Advantages of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in detecting post cardiac surgery infections

Adjtoutah, D.; Azhari, Alaa; Larabi, Youcef; Dorigo, Enrica; Merlin, C.; Marcaggi, X.; Nana, Armel Simplice; Camilleri, Lionel; Azarnoush, Kasra

doi:10.1016/j.jsha.2013.09.001

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…False negative results might be due to prior administration of antimicrobial therapy, 41,44,[61][62][63] small size of vegetations, 49 and elevated blood glucose concentration. 58 False positive results might be a result of recent cardiac procedures, 48,58,64,65 recent thrombi, 61,66 and inadequate patient preparation (eg, not enforcing a low-carbohydrate, fat-allowed diet). Additionally, interpretation of ¹⁸F-FDG PET/CT is not straightforward because the distribution and pattern of ¹⁸F-FDG uptake rather than the intensity only should be used as a diagnostic criterion of infection.…”

Section: Imaging Modalitiesmentioning

confidence: 99%

Diagnostic value of imaging in infective endocarditis: a systematic review

Gomes

Glaudemans

Touw

et al. 2017

The Lancet Infectious Diseases

221

151

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Section: Imaging Modalitiesmentioning

confidence: 99%

Diagnostic value of imaging in infective endocarditis: a systematic review

Gomes

Glaudemans

Touw

et al. 2017

The Lancet Infectious Diseases

221

151

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“…Whereas this technique has proven its value in detection of endocarditis [ 58 – 60 ], general application was compromised by limited sensitivity due to a weak signal from the valvular target region and difficult localization of inflammatory foci. The specificity of leukocyte scintigraphy with SPECT/CT could be particularly useful when diagnostic uncertainty remains after echocardiography and FDG-PET/CT, especially in patients who have had cardiac surgery within the past 4 weeks [ 56 , 57 , 61 , 62 ].…”

Section: Endocarditismentioning

confidence: 99%

Novel Noninvasive Nuclear Medicine Imaging Techniques for Cardiac Inflammation

Kircher

Lapa

2017

Curr Cardiovasc Imaging Rep

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Purpose of ReviewInflammation is a key player in a wide range of cardiovascular and myocardial diseases. Given the numerous implications of inflammatory processes in disease initiation and progression, functional imaging modalities including positron emission tomography (PET) represent valuable diagnostic, prognostic, and monitoring tools in patient management. Since increased glucose metabolism is a hallmark of inflammation, PET using the radiolabeled glucose analog [18F]-2-deoxy-2-fluoro-d-glucose (FDG) is the mainstay diagnostic test for nuclear imaging of (cardiac) inflammation. Recently, new approaches using more specific tracers to overcome the limited specificity of FDG have emerged.Recent FindingsPET imaging has proven its value in a number of inflammatory conditions of the heart including myocarditis, endocarditis, sarcoidosis, or reactive changes after myocardial infarction. In infection-related endocarditis, FDG-PET and white blood cell scintigraphy have been implemented in current guidelines. FDG-PET is considered as nuclear medical gold standard in myocarditis, pericarditis, or sarcoidosis. Novel strategies, including targeting of somatostatin receptors or C-X-C motif chemokine receptor CXCR4, have shown promising results in first studies.SummaryNuclear medicine techniques offer valuable information in the assessment of myocardial inflammation. Given the possibility to directly visualize inflammatory activity, they represent useful tools for diagnosis, risk stratification, and therapy monitoring.

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“…Mas a altíssima especificidade da cintilografia com leucócitos marcados para infecção, quando são realizadas as imagens com SPECT/TC, pode ser particularmente útil quando a incerteza diagnóstica permanece após a ecocardiografia e PET/TC FDG - 18 F, especialmente em pacientes submetidos à cirurgia cardíaca nos últimos dois meses. [404][405][406][407] Como possibilidade adicional, sugere-se combinar as imagens da cintilografia com leucócitos marcados simultaneamente à CPM, adquirida para melhorar a localização de pontos infecciosos em relação ao plano valvar definido pela perfusão. As limitações para a realização do SPECT/TC com leucócitos marcados são: a necessidade de estrutura específica com capela de fluxo laminar; a manipulação de componentes sanguíneos; a duração do procedimento e pior resolução espacial em relação ao PET/TC.…”

Section: Endocarditeunclassified