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Diagnostic value of 18F-FDG PET/CT in infective endocarditis

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A Correction to this article was published on 20 December 2021

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Abstract

Introduction

18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET/CT) is not routinely recommended for the diagnosis of infective endocarditis (IE) due to the lack of clinical impact.

Materials and methods

Between January 2016 and January 2020, clinical data from patients with a possible diagnosis of IE were reviewed retrospectively to evaluate the value of 18F-FDG-PET/CT in the diagnosis of IE. 18F-FDG PET/CT scan was performed as an additional diagnostic tool in possible IE when echocardiography was inconclusive or in patients with definite IE to identify extracardiac complications. Cases were classified according to modified Duke criteria as rejected, definite or possible.

Results

313 patients with suspected IE were included. 72 (23%) patients underwent 18F-FDG PET/CT. 18F-FDG PET/CT resulted in a reclassification of Duke criteria in 29/72 (40%) patients, from “possible” to “definite” (n, 10) and to “rejected” (n, 19). Patients who benefited from a Duke criteria reclassification following 18F-FDG PET/CT were more frequently classified as possible IE at inclusion or had a non-conclusive baseline echocardiography (100% vs 58%; p 0.001) and had more likely a prosthetic metallic valve replacement (59% vs 21%; p 0.001). Abnormal perivalvular uptake was identified in 46 patients (71% prosthetic vs 50% native; p 0.118). 18F-FDG PET/CT identified extracardiac uptake consistent with septic emboli in 14/72 (19%) patients. In addition, extracardiac uptake indicative of an alternative diagnosis was identified in 5 patients (2% prosthetic vs 17% native; p 0.039).

Conclusion

The use of 18F-FDG-PET/CT has shown to be useful in the diagnosis of IE, particularly in prosthetic IE and may provide additional value in the detection of septic emboli and/or the identification of an alternative diagnosis different from IE.

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Authors and Affiliations

  1. Department of Infectious Diseases and Medical Microbiology, Kings College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK

    Vanesa Anton-Vazquez & Amanda Fife

  2. Department of Cardiology, Kings College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK

    Antonio Cannata, George Amin-Youssef, Samuel Watson, Margaret Gunning, Alexandros Papachristidis, Phil MacCarthy, Max Baghai, Ranjit Deshpande, Habib Khan, Jonathan Byrne & Rafal Dworakowski

  3. Department of Nuclear Medicine, Kings College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK

    Nicola Mulholland

  4. Honorary Senior Clinical Lecturer, Kings College London, London, UK

    Rafal Dworakowski

  5. 1st Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland

    Rafal Dworakowski

Authors
  1. Vanesa Anton-Vazquez
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  2. Antonio Cannata
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  3. George Amin-Youssef
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  4. Samuel Watson
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  5. Amanda Fife
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  6. Nicola Mulholland
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  7. Margaret Gunning
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  8. Alexandros Papachristidis
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  9. Phil MacCarthy
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  10. Max Baghai
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  11. Ranjit Deshpande
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  12. Habib Khan
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  13. Jonathan Byrne
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  14. Rafal Dworakowski
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Corresponding author

Correspondence to Vanesa Anton-Vazquez.

Additional information

The original online version of this article was revised: In this article, the author’s name Alexandros Papachristidis was incorrectly written as Alexandros Papachristids. The original article has been corrected.

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Anton-Vazquez, V., Cannata, A., Amin-Youssef, G. et al. Diagnostic value of 18F-FDG PET/CT in infective endocarditis. Clin Res Cardiol 111, 673–679 (2022). https://doi.org/10.1007/s00392-021-01975-z

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  • DOI: https://doi.org/10.1007/s00392-021-01975-z

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