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[18F]FDG-PET CT for the evaluation of native valve endocarditis

  • ORIGINAL ARTICLE
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

We examined the use of [18F]FDG-PET/CT for the diagnosis of native valve endocarditis (NVE).

Methods

PET/CT images in patients with suspected NVE were retrospectively reviewed independently by two experienced physicians blinded to all clinical information. The gold standard consisted of surgical findings, when available, or the modified Duke criteria.

Results

Fifty four subjects were included, 31 (57%) with a diagnosis of NVE. [18F]FDG-PET/CT correctly identified 21/31 (67.7%) subjects, yielding a sensitivity and specificity of 68% (95% CI 49-83%) and 100% (95% CI 85-100%), respectively. The sensitivity and specificity of the modified Duke criteria were 48% and 74%, respectively. Positive and negative predictive values of PET were 100% (95% CI 84-100%) and 70% (95% CI 51-84%), respectively. Modifying the Duke criteria to include [18F]FDG-PET positivity as a major criterion increased sensitivity to 77% without affecting specificity and led to the correct reclassification of 8/18 (44.4%) subjects from Possible IE to Definite IE.

Conclusion

The addition of a positive [18F]FDG-PET/CT as a major criterion in the modified Duke Criteria improved performance of the criteria for the diagnosis of NVE, particularly in those subjects with Possible IE.

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Abbreviations

IE:

Infective Endocarditis

NVE:

Native valve endocarditis

PVE:

Prosthetic valve endocarditis

TEE:

Transesophageal echocardiogram

TTE:

Transthoracic echocardiogram

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Disclosure

Gad Abikhzer, Patrick Martineau, Jean Grégoire, Vincent Finnerty, Francois Harel, Matthieu Pelletier-Galarneau declare that they have no conflict of interest.

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Authors and Affiliations

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

    Gad Abikhzer MD

  2. Department of Radiology, University of Manitoba, Winnipeg, MB, Canada

    Patrick Martineau MD, PhD

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

    Patrick Martineau MD, PhD & Matthieu Pelletier-Galarneau MD, MSc

  4. Department of Medical Imaging, Montreal Heart Institute, 5000 Bélanger, Montreal, QC, H1T1C8, Canada

    Jean Grégoire MD, Vincent Finnerty MD, Francois Harel MD, PhD & Matthieu Pelletier-Galarneau MD, MSc

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  1. Gad Abikhzer MD
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Correspondence to Matthieu Pelletier-Galarneau MD, MSc.

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In patients with Possible native valve endocarditis, the addition of a positive [18F]FDG-PET/CT as a major criterion in the modified Duke Criteria improved performance of the criteria.

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Abikhzer, G., Martineau, P., Grégoire, J. et al. [18F]FDG-PET CT for the evaluation of native valve endocarditis. J. Nucl. Cardiol. 29, 158–165 (2022). https://doi.org/10.1007/s12350-020-02092-6

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  • DOI: https://doi.org/10.1007/s12350-020-02092-6

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