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18F-fluorodeoxyglucose positron emission tomography/CT in the diagnosis of right-sided endocarditis in children and adults with infective endocarditis
Published online by Cambridge University Press: 02 January 2024
Abstract
Objective:
Infectious endocarditis poses a diagnostic challenge due to its highly variable clinical presentation. To establish a definitive diagnosis, different imaging modalities are essential. In recent years, positron emission tomography/CT has gained increasing significance in diagnosing infective endocarditis; however, its application in the pediatric age group remains limited. This study encompasses patients definitively or potentially diagnosed with infectious endocarditis at our institution from 2018 to 2023.
Methods:
A total of 29 patients underwent 18F-fluorodeoxyglucose positron emission tomography/CT examinations, with 19 of them presenting with right-sided infective endocarditis.
Results:
Evidence consistent with infective endocarditis was observed in 18 (94.7%) of the patients. Pulmonary septic embolism was identified in 15 (78.9%) cases, and splenic involvement was noted in 12 (57.8%) cases. Transthoracic/transesophageal echocardiography failed to reveal vegetation or provided uncertain results in six patients, whereas fluorodeoxyglucose-positron emission tomography-CT exhibited involvement. Subsequently, the diagnosis of infective endocarditis was confirmed post-surgery based on the fluorodeoxyglucose-positron emission tomography-CT findings.
Conclusion:
Our results, along with our clinical experience, demonstrate that fluorodeoxyglucose-positron emission tomography-CT is a safe and viable method for diagnosing right-sided endocarditis, which is often challenging to visualize using echocardiography.
Keywords
- Type
- Original Article
- Information
- Copyright
- © The Author(s), 2024. Published by Cambridge University Press
References
Baltimore, RS, Gewitz, M, Baddour, LM, et al. American heart association rheumatic fever, endocarditis, and kawasaki disease committee of the council on cardiovascular disease in the young and the council on cardiovascular and stroke nursing, 2015 infective endocarditis in childhood: 2015 update: a scientific statement from the American heart association. Circulation 2015; 132: 1487–1515.10.1161/CIR.0000000000000298CrossRefGoogle Scholar
Cahill, TJ, Prendergast, BD. Infective endocarditis. Lancet 2016; 387: 882–893.10.1016/S0140-6736(15)00067-7CrossRefGoogle ScholarPubMed
Habib, G, Lancellotti, P, Antunes, MJ, Group ESCSD, et al. 2015 ESC guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European society of cardiology (ESC). Endorsed by: European association for cardio-thoracic surgery (EACTS), the European association of nuclear medicine (EANM). Eur Heart J 2015; 36: 3075–3128.10.1093/eurheartj/ehv319CrossRefGoogle Scholar
Akinosoglou, K, Apostolakis, E, Marangos, M, Pasvol, G. Native valve right sided infective endocarditis. Eur J Intern Med 2013; 24: 510–519.10.1016/j.ejim.2013.01.010CrossRefGoogle ScholarPubMed
Shmueli, H, Thomas, F, Flint, N, Setia, G, Janjic, A, Siegel, RJ. Right-sided infective endocarditis 2020: challenges and updates in diagnosis and treatment. J Am Heart Assoc 2020; 9: e017293. DOI: 10.1161/JAHA.120.017293.10.1161/JAHA.120.017293CrossRefGoogle ScholarPubMed
Casali, M, Lauri, C, Altini, C, et al. State of the art of 18FFDG PET/CT application in inflammation and infection: a guide for image acquisition and interpretation. Clin Transl Imaging 2021; 9: 299–339. DOI: 10.1007/s40336-021-00445-w.Epub 2021-07-10.10.1007/s40336-021-00445-wCrossRefGoogle ScholarPubMed
Pijl, JP, Kwee, TC, Legger, GE, et al. Role of FDG-PET/CT in children with fever of unknown origin. Eur J Nucl Med Mol Imaging 2020; 47: 1596–1604. DOI: 10.1007/s00259-020-04707-z.10.1007/s00259-020-04707-zCrossRefGoogle ScholarPubMed
Chau, A, Renella, P, Arrieta, A. Multimodality cardiovascular imaging in the diagnosis and management of prosthetic valve infective endocarditis in children report of two cases and brief review of the literature. Cardiol Young 2019; 29: 1526–1529. DOI: 10.1017/S1047951119002233.10.1017/S1047951119002233CrossRefGoogle ScholarPubMed
Eleyan, L, Khan, AA, Musollari, G, et al. Infective endocarditis in paediatric population. Eur J Pediatr 2021; 180: 3089–3100. DOI: 10.1007/s00431-021-04062-7.10.1007/s00431-021-04062-7CrossRefGoogle ScholarPubMed
Orvin, K, Goldberg, E, Bernstine, H, et al. The role of FDG-PET/CT imaging in early detection of extra-cardiac complications of infective endocarditis. Clin Microbiol Infect 2015; 21: 69–76.10.1016/j.cmi.2014.08.012CrossRefGoogle ScholarPubMed
Ten Hove, D, Slart, RHJA, Sinha, B, Glaudemans, AWJM, Budde, RPJ. 18F-FDG PET/CT in infective endocarditis: indications and approaches for standardization. Curr Cardiol Rep 2021; 23: 130. DOI: 10.1007/s11886-021-01542-y.10.1007/s11886-021-01542-yCrossRefGoogle ScholarPubMed
Habib, G, Erba, PA, Iung, B, et al. Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study. Eur Heart J 2019; 40: 3222–3232. DOI: 10.1093/eurheartj/ehz620.10.1093/eurheartj/ehz620CrossRefGoogle ScholarPubMed
Jiménez-Ballvé, A, Pérez-Castejón, MJ, Delgado-Bolton, RC, et al. Assessment of the diagnostic accuracy of (18)FFDG PET/CT in prosthetic infective endocarditis and cardiac implantable electronic device infection: comparison of different interpretation criteria. Eur J Nucl Med Mol Imaging 2016; 43: 2401–2412.10.1007/s00259-016-3463-9CrossRefGoogle Scholar