Correlating cardiac F-18 FDG PET/CT results with intra-operative findings in infectious endocarditis.

Autor: El-Dalati S; Division of Infectious Diseases, Department of Internal Medicine, Michigan Medicine - University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA. seldalat@med.umich.edu.; Ann Arbor, USA. seldalat@med.umich.edu., Murthy VL; Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine - University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA., Owczarczyk AB; Department of Pathology, Michigan Medicine - University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA., Fagan C; Department of Internal Medicine, Michigan Medicine - University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA., Riddell J 4th; Division of Infectious Diseases, Department of Internal Medicine, Michigan Medicine - University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA., Cinti S; Division of Infectious Diseases, Department of Internal Medicine, Michigan Medicine - University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA., Weinberg RL; Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine - University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA.
Jazyk: angličtina
Zdroj: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2021 Feb; Vol. 28 (1), pp. 289-294. Date of Electronic Publication: 2019 Sep 04.
DOI: 10.1007/s12350-019-01874-x
Abstrakt: Background: Multiple studies have demonstrated that when incorporated with conventional imaging modalities, cardiac F-18 PET/CT can aid in diagnosis of endocarditis and improve the sensitivity of the Duke Criteria. These studies used as their gold standard the opinion of an endocarditis team and were characterized by low percentages of patients who underwent surgery. We reviewed 4 years of surgically managed IE cases where F-18 cardiac PET/CT was used to aid diagnosis.
Methods: Between July 2014 and December 2018, we retrospectively reviewed 68 surgically managed endocarditis cases to identify patients who underwent pre-operative PET scans.
Results: Fourteen patients were identified who underwent F-18 cardiac PET/CT prior to surgical intervention. Nine cases were classified as possible endocarditis by Duke Criteria and 8 involved prosthetic valves. Twelve out of fourteen scans were interpreted as suggestive of or consistent with endocarditis based on FDG uptake. Twelve positive PETs were associated with either operative findings of infection and/or positive PCR testing on the excised valve. Two patients with negative scans were found to have non-infectious mobile masses intra-operatively, negative valve cultures and negative pathology.
Conclusion: In a small cohort, F-18 FDG cardiac PET/CT correlated closely with intra-operative findings in patients with endocarditis and helped guide surgical decision-making. It could be considered for addition to the Duke Criteria in the American Heart Association endocarditis guidelines similar to European protocols.
Databáze: MEDLINE
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