Clinical impact of 18F-FDG-PET/CT in the extra cardiac work-up of patients with infective endocarditis. (1st September 2014)

• Record Type: Journal Article
• Authors: Asmar, Ali; Özcan, Cengiz; Diederichsen, Axel C.P.; Thomassen, Anders; Gill, Sabine
• Is Part Of: European heart journal. Volume 15:Number 9(2014:Sep.)
• Page Start: 1013
• Page End: 1019
• Publication Date: 2014-09-01
• Subjects: 18F-FDG-PET/CT -- Clinical impact -- Infective endocarditis -- Extra cardiac work-up; Cardiovascular system -- Imaging -- Periodicals; Heart -- Imaging -- Periodicals; 616.10754
• DOI: 10.1093/ehjci/jeu054
• Languages: English
• ISSNs: 2047-2404

Abstract

Abstract: Objective: The purpose of this study was to assess the clinical importance of 18 F-FDG-PET/CT used in the extra cardiac work-up of patients with infective endocarditis (IE). Background: IE is a serious condition with a significant mortality. Besides the degree of valvular involvement, the prognosis relies crucially on the presence of systemic infectious embolism. Methods: Seventy-two patients (71% males and mean age 63 ± 17 years) with IE were evaluated with 18 F-FDG-PET/CT in addition to standard work-up including patient history, physical examination, conventional imaging modalities, and weekly interdisciplinary conferences. When previous unknown lesions detected by 18 F-FDG-PET/CT were confirmed by succeeding examinations, they were considered true positive new findings and were further assessed for their clinical importance . Number needed to investigate was calculated as the number of patients who needed to undergo 18 F-FDG-PET/CT to find at least one clinical important true positive new finding, not identified by standard work-up prior to 18 F-FDG-PET/CT. Results: 18 F-FDG-PET/CT detected 114 lesions and 64 were true positive, of which 25 were new findings and detected in 17 patients. In 11 patients, the lesions were considered to have a clinical importance; osteomyelitis ( n = 7), iliopsoas abscess ( n = 1), gastrointestinal lesions ( n = 2), and vascular prosthetic graft ( n = 1). Number needed to investigate was 7 (11 of 72 patients). Conclusions: 18 F-FDG-PET/CT detected lesions of clinical importance in one of seven IE patients and may be a substantial imaging technique for tracing peripheral infectious embolism due to IE. Thus, 18 F-FDG-PET/CT may help to guide adequate therapy and thereby improve the prognosis of patients with IE.