Navid Kooshki1, Julia Grambow-Velilla1, Besma Mahida1, Khadija Benali1, Caroline Nguyen2, Claire Cimadevilla2, Wael Braham3, Angelo Pisani3, Bernard Iung2, Richard Raffoul3, François Rouzet1, Fabien Hyafil4. 1. Department of Nuclear Medicine, Bichat University Hospital, DMU DREAM, Assistance Publique -Hôpitaux de Paris, University of Paris, 75018, Paris, France. 2. Department of Cardiology, Bichat University Hospital, DMU DREAM, Assistance Publique-Hôpitaux de Paris, University of Paris, 75018, Paris, France. 3. Department of Cardiac Surgery, Bichat University Hospital, DMU DREAM, Assistance Publique -Hôpitaux de Paris, University of Paris, 75018, Paris, France. 4. Department of Nuclear Medicine, Hôpital Européen Georges-Pompidou, DMU IMAGINA, Assistance Publique -Hôpitaux de Paris, University of Paris, 20 Rue Leblanc, 75015, Paris, France. fabien.hyafil@aphp.fr.
Abstract
AIM: The objective of this study was to evaluate the diagnostic performance of white blood cells (WBC)-SPECT imaging in patients with suspicion of prosthetic valve endocarditis (PVE) against intra-operative findings. METHODS: 36 consecutive patients who underwent cardiac surgery 30 days after WBC-SPECT imaging were identified retrospectively. Clinical, imaging, and biological results were collected from reports. WBC-SPECT results were classified as positive or negative and, if positive, the intensity of signal graded as intense or mild. Lesions observed during cardiac surgery were collected from surgeons' reports. RESULTS: The 20 patients with positive WBC-SPECT study had confirmed PVE intra-operatively. Patients with intense signal on WBC-SPECT had high prevalence of abscesses (83%) compared to patients with only mild signal (12%). The three patients with negative WBC-SPECT but confirmed PVE had longer duration of antibiotic treatment before imaging and had no perivalvular abscess. Sensitivity, specificity, positive predictive and negative values, and accuracy of WBC-SPECT were measured at 87%, 100%, 100%, 81%, and 92%, respectively. Addition of WBC-SPECT results to the modified Duke score helped re-classify correctly 25% of patients from possible to definite PVE. CONCLUSION: In patients with suspicion of PVE, WBC-SPECT imaging provides excellent diagnostic performance against intra-operative findings.
AIM: The objective of this study was to evaluate the diagnostic performance of white blood cells (WBC)-SPECT imaging in patients with suspicion of prosthetic valve endocarditis (PVE) against intra-operative findings. METHODS: 36 consecutive patients who underwent cardiac surgery 30 days after WBC-SPECT imaging were identified retrospectively. Clinical, imaging, and biological results were collected from reports. WBC-SPECT results were classified as positive or negative and, if positive, the intensity of signal graded as intense or mild. Lesions observed during cardiac surgery were collected from surgeons' reports. RESULTS: The 20 patients with positive WBC-SPECT study had confirmed PVE intra-operatively. Patients with intense signal on WBC-SPECT had high prevalence of abscesses (83%) compared to patients with only mild signal (12%). The three patients with negative WBC-SPECT but confirmed PVE had longer duration of antibiotic treatment before imaging and had no perivalvular abscess. Sensitivity, specificity, positive predictive and negative values, and accuracy of WBC-SPECT were measured at 87%, 100%, 100%, 81%, and 92%, respectively. Addition of WBC-SPECT results to the modified Duke score helped re-classify correctly 25% of patients from possible to definite PVE. CONCLUSION: In patients with suspicion of PVE, WBC-SPECT imaging provides excellent diagnostic performance against intra-operative findings.
Authors: Paola Anna Erba; Francesco Bartoli; Martina Sollini; Berchiolli Raffaella; Roberta Zanca; Esposito Enrica; Elena Lazzeri Journal: Curr Cardiol Rep Date: 2022-06-13 Impact factor: 3.955