Prognostic Value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Infective Endocarditis

San, Sovannarith; Ravis, Eléonore; Tessonier, Laetitia; Philip, Mary; Cammilleri, Serge; Lavagna, F; Norscini, Giulia; Arregle, Florent; Martel, Hélène; Oliver, Léopold; Torras, Olivier; Renard, Sébastien; Ambrosi, Pı̈erre; Camoin, Laurence; Casalta, Anne Claire; Hubert, Sandrine; Casalta, Jean Paul; Gouriet, Frédérique; Ribéri, Alberto; Avierinos, Jean-François; Lépidi, Hubert; Collart, Frédéric; Raoult, Didier; Drancourt, Michel; Habib, Gilbert

doi:10.1016/j.jacc.2019.06.050

Cited by 79 publications

(35 citation statements)

References 25 publications

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“…This study also confirmed that possible IE could be reduced from 33% to 8% if the diagnosis included FDG PET/CT findings [15]. Recent research has indicated that positive FDG PET/CT results are related to major cardiac events such as, death, recurrence of IE, acute heart failure, unsuspected cardiovascular hospitalization, and new embolic events [16].…”

Section: Prosthetic Valve Endocarditissupporting

confidence: 79%

“…Based on these extracardiac findings on FDG PET/CT, the incidence of IE relapse decreased by two-fold as a result of appropriate treatment [18]. In line with this, moderate to intense FDG uptake in the perivalvular area is associated with worse prognosis, such as increased new embolic events (hazard ratio [HR], 8.8) and rehospitalization (HR, 3.57) [16].…”

Section: Native Valve Endocarditismentioning

confidence: 79%

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F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the infection of heart

Kong

2021

Yeungnam Univ J Med

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Infections involving the heart are becoming increasingly common, and a timely diagnosis of utmost importance, despite its challenges. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a recently introduced diagnostic tool in cardiology. This review focuses on the current evidence for the use of FDG PET/CT in the diagnosis of infective endocarditis, cardiac implantable device infection, left ventricular assist device infection, and secondary complications. The author discuss considerations when using FDG PET/CT in routine clinical practice, patient preparation for reducing physiologic myocardial uptake, acquisition of images, and interpretation of PET/CT findings. This review also functions to highlight the need for a standardized acquisition protocol.

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Section: Prosthetic Valve Endocarditissupporting

confidence: 79%

Section: Native Valve Endocarditismentioning

confidence: 79%

F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the infection of heart

Kong

2021

Yeungnam Univ J Med

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“… 2 PET can identify both extracardiac manifestations of IE and characteristic avidity of the valve, particularly in PVE, with sensitivity and specificity of 85–90%. 2 , 14 The use of PET for diagnosis in IE has increased since the 2015 European Society of Cardiology Guidelines, for those in whom the clinical suspicion of IE remains high despite equivocal imaging/microbiology findings. 15 In the absence of large prospective trials, we would continue to be cautious when PET is a diagnostic outlier compared to established components of the mDC.…”

Section: Discussionmentioning

confidence: 99%

Recurrent strokes in an occult case of recurrent Cutibacterium acnes prosthetic valve infective endocarditis: a case report

Fry

Primus

Serafino-Wani

et al. 2021

European Heart Journal - Case Reports

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Background Infective endocarditis (IE) is a known but uncommon cause of cardioembolic stroke and there are rare but recognized cases of IE without an inflammatory response. Cutibacterium acnes is an increasingly recognized source of invasive infections, including IE, but diagnosis is challenging due to its low virulence and fastidious nature. Case summary A 47-year-old man presented with a multi-focal stroke suggestive of a cardioembolic source. Outpatient transoesophageal echocardiography (TOE) was concerning for vegetation or thrombus associated with his previous mitral valve repair. He remained clinically well, with no evidence of an inflammatory response and sterile blood cultures. Computed tomography–positron emission tomography (CT-PET) corroborated the TOE findings, however, given the atypical presentation, he was treated for valvular thrombus. Following discharge, he quickly re-presented with further embolic phenomena and underwent emergency mitral valve replacement. Intraoperative findings were consistent with prosthetic valve IE (PVE) and a 6-week course of antibiotics commenced. C. acnes was identified on molecular testing. Eighteen months later, he re-presented with further neurological symptoms. Early TOE and CT–PET were consistent with IE. Blood cultures grew C. acnes after prolonged incubation. Given the absence of surgical indications, he was managed medically, and the vegetation resolved without valvular dysfunction. He continues to be followed up in an outpatient setting. Discussion In patients presenting with multi-territory stroke, IE should be considered despite sterile blood cultures and absent inflammatory response. C. acnes is an increasingly recognized cause of PVE in this context, often requiring surgical intervention. A high index of suspicion and collaboration with an Endocarditis Team is therefore essential to diagnose and treat.

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“…Very recent data proved the prognostic value of ( 18 F)FDG PET/CT in PVE. In a large retrospective study on 173 patients with left-sided IE and examined after seven days from the first antibiotic administration, a moderate to intense valvular ( 18 F)FDG uptake was predictive of major adverse cardiac events defined as in-hospital death, one-year death, recurrence of IE, acute cardiac insufficiency, symptomatic embolism under antibiotics, and nonscheduled rehospitalization for cardiovascular indication [54]. These results reinforce the utility of ( 18 F)FDG PET/CT in PVE and justify its use in this population, not only for diagnostic purposes, but also for prognostic assessment.…”

Section: When To Ask For Nuclear Imagingmentioning

confidence: 99%

Multimodality Imaging in the Diagnostic Work-Up of Endocarditis and Cardiac Implantable Electronic Device (CIED) Infection

Galea

Bandera

Lauri

et al. 2020

JCM

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Infective endocarditis (IE) is a serious cardiac condition, which includes a wide range of clinical presentations, with varying degrees of severity. The diagnosis is multifactorial and a proper characterization of disease requires the identification of the primary site of infection (usually the cardiac valve) and the search of secondary systemic complications. Early depiction of local complications or distant embolization has a great impact on patient management and prognosis, as it may induce to aggressive antibiotic treatment or, in more advanced cases, cardiac surgery. In this setting, the multimodality imaging has assumed a pivotal role in the clinical decision making and it requires the physician to be aware of the advantages and disadvantages of each imaging technique. Echocardiography is the first imaging test, but it has several limitations. Therefore, the integration with other imaging modalities (computed tomography, magnetic resonance imaging, nuclear imaging) becomes often necessary. Different strategies should be applied depending on whether the infection is suspected or already ascertained, whether located in native or prosthetic valves, in the left or right chambers, or if it involves an implanted cardiac device. In addition, detection of extracardiac IE-related lesions is crucial for a correct management and treatment. The aim of this review is to illustrate strengths and weaknesses of the various methods in the most common clinical scenarios.

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Prognostic Value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Infective Endocarditis

Cited by 79 publications

References 25 publications

F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the infection of heart

F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the infection of heart

Recurrent strokes in an occult case of recurrent Cutibacterium acnes prosthetic valve infective endocarditis: a case report

Multimodality Imaging in the Diagnostic Work-Up of Endocarditis and Cardiac Implantable Electronic Device (CIED) Infection

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