Radionuclide Imaging of Infective Endocarditis: State of Art and Future Perspective

Abstract

Purpose of Review Infectious endocarditis is a serious disease requiring rapid diagnosis and accurate risk stratification to offer the best therapeutic strategy. Infection of prosthetic valve (PV) and cardiovascular implantable electronic device (CIED) is increasing due to the ageing of the population and the growing number of implants. Foreign material infection remains clinically challenging given the limitation of ultrasound techniques in this context whereas the diagnosis must be precocious. Recent Findings 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ([ 18 F]FDG PET/CT) and radiolabelled leukocytes single-photon emission computed tomography/computed tomography (SPECT/CT) are commonly used for this purpose.Summary In the present article, we summarized the available evidence for the use of nuclear imaging for the evaluation of infectious endocarditis.

Native valve, prosthetic valve, and cardiac device-related infective endocarditis: A review and update on current innovative diagnostic and therapeutic strategies

“…The sensitivity of [ 18 F]FDG PET/CT is 15% higher than echocardiography for cardiac devices (6% for prosthetic valves), and 58% lower for native valves ( Guenther et al, 2015 ; Dell’Aquila et al, 2016 ; Fagman et al, 2016 ; Granados et al, 2016 ; Memmott et al, 2016 ; Salomäki et al, 2017 ; Sánchez-Enrique et al, 2018 ; Calais et al, 2019 ; de Camargo et al, 2019 ; Abikhzer et al, 2020 ; Gomes et al, 2020 ; Wang et al, 2020 ). Besides the poor detection accuracy in NVE, this imaging modality has possible false-negatives in patients with small biofilms, possible false-positives concerning early post-surgical prosthetic valve implantation ( Rosenbaum et al, 2006 ) or when active thrombi, cardiac tumors, and atrial fibrillation are present, a complex preparation protocol, and limited availability in peripheral centers ( Marchetta et al, 2017 ). Current guidelines stipulate that [ 18 F]FDG PET/CT should only be considered for IE diagnosis when > 3 months have elapsed after valve implantation to prevent false positives from artefacts following surgery ( Habib et al, 2015 ).…”