Abstract
Purpose
In the acute setting of endocarditis it is very important to assess both the vegetation itself, as well as potential life-threatening complications, in order to decide whether antibiotic therapy will be sufficient or urgent surgery is indicated. A single whole-body scan investigating inflammatory changes could be very helpful to achieve a swift and efficient assessment.
Methods
In this study we assessed whether 18F-FDG can be used to detect and localize peripheral embolism or distant infection. Twenty-four patients with 25 episodes of endocarditis, enrolled between March 2006 and February 2008, underwent 18F-FDG PET/CT imaging on a dedicated PET/CT scanner.
Results
PET/CT imaging revealed a focus of peripheral embolization and/or metastatic infection in 11 episodes (44%). One episode had a positive PET/CT scan result for both embolism and metastatic infection. PET/CT detected seven positive cases (28%) in which there was no clinical suspicion. Valve involvement of endocarditis was seen only in three patients (12%).
Conclusion
PET/CT may be an important diagnostic tool for tracing peripheral embolism and metastatic infection in the acute setting of infective endocarditis, since a PET/CT scan detected a clinically occult focus in nearly one third of episodes.
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The work was performed in the Department of Nuclear Medicine, University Hospital KU Leuven, Herestraat 49, 3000 Leuven, Belgium. All authors have seen and approved the manuscript.
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Van Riet, J., Hill, E.E., Gheysens, O. et al. 18F-FDG PET/CT for early detection of embolism and metastatic infection in patients with infective endocarditis. Eur J Nucl Med Mol Imaging 37, 1189–1197 (2010). https://doi.org/10.1007/s00259-010-1380-x
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DOI: https://doi.org/10.1007/s00259-010-1380-x