18F-fluorodeoxyglucose positron emission tomographycombined with computed tomography in prostheticvalve endocarditis. Initial results
Authors:
Company: Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation
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Type: Original articles
DOI:
For citation: Bockeria L.A., Aslanidis I.P., Pursanova D.M., Mukhortova O.V., Shurupova I.V., Ekaeva I.V., Golukhova E.Z., Tetvadze I.V., Muratov R.M., Mironenko V.A., Skopin I.I. 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in prosthetic valve endocarditis. Initial results. Creative Cardiology. 2019; 13 (2): 98–113 (in Russ.). DOI: 10.24022/1997-3187-2019-13-2-98-113
Received / Accepted: 12.12.2018/30.12.2018
Keywords: positron emission tomography combined with computed tomography 18F-fluorodeoxyglucose infectious endocarditis prosthetic valve endocarditis SUVratio
Abstract
Objective. To investigate the diagnostic value of 18F-fluorodeoxyglucose (18F-FDG) PET/CT in patients with suspected prosthetic valve endocarditis (PVE) and to compare 18F-FDG-uptake around prosthetic valves in patients with and without PVE.
Material and methods. The analysis included results of 18F-FDG PET/CT examinations performed in 30 patients with prosthetic valve – with suspected PVE (n=15) and malignance used as negative controls (n=15). PET/CT results were assessed visually and semi-quantitatively with calculation of parameters of 18F-FDG uptake intensity. All PET/CT results were confirmed according to clinical, laboratory and morphological data. 11 patients had final diagnosis of definite PVE.
Results. In patients with suspected PVE PET/CT correctly confirmed the diagnosis in 67% of cases and ruled it out – in 20%. In 2/15 cases false positive and false negative results were obtained. In negative control patients with malignancies – 1 false positive result. The sensitivity, specificity and accuracy of 18F-FDG PET/CT were 91, 89 and 90%, respectively; positive and negative predictive values – of 83 and 94%. In semiquantitative analysis both SUVmax and SUVratio in the region of PV were higher in confirmed PVE patients compared to non-PVE patients (p<0.002): median 4.3 and 3.4 vs 2.9 and 1.5. SUVmax of 3.3 and SUVratio of 1.95 were the optimal thresholds for the PVE diagnosis by PET/CT using ROC-curve analysis (AUC=0.904).
Conclusion. 18F-FDG PET/CT appears to be useful in the diagnosis of PVE – the level of 18F-FDG-uptake in the prosthetic valve area showed a good diagnostic performance. However, further studies on larger groups are needed to assess the role of 18F-FDG PET/CT in the detection of PVE.
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About Authors
- Leo A. Bockeria, Academician of Russian Academy of Sciences and Russian Academy of Medical Sciences, Director, ORCID
- Irakliy P. Aslanidis, Dr Med. Sc., Professor, Head of Department, ORCID
- Diana M. Pursanova, Cand. Med. Sc., Researcher, ORCID
- Ol’ga V. Mukhortova, Dr Med. Sc., Senior Researcher, ORCID
- Irina V. Shurupova, Dr Med. Sc., Senior Researcher, Radiologist, ORCID
- Irina V. Ekaeva, Cand. Chem. Sc., Leading Researcher, Head of Laboratory, ORCID
- Elena Z. Golukhova, Dr Med. Sc., Academician of Russian Academy of Sciences, Head of Department, ORCID
- Inga V. Tetvadze, Cand. Med. Sc., Head Physician of V.I. Bourakovsky Institute of Cardiac Surgery, ORCID
- Ravil’ M. Muratov, Dr Med. Sc., Professor, Head of Department;
- Vladimir A. Mironenko, Dr Med. Sc., Head of Department;
- Ivan I. Skopin, Dr Med. Sc., Professor, Head of Department, ORCID