Characterization of 18-Fluorodeoxyglucose uptake pattern in infective endocarditis after transcatheter aortic valve implantation

Acute uptake of 18F-fluorodeoxyglucose following transcatheter aortic valve replacement: first documentation of inflammatory response to injury

“…However, contrary to the study by San et al, a hemicircumferential uptake was demonstrable in patients with infective endocarditis at 3 months, and even as late as 8 months, after TAVR in a study by Salaun et al 5 . Our study findings indicate that the focal/multifocal 18 F-FDG uptake pattern that has been described in patients with infective endocarditis 4 is not seen in noninfected patients in the 7 days following TAVR. Therefore, the presence of a focal/multifocal 18 F-FDG uptake pattern within the 7 days following TAVR could raise the suspicion of infective endocarditis in some patients who may develop a high-grade fever (≥38.0 o C) following the procedure.…”

“…For instance, del Val et al concluded that noninfected patients do not exhibit significant periprosthetic 18 F-FDG PET/CT uptake 3 months after TAVR and have suggested that significant periprosthetic uptake >3 months after TAVR may be highly indicative of infective endocarditis 3 . On the other hand, 23% of noninfected patients demonstrated positive periprosthetic uptake of 18 F-FDG PET/CT at 1 month and 13% at 3 months post-TAVR in another study 4 . San et al have also suggested that uptake patterns could be used to accurately differentiate between noninfected patients and patients with infective endocarditis; the 18 F-FDG PET/CT uptake pattern was hemicircumferential or circumferential in noninfected patients, and focal or multifocal in patients with infective endocarditis in their study 4 .…”

“…On the other hand, 23% of noninfected patients demonstrated positive periprosthetic uptake of 18 F-FDG PET/CT at 1 month and 13% at 3 months post-TAVR in another study 4 . San et al have also suggested that uptake patterns could be used to accurately differentiate between noninfected patients and patients with infective endocarditis; the 18 F-FDG PET/CT uptake pattern was hemicircumferential or circumferential in noninfected patients, and focal or multifocal in patients with infective endocarditis in their study 4 . However, contrary to the study by San et al, a hemicircumferential uptake was demonstrable in patients with infective endocarditis at 3 months, and even as late as 8 months, after TAVR in a study by Salaun et al 5 .…”

“…Current European Society of Cardiology guidelines include abnormal periprosthetic uptake in 18 F-FDG PET/CT as a major criterion in the diagnosis of infective endocarditis if performed >3 months after surgical valve implantation 1 . While the characteristics of 18 F-FDG PET/CT uptake in noninfected patients with surgically implanted prosthetic aortic valves have been described 2 , data on 18 F-FDG PET/CT uptake following transcatheter aortic valve replacement (TAVR) are limited [3][4][5] . Importantly, the pattern of 18 F-FDG PET/CT uptake immediately following TAVR, which represents the inflammatory response to injury, is unknown.…”