Clinical usefulness of FDG-PET/CT for identification of abnormal extra-cardiac foci in patients with infective endocarditis

Holle, Sarah Louise Kjølhede; Andersen, Malene Højgaard; Klein, Christine Falk; Bruun, Niels Eske; Tønder, Niels; Haarmark, Christian; Loft, Annika; Høilund‐Carlsen, Poul Flemming; Bundgaard, Henning; Iversen, Kasper

doi:10.1007/s10554-020-01787-8

Cited by 14 publications

(11 citation statements)

References 28 publications

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“…Additionally, the incidental discovery of colonic focus with PET/CT should lead to a colonoscopy (23). In a recent study of 114 patients with definite IE, PET/CT identified seven (4%) unknown cancers; in two cases, this finding led to diagnostic workup and treatment modification (24). Our findings are consistent with previous studies; the most frequently associated pathogen with IE and colorectal cancer is S. gallolyticus subsp.…”

Section: Discussionsupporting

confidence: 89%

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FDG-PET/CT Incidental Detection of Cancer in Patients Investigated for Infective Endocarditis

et al. 2020

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Background: Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is an imaging technique largely used in the management of infective endocarditis and in the detection and staging of cancer. We evaluate our experience of incidental cancer detection by PET/CT during IE investigations and follow-up. Methods and Findings: Between 2009 and 2018, our center, which includes an "endocarditis team," managed 750 patients with IE in a prospective cohort. PET/CT became available in 2011 and was performed in 451 patients. Incidental diagnosis of cancer by PET/CT was observed in 36 patients and confirmed in 34 of them (7.5%) (colorectal n = 17; lung n = 7; lymphoma n = 2; melanoma n = 2; ovarian n = 2; prostate n = 1; bladder n = 1; ear, nose, and throat n = 1; brain n = 1). A significant association has been found between colorectal cancer and Streptococcus gallolyticus and/or Enterococcus faecalis [12/26 vs. 6/33 for other cancers, p = 0.025, odds ratio = 3.86 (1.19-12.47)]. Two patients had a negative PET/CT (a colon cancer and a bladder cancer), and two patients, with positive PET/CT, had a benign colorectal tumor. PET/CT had a sensitivity of 94-100% for the diagnosis of cancer in this patient. Conclusions: Whole-body PET/CT confirmed the high incidence of cancer in patients with IE and could now be proposed in these cases.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

FDG-PET/CT Incidental Detection of Cancer in Patients Investigated for Infective Endocarditis

et al. 2020

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“…Stress imaging such as myocardial perfusion imaging (MPI) and echocardiography were described as low-value in low risk patients, and patients with more than one risk factor for cardiac disease [ 264 , 265 ]. In patients with infective endocarditis, only 10% of the findings in FDG PET/CT of the heart led to changes in treatment [ 266 ]. Routine transthoracic echocardiography in acute ischemic stroke patients had relevant findings in 38% of patients, however only 8.5% of patients had additional work-up [ 267 ].…”

Section: Resultsmentioning

confidence: 99%

Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review

et al. 2022

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Background Inappropriate and wasteful use of health care resources is a common problem, constituting 10–34% of health services spending in the western world. Even though diagnostic imaging is vital for identifying correct diagnoses and administrating the right treatment, low-value imaging—in which the diagnostic test confers little to no clinical benefit—is common and contributes to inappropriate and wasteful use of health care resources. There is a lack of knowledge on the types and extent of low-value imaging. Accordingly, the objective of this study was to identify, characterize, and quantify the extent of low-value diagnostic imaging examinations for adults and children. Methods A scoping review of the published literature was performed. Medline-Ovid, Embase-Ovid, Scopus, and Cochrane Library were searched for studies published from 2010 to September 2020. The search strategy was built from medical subject headings (Mesh) for Diagnostic imaging/Radiology OR Health service misuse/Medical overuse OR Procedures and Techniques Utilization/Facilities and Services Utilization. Articles in English, German, Dutch, Swedish, Danish, or Norwegian were included. Results A total of 39,986 records were identified and, of these, 370 studies were included in the final synthesis. Eighty-four low-value imaging examinations were identified. Imaging of atraumatic pain, routine imaging in minor head injury, trauma, thrombosis, urolithiasis, after thoracic interventions, fracture follow-up and cancer staging/follow-up were the most frequently identified low-value imaging examinations. The proportion of low-value imaging varied between 2 and 100% inappropriate or unnecessary examinations. Conclusions A comprehensive list of identified low-value radiological examinations for both adults and children are presented. Future research should focus on reasons for low-value imaging utilization and interventions to reduce the use of low-value imaging internationally. Systematic review registration: PROSPERO: CRD42020208072.

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“…To identify extra cardiac IE manifestations, classification, and also management, PET/CT scan is helpful. In our patient all the studies except PET/CT scan couldn't reveal the IE evidence, therefore we should declare that performing PET/CT scan is a necessary evaluation in IE cases or even in those with suspicious IE diagnosis [27,28].…”

Section: Discussionmentioning

confidence: 77%

Recurrent culture-negative endocarditis and osteomyelitis caused by Q fever in Iran, a case report.

Ghaderkhani

Kanafgorabi

Larti

et al. 2023

Preprint

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show abstract

Clinical usefulness of FDG-PET/CT for identification of abnormal extra-cardiac foci in patients with infective endocarditis

Cited by 14 publications

References 28 publications

FDG-PET/CT Incidental Detection of Cancer in Patients Investigated for Infective Endocarditis

FDG-PET/CT Incidental Detection of Cancer in Patients Investigated for Infective Endocarditis

Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review

Recurrent culture-negative endocarditis and osteomyelitis caused by Q fever in Iran, a case report.

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