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18F-FDG PET/CT in the diagnosis of prosthetic valve endocarditis

Artikel i vetenskaplig tidskrift
Författare Erika Fagman
Martijn van Essen
Johan Fredén Lindqvist
Ulrika Snygg-Martin
Odd Bech-Hanssen
Gunnar Svensson
Publicerad i The International Journal of Cardiovascular Imaging
Volym 32
Nummer/häfte 4
Sidor 679-686
ISSN 1569-5794
Publiceringsår 2016
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för radiologi
Institutionen för medicin, avdelningen för molekylär och klinisk medicin
Institutionen för biomedicin, avdelningen för infektionssjukdomar
Sidor 679-686
Språk en
Länkar dx.doi.org/10.1007/s10554-015-0814-...
Ämnesord Prosthetic valve endocarditis, prosthetic heart valve, 18F-FDG PET/CT, Positron Emission Tomography
Ämneskategorier Diagnostisk radiologi

Sammanfattning

Recent studies have shown promising results using 18F-fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) in the diagnosis of prosthetic valve endocarditis (PVE). However, previous studies did not include negative controls. The aim of this study was to compare 18F-FDG-uptake around prosthetic aortic valves in patients with and without PVE and to determine the diagnostic performance of 18F-FDG PET/CT in the diagnosis of PVE. 18F-FDG PET/CT examinations in patients with a prosthetic aortic valve performed 2008–2014 were retrieved. Eight patients with a final diagnosis of definite PVE were included in the analysis of the diagnostic performance of 18F-FDG PET/CT. Examinations performed on suspicion of malignancy in patients without PVE (n = 19) were used as negative controls. Visual and semi-quantitative analysis was performed. Maximal standardized uptake value (SUVmax) in the valve area was measured and SUVratio was calculated by dividing valve SUVmax by SUVmax in the descending aorta. The sensitivity was 75 %, specificity 84 %, positive likelihood ratio [LR(+)] 4.8 and negative likelihood ratio [LR(-)] 0.3 on visual analysis. Both SUVmax and SUVratio were significantly higher in PVE patients [5.8 (IQR 3.5–6.5) and 2.4 (IQR 1.7–3.0)] compared to non-PVE patients [3.2 (IQR 2.8–3.8) and 1.5 (IQR 1.3–1.6)] (p<0.001). ROC-curve analysis of SUVratio yielded an area under the curve of 0.90 (95 % CI 0.74–1.0). 18F-FDG-uptake around non-infected aortic prosthetic valves was low. The level of 18F-FDG-uptake in the prosthetic valve area showed a good diagnostic performance in the diagnosis of PVE.

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