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Diagnostic performance of White Blood Cell SPECT imaging against intra-operative findings in patients with a suspicion of prosthetic valve endocarditis

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Journal of Nuclear Cardiology Aims and scope

Abstract

Aim

The objective of this study was to evaluate the diagnostic performance of white blood cells (WBC)-SPECT imaging in patients with suspicion of prosthetic valve endocarditis (PVE) against intra-operative findings.

Methods

36 consecutive patients who underwent cardiac surgery 30 days after WBC-SPECT imaging were identified retrospectively. Clinical, imaging, and biological results were collected from reports. WBC-SPECT results were classified as positive or negative and, if positive, the intensity of signal graded as intense or mild. Lesions observed during cardiac surgery were collected from surgeons’ reports.

Results

The 20 patients with positive WBC-SPECT study had confirmed PVE intra-operatively. Patients with intense signal on WBC-SPECT had high prevalence of abscesses (83%) compared to patients with only mild signal (12%). The three patients with negative WBC-SPECT but confirmed PVE had longer duration of antibiotic treatment before imaging and had no perivalvular abscess. Sensitivity, specificity, positive predictive and negative values, and accuracy of WBC-SPECT were measured at 87%, 100%, 100%, 81%, and 92%, respectively. Addition of WBC-SPECT results to the modified Duke score helped re-classify correctly 25% of patients from possible to definite PVE.

Conclusion

In patients with suspicion of PVE, WBC-SPECT imaging provides excellent diagnostic performance against intra-operative findings.

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Figure 1
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Abbreviations

FDG:

18F-Fluorodeoxyglucose

HMPAO:

Hexa-méthyl-propyl-amineoxime

IE:

Infective endocarditis

PET-CT:

Positron emission tomography-computed tomography

PVE:

Prosthetic valve endocarditis

SPECT:

Single photon emission computed tomography

SUV :

standardized uptake value

WBC:

Radiolabeled white blood cells

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Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Bichat University Hospital, DMU DREAM, Assistance Publique -Hôpitaux de Paris, University of Paris, 75018, Paris, France

    Navid Kooshki MD, Julia Grambow-Velilla MD, Besma Mahida MD, Khadija Benali MD, PhD & François Rouzet MD, PhD

  2. Department of Cardiology, Bichat University Hospital, DMU DREAM, Assistance Publique-Hôpitaux de Paris, University of Paris, 75018, Paris, France

    Caroline Nguyen MD, Claire Cimadevilla MD & Bernard Iung MD, PhD

  3. Department of Cardiac Surgery, Bichat University Hospital, DMU DREAM, Assistance Publique -Hôpitaux de Paris, University of Paris, 75018, Paris, France

    Wael Braham MD, Angelo Pisani MD & Richard Raffoul MD

  4. Department of Nuclear Medicine, Hôpital Européen Georges-Pompidou, DMU IMAGINA, Assistance Publique -Hôpitaux de Paris, University of Paris, 20 Rue Leblanc, 75015, Paris, France

    Fabien Hyafil MD, PhD

Authors
  1. Navid Kooshki MD
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  2. Julia Grambow-Velilla MD
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  3. Besma Mahida MD
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  4. Khadija Benali MD, PhD
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  5. Caroline Nguyen MD
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  6. Claire Cimadevilla MD
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  7. Wael Braham MD
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  8. Angelo Pisani MD
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  9. Bernard Iung MD, PhD
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  10. Richard Raffoul MD
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  11. François Rouzet MD, PhD
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  12. Fabien Hyafil MD, PhD
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Corresponding author

Correspondence to Fabien Hyafil MD, PhD.

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Kooshki, N., Grambow-Velilla, J., Mahida, B. et al. Diagnostic performance of White Blood Cell SPECT imaging against intra-operative findings in patients with a suspicion of prosthetic valve endocarditis. J. Nucl. Cardiol. 29, 528–534 (2022). https://doi.org/10.1007/s12350-021-02674-y

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  • DOI: https://doi.org/10.1007/s12350-021-02674-y

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