Xavier Duval1,2,3,4, Vincent Le Moing5, Sarah Tubiana1,2,3, Marina Esposito-Farèse1,2,6, Emila Ilic-Habensus1,2, Florence Leclercq7, Aurélie Bourdon8, François Goehringer9, Christine Selton-Suty10, Elodie Chevalier11, David Boutoille12, Nicolas Piriou13,14, Thierry Le Tourneau13, Catherine Chirouze15, Marie-France Seronde16, Olivier Morel17, Lionel Piroth18, Jean-Christophe Eicher19, Olivier Humbert20, Matthieu Revest21,22, Elise Thébault22, Anne Devillers23, François Delahaye24, André Boibieux25, Bastien Grégoire26, Bruno Hoen9, Cédric Laouenan1,2,3,4,6, Bernard Iung1,2,3,4, François Rouzet1,2,3,4,27. 1. INSERM CIC 1425, Paris, France. 2. AP-HP, University Hospital of Bichat, Paris, France. 3. INSERM UMR-1137 IAME, Paris, France. 4. University Paris Diderot, Paris 7, UFR de Médecine-Bichat, Paris, France. 5. Department of Infectious Diseases, University Hospital of Montpellier, Montpellier, France. 6. Unité de Recherche Clinique, AP-HP, HUPNVS, Hôpital Universitaire Paris Nord-Val de Seine, Paris, France. 7. Department of Cardiology, University Hospital of Montpellier, Montpellier, France. 8. Department of Nuclear Medicine, University Hospital of Montpellier, Montpellier, France. 9. Department of Infectious Diseases, University Hospital of Nancy, Nancy, France. 10. Department of Cardiology, University Hospital of Nancy, Nancy, France. 11. Department of Nuclear Medicine, University Hospital of Nancy, Nancy, France. 12. Department of Infectious Diseases, CIC UIC 1413 INSERM, University Hospital of Nantes, Nantes, France. 13. Thorax Institute, INSERM, UMR 1087, University Hospital of Nantes, Nantes, France. 14. Department of Nuclear Medicine, Nantes University Hospital, G. et R. Laennec Hospital, Nantes, France. 15. University Hospital of Besançon, France, UMR CNRS 6249 Chrono-Environnement, Bourgogne University, Franche-Comté, Dijon, France. 16. Department of Cardiology, University Hospital of Besançon, Besançon, France. 17. Department of Nuclear Medicine, University Hospital of Besançon, Besançon, France. 18. Department of Infectious Diseases, University Hospital of Dijon, INSERM CIC 1432, CHU Dijon, France. 19. Department of Cardiology, University Hospital of Dijon, Dijon, France. 20. Department of Nuclear Medicine, University Hospital of Dijon, Dijon, France. 21. Infectious Diseases and Intensive Care Unit, University Hospital of Rennes France, INSERM U1230 CHU Rennes, France. 22. INSERM CIC 1414, University Hospital of Rennes, France. 23. Department of Nuclear Medicine, University Hospital of Rennes, France. 24. Department of Cardiology, University Hospital of Lyon, Lyon, France. 25. Department of Nuclear Medicine, University Hospital of Lyon, Lyon, France. 26. Department of Infectious Diseases, University Hospital of Lyon, Lyon, France. 27. Department of Nuclear Medicine, AP-HP, University Hospital of Bichat, Paris, France.
Abstract
BACKGROUND: Diagnostic and patients' management modifications induced by whole-body 18F-FDG-PET/CT had not been evaluated so far in prosthetic valve (PV) or native valve (NV) infective endocarditis (IE)-suspected patients. METHODS: In sum, 140 consecutive patients in 8 tertiary care hospitals underwent 18F-FDG-PET/CT. ESC-2015-modified Duke criteria and patients' management plan were established jointly by 2 experts before 18F-FDG-PET/CT. The same experts reestablished Duke classification and patients' management plan immediately after qualitative interpretation of 18F-FDG-PET/CT. A 6-month final Duke classification was established. RESULTS: Among the 70 PV and 70 NV patients, 34 and 46 were classified as definite IE before 18F-FDG-PET/CT. Abnormal perivalvular 18F-FDG uptake was recorded in 67.2% PV and 24.3% NV patients respectively (P < .001) and extracardiac uptake in 44.3% PV and 51.4% NV patients. IE classification was modified in 24.3% and 5.7% patients (P = .005) (net reclassification index 20% and 4.3%). Patients' managements were modified in 21.4% PV and 31.4% NV patients (P = .25). It was mainly due to perivalvular uptake in PV patients and to extra-cardiac uptake in NV patients and consisted in surgery plan modifications in 7 patients, antibiotic plan modifications in 22 patients and both in 5 patients. Altogether, 18F-FDG-PET/CT modified classification and/or care in 40% of the patients (95% confidence interval: 32-48), which was most likely to occur in those with a noncontributing echocardiography (P < .001) or IE classified as possible at baseline (P = .04), while there was no difference between NV and PV. CONCLUSIONS: Systematic 18F-FDG-PET/CT did significantly and appropriately impact diagnostic classification and/or IE management in PV and NV-IE suspected patients. CLINICAL TRIALS REGISTRATION: NCT02287792.
BACKGROUND: Diagnostic and patients' management modifications induced by whole-body 18F-FDG-PET/CT had not been evaluated so far in prosthetic valve (PV) or native valve (NV) infective endocarditis (IE)-suspected patients. METHODS: In sum, 140 consecutive patients in 8 tertiary care hospitals underwent 18F-FDG-PET/CT. ESC-2015-modified Duke criteria and patients' management plan were established jointly by 2 experts before 18F-FDG-PET/CT. The same experts reestablished Duke classification and patients' management plan immediately after qualitative interpretation of 18F-FDG-PET/CT. A 6-month final Duke classification was established. RESULTS: Among the 70 PV and 70 NV patients, 34 and 46 were classified as definite IE before 18F-FDG-PET/CT. Abnormal perivalvular 18F-FDG uptake was recorded in 67.2% PV and 24.3% NV patients respectively (P < .001) and extracardiac uptake in 44.3% PV and 51.4% NV patients. IE classification was modified in 24.3% and 5.7% patients (P = .005) (net reclassification index 20% and 4.3%). Patients' managements were modified in 21.4% PV and 31.4% NV patients (P = .25). It was mainly due to perivalvular uptake in PV patients and to extra-cardiac uptake in NV patients and consisted in surgery plan modifications in 7 patients, antibiotic plan modifications in 22 patients and both in 5 patients. Altogether, 18F-FDG-PET/CT modified classification and/or care in 40% of the patients (95% confidence interval: 32-48), which was most likely to occur in those with a noncontributing echocardiography (P < .001) or IE classified as possible at baseline (P = .04), while there was no difference between NV and PV. CONCLUSIONS: Systematic 18F-FDG-PET/CT did significantly and appropriately impact diagnostic classification and/or IE management in PV and NV-IE suspected patients. CLINICAL TRIALS REGISTRATION: NCT02287792.
Authors: Julia Grapsa; Christopher Blauth; Y S Chandrashekhar; Bernard Prendergast; Blair Erb; Michael Mack; Valentin Fuster Journal: JACC Case Rep Date: 2021-11-15
Authors: B Rodríguez-Alfonso; S Ruiz Solís; L Silva-Hernández; I Pintos Pascual; S Aguado Ibáñez; C Salas Antón Journal: Rev Esp Med Nucl Imagen Mol Date: 2021-07-12 Impact factor: 1.359
Authors: Joop J P Kouijzer; Daniëlle J Noordermeer; Wouter J van Leeuwen; Nelianne J Verkaik; Kirby R Lattwein Journal: Front Cell Dev Biol Date: 2022-10-03
Authors: B Rodríguez-Alfonso; S Ruiz Solís; L Silva-Hernández; I Pintos Pascual; S Aguado Ibáñez; C Salas Antón Journal: Rev Esp Med Nucl Imagen Mol (Engl Ed) Date: 2021-07-28