Integration of ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography in diagnostic algorithm of prosthetic valve endocarditis: A case report and review of literature

Abstract

Prosthetic valve endocarditis (PVE) is a sinister complication, with high morbidity and mortality. Diagnosis is conventionally based on modified Duke Criteria. 18F-Fluorodeoxyglucose ( 18 F-FDG) positron emission tomography-computed tomography (PET-CT) has shown high accuracy in diagnosing PVE. Positive 18 F-FDG uptake in prosthetic valves on PET-CT is now considered major criteria for diagnosis of PVE. We share our experience of 18 F-FDG PET-CT imaging as a problem solving tool in a case of suspected PVE and review the relevant literature.

Usefulness of 18F‐FDG PET‐CT for the management of invasive fungal infections: A retrospective cohort from a tertiary university hospital

“…It is relevant to underline the value of a negative 18 F‐FDG PET‐CT in this setting due to its high negative predictive value for IFI that allows early discontinuation of antifungals, 13 although in native valve endocarditis, it is considered that the diagnosis of endocarditis cannot be excluded in the absence of abnormal 18 F‐FDG uptake 18 . Similar to Sharma et al., 21 who found 18 F‐FDG PET‐CT is particularly useful in cases where other tests were equivocal or with diagnosis of “possible endocarditis”, in our series, 18 F‐FDG PET‐CT was especially helpful in cases with dubious or negative echocardiography.…”

Endocarditis Presenting as Right Atrial Mass, Diagnosed with 18F-Fluorodeoxyglucose-PET: A Case Report

“…Previous literature has supported the use of FDG-PET as a diagnostic tool for infective endocarditis, although it is more commonly used to evaluate infective endocarditis of prosthetic valves. 2,3 In a meta-analysis of 13 studies involving 537 patients, the pooled sensitivity for the diagnosis of infective endocarditis using FDG-PET was 76.8% and pooled specificity was 77.9%. 4 Diagnostic accuracy in prosthetic valves was slightly higher in sensitivity but reduced in specificity.…”

Multimodality Imaging Diagnosis in Infective Endocarditis

“…In situations with false-positive results, WBC SPECT-CT or other imaging tests are preferred [4,6,106]. False-positive results may be recorded in recent thrombi [110] and inadequate patient preparation. False-negative results are produced in the case of small-size vegetations, prior antibiotic treatment and elevated blood glucose levels.…”