic value over other clinical and para-clinical parameters, enabling prediction of in-hospital mortality, IE recurrence, hospitalization, and new onset heart failure and embolic events.

Summary

FDG PET/CT plays a key role in the investigation of patients with suspected IE, enabling detection of valvular infection and extra-cardiac manifestations of the infection which has important prognostic implications.

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Authors and Affiliations

  1. Department of Medical Imaging, Institut de Cardiologie de Montréal, Université de Montréal, 5000 Bélanger, Montréal, Québec, H1T1C8, Canada

    Matthieu Pelletier-Galarneau & Francois Harel

  2. Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Matthieu Pelletier-Galarneau

  3. Department of Medical Imaging, Jewish General Hospital, McGill University, Montréal, Québec, Canada

    Gad Abikhzer

  4. Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Vasken Dilsizian

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  1. Matthieu Pelletier-Galarneau
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Correspondence to Matthieu Pelletier-Galarneau.

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Matthieu Pelletier-Galarneau, Gad Abikhzer, Francois Harel, and Vasken Dilsizian declare that they have no conflict of interest. Matthieu Pelletier-Galarneau is supported by a Junior 1 Research Award from the Fonds de Recherche du Québec – Santé (FRQS).

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Pelletier-Galarneau, M., Abikhzer, G., Harel, F. et al. Detection of Native and Prosthetic Valve Endocarditis: Incremental Attributes of Functional FDG PET/CT over Morphologic Imaging. Curr Cardiol Rep 22, 93 (2020). https://doi.org/10.1007/s11886-020-01334-w

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