Improving the Diagnostic Performance of F-18-Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography in Prosthetic Heart Valve Endocarditis
| Autor: | Andor W. J. M. Glaudemans, Peter Paul van Geel, Wilco Tanis, Asbjørn M. Scholtens, Riemer H. J. A. Slart, Sander van Assen, Bhanu Sinha, Anna Gomes, Jolien W. Roos-Hesselink, Laurens E. Swart, Sebastian A.F. Streukens, Ricardo P.J. Budde, Gabriel P. Krestin, Joost P. van Melle, Jan Bucerius, Maureen J. van der Vlugt, Marnix G.E.H. Lam, Chantal P. Bleeker-Rovers, Erik H.J.G. Aarntzen |
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| Přispěvatelé: | MUMC+: MA Med Staf Spec Cardiologie (9), Beeldvorming, RS: CARIM - R3.11 - Imaging, MUMC+: DA BV Medisch Specialisten Nucleaire Geneesk (9), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Microbes in Health and Disease (MHD), Cardiovascular Centre (CVC), Translational Immunology Groningen (TRIGR), Vascular Ageing Programme (VAP), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Nuclear Medicine, Biomedical Photonic Imaging, Cardiology, Radiology & Nuclear Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] Computed tomography 030204 cardiovascular system & hematology GUIDELINES Severity of Illness Index 030218 nuclear medicine & medical imaging fluorodeoxyglucose F18 0302 clinical medicine Risk Factors Positron Emission Tomography Computed Tomography Non-U.S. Gov't Heart valve prosthesis Netherlands Prosthetic heart Computed tomography angiography Observer Variation Endocarditis medicine.diagnostic_test Research Support Non-U.S. Gov't Middle Aged F-18-FDG PET/CT Prosthesis-Related Infections/diagnostic imaging Radiopharmaceuticals/administration & dosage Multicenter Study Fluorodeoxyglucose F18/administration & dosage Treatment Outcome Positron emission tomography Infective endocarditis Endocarditis Bacterial/diagnostic imaging endocarditis Female Radiology Tomography Cardiology and Cardiovascular Medicine computed tomography angiography Heart Valve Prosthesis Implantation/adverse effects Adult medicine.medical_specialty Heart Valve Prosthesis/adverse effects Research Support Fluorodeoxyglucose positron emission tomography Fuorodeoxyglucose F18 03 medical and health sciences All institutes and research themes of the Radboud University Medical Center Predictive Value of Tests Physiology (medical) Journal Article medicine MANAGEMENT Humans Video-Audio Media INFECTIVE ENDOCARDITIS Retrospective Studies Aged SUPPRESSION business.industry Other Research Radboud Institute for Health Sciences [Radboudumc 0] Reproducibility of Results DUKE CRITERIA medicine.disease n/a OA procedure lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] heart valve prosthesis Heart Valves/diagnostic imaging Bacterial/diagnostic imaging positron-emission tomography business |
| Zdroj: | Circulation, 138(14), 1412-1427. LIPPINCOTT WILLIAMS & WILKINS Circulation, 138(14). LIPPINCOTT WILLIAMS & WILKINS Circulation, 138, 1412-1427 Circulation, 138(14), 1412-1427. Lippincott Williams and Wilkins Circulation, 138(14), 1412-1427. Lippincott Williams & Wilkins Circulation, 138, 14, pp. 1412-1427 Circulation, 138(14), 1412. Lippincott Williams and Wilkins |
| ISSN: | 0009-7322 |
| Popis: | Background: 18 F-Fluorodeoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) was recently introduced as a new tool for the diagnosis of prosthetic heart valve endocarditis (PVE). Previous studies reporting a modest diagnostic accuracy may have been hampered by unstandardized image acquisition and assessment, and several confounders, as well. The aim of this study was to improve the diagnostic performance of FDG PET/CT in patients in whom PVE was suspected by identifying and excluding possible confounders, using both visual and standardized quantitative assessments. Methods: In this multicenter study, 160 patients with a prosthetic heart valve (median age, 62 years [43–73]; 68% male; 82 mechanical valves; 62 biological; 9 transcatheter aortic valve replacements; 7 other) who underwent FDG PET/CT for suspicion of PVE, and 77 patients with a PV (median age, 73 years [65–77]; 71% male; 26 mechanical valves; 45 biological; 6 transcatheter aortic valve replacements) who underwent FDG PET/CT for other indications (negative control group), were retrospectively included. Their scans were reassessed by 2 independent observers blinded to all clinical data, both visually and quantitatively on available European Association of Nuclear Medicine Research Ltd–standardized reconstructions. Confounders were identified by use of a logistic regression model and subsequently excluded. Results: Visual assessment of FDG PET/CT had a sensitivity/specificity/positive predictive value/negative predictive value for PVE of 74%/91%/89%/78%, respectively. Low inflammatory activity (C-reactive protein Conclusions: Both visual and quantitative assessments of FDG PET/CT have a high diagnostic accuracy in patients in whom PVE is suspected. FDG PET/CT should be implemented early in the diagnostic workup to prevent the negative confounding effects of low inflammatory activity (eg, attributable to prolonged antibiotic therapy). Recent valve implantation was not a significant predictor of false-positive interpretations, but surgical adhesives used during implantation were. |
| Databáze: | OpenAIRE |
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