A Roque1,2,3, M N Pizzi4,5, H Cuéllar-Calàbria6,7,5, S Aguadé-Bruix8,5. 1. Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. albert_roque@hotmail.com. 2. IDI (Institut de Diagnòstic per la Imatge), Barcelona, Spain. albert_roque@hotmail.com. 3. Universitat Autònoma de Barcelona, Bellaterra, Spain. albert_roque@hotmail.com. 4. Department of Cardiology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. 5. Universitat Autònoma de Barcelona, Bellaterra, Spain. 6. Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. 7. IDI (Institut de Diagnòstic per la Imatge), Barcelona, Spain. 8. Department of Nuclear Medicine, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Abstract
PURPOSE OF REVIEW: This article reviews the current imaging role of 18F-fluordeoxyglucose positron emission computed tomography (18F-FDG-PET/CT) combined with cardiac CT angiography (CTA) in infective endocarditis and discusses the strengths and limitations of this technique. RECENT FINDINGS: The diagnosis of infective endocarditis affecting prosthetic valves and intracardiac devices is challenging because echocardiography and, therefore, the modified Duke criteria have well-recognized limitations in this clinical scenario. The high sensitivity of 18F-FDG-PET/CT for the detection of infection associated with the accurate definition of structural damage by gated cardiac CTA in a combined technique (PET/CTA) has provided a significant increase in diagnostic sensitivity for the detection of IE. PET/CTA has proven to be a useful diagnostic tool in patients with suspected infective endocarditis. The additional information provided by this technique improves diagnostic performance in prosthetic valve endocarditis when it is used in combination with the Duke criteria. The findings obtained in PET/CTA studies have been included as a major criterion in the recently updated diagnostic algorithm in infective endocarditis guidelines.
PURPOSE OF REVIEW: This article reviews the current imaging role of 18F-fluordeoxyglucose positron emission computed tomography (18F-FDG-PET/CT) combined with cardiac CT angiography (CTA) in infective endocarditis and discusses the strengths and limitations of this technique. RECENT FINDINGS: The diagnosis of infective endocarditis affecting prosthetic valves and intracardiac devices is challenging because echocardiography and, therefore, the modified Duke criteria have well-recognized limitations in this clinical scenario. The high sensitivity of 18F-FDG-PET/CT for the detection of infection associated with the accurate definition of structural damage by gated cardiac CTA in a combined technique (PET/CTA) has provided a significant increase in diagnostic sensitivity for the detection of IE. PET/CTA has proven to be a useful diagnostic tool in patients with suspected infective endocarditis. The additional information provided by this technique improves diagnostic performance in prosthetic valve endocarditis when it is used in combination with the Duke criteria. The findings obtained in PET/CTA studies have been included as a major criterion in the recently updated diagnostic algorithm in infective endocarditis guidelines.
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