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Native-Valve Endocarditis

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FDG-PET/CT and PET/MR in Cardiovascular Diseases

Abstract

Although relatively rare, infective endocarditis (IE) is associated with significant morbidity and mortality [1]. The diagnosis of IE is clinically challenging due to diverse and variable clinical presentations, ranging from chronic, to subacute, to rapidly progressive disease. To circumvent these diagnostic difficulties, the Duke criteria were established. The diagnosis of IE mostly relies on a modified version of those criteria (the modified Duke criteria), consisting of major and minor criteria that are composed of clinical and paraclinical findings including blood cultures and echocardiographic findings. Studies have demonstrated that approximately one third of patients investigated for IE are classified as possible IE [2, 3]. In patients categorized as having possible IE by the modified Duke criteria, 24–72% of these patients are subsequently found to have IE following additional investigations, such as repeat TTE or TEE [4, 5]. This ultimately leads to delays in diagnosis and initiation of treatment which is in turn associated with poorer outcomes, including increased rates of irreversible morphologic valvular damage, embolic events, surgery, and death [6, 7]. Advanced multimodality imaging has become increasingly integrated in the diagnosis and evaluation of IE. Although the role of FDG-PET/CT in native valve infective endocarditis (NVIE) is still being defined, there is a growing body of evidence supporting the role for FDG-PET/CT in the diagnosis and staging of this disease.

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Abbreviations

IE:

Infective endocarditis

NVIE:

Native-valve infective endocarditis

PVE:

Prosthetic valve endocarditis

TEE:

Transesophageal echocardiogram

TTE:

Transthoracic echocardiogram

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Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, Jewish General Hospital, Montreal, QC, Canada

    Gad Abikhzer

  2. Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada

    Gad Abikhzer, Jeremy Y. Levett & Igal A. Sebag

  3. Division of Cardiology, Jewish General Hospital, Montreal, QC, Canada

    Igal A. Sebag

  4. Montreal Heart Institute, Montréal, QC, Canada

    Matthieu Pelletier-Galarneau

Authors
  1. Gad Abikhzer
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  2. Jeremy Y. Levett
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  3. Igal A. Sebag
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  4. Matthieu Pelletier-Galarneau
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Correspondence to Gad Abikhzer .

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  1. Montreal Heart Institute, Montréal, QC, Canada

    Matthieu Pelletier-Galarneau

  2. BC Cancer Agency, Vancouver, BC, Canada

    Patrick Martineau

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Abikhzer, G., Levett, J.Y., Sebag, I.A., Pelletier-Galarneau, M. (2022). Native-Valve Endocarditis. In: Pelletier-Galarneau, M., Martineau, P. (eds) FDG-PET/CT and PET/MR in Cardiovascular Diseases. Springer, Cham. https://doi.org/10.1007/978-3-031-09807-9_13

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