Register
Forgot your password?

18F-fluorodeoxyglucose positron emission tomographycombined with computed tomography in prostheticvalve endocarditis. Initial results

Authors: 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.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

For correspondence:  Sign in or register.

Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2019-13-2-98-113

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

Full text:  

 

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.

References

  1. Clinical recommendations of the Ministry ofHealth of the Russian Federation. Infective endo-carditis. 2016. Available at https://racvs.ru/clinic/files/2016/infective-endocarditis.pdf.
  2. Bockeria L.A., Milievskaya E.B., Kudzoeva Z.F.,Pryanishnikov V.V. Cardiovascular Surgery – 2017.Diseases and congenital anomalies of circulatorysystem. Moscow; 2016 (in Russ.)
  3. Zheltovskiy Yu.V., Grigor'ev E.G. Psothetic valveinfective endocarditis. Siberian Medical Journal(Irkutsk).2014; 129 (6): 138–44 (in Russ.).
  4. Habib G., Lancellotti P., Antunes M.J., Bongiorni M.G., Casalta J.P., Del Zotti F. et al. ESC Scientific Document Group. 2015. ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur. Heart J. 2015; 36: 3075–128. DOI: 10.1093/eurheartj/ehv319
  5. Nikolaevskiy E.N., Sukhova E.V. Infectious endo-carditis as an actual problem of modern Russiancardiology. Innovatsionnaya Nauka (InnovationScience). 2016; 12 (4): 178–80 (in Russ.).
  6. Li J.S., Sexton D.J., Mick N., Nettles R., Fowler V.G., Jr., Ryan T. et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin. Infect. Dis. 2000; 30: 633–8. DOI: 10.1086/313753
  7. Aslanidi I.P., Manukova V.A., Mukhortova O.V.,Katunina T.A., Rudas M.S., Pozharov I.V., Novi-kov P.I., Meshkov A.D. 18F-fluorodeoxyglucosepositron emission tomography in monitoring oftherapy effectiveness in large vessel vasculitides.Bulletin of Bakoulev Center for CardiovascularDiseases. 2017; 18 (4): 380–90 (in Russ.).
  8. Ricciardi A., Sordillo P., Ceccarelli L., Maffongelli G., Calisti G., Di Pietro B. et al. 18-Fluoro-2- deoxyglucose positron emission tomography-computed tomography: an additional tool in the diagnosis of prosthetic valve endocarditis. Int. J. Infect. Dis. 2014; 28: 219–24. DOI: 10.1016/j.ijid.2014.04.028
  9. Rouzet F., Chequer R., Benali K., Lepage L., Ghodbane W., Duval X. et al. Respective performance of 18F-FDG PET and radiolabeled leukocyte scintigraphy for the diagnosis of prosthetic valve endocarditis. J. Nucl. Med. 2014; 55 (12): 1980–5. DOI: 10.2967/jnumed.114.141895
  10. Saby L., Laas O., Habib G., Cammilleri S., Mancini J., Tessonnier L. et al. Positron emission tomography/computed tomography for diagnosis of prosthetic valve endocarditis: increased valvular 18F-fluorodeoxyglucose uptake as a novel major criterion. J. Am. Coll. Cardiol. 2013; 61 (23): 2374–82. DOI: 10.1016/j.jacc.2013.01.092
  11. Pizzi M.N., Roque A., Fernandez-Hidalgo N., Cuellar-Calabria H., Ferreira-Gonzalez I., Gonzalez- Alujas M.T. et al. Improving the diagnosis of infective endocarditis in prosthetic valves and intracardiac devices with 18F-FDG-PET/CTangiography: initial results at an infective endocarditis referral center. Circulation. 2015; 132 (12): 1113–26. DOI: 10.1161/circulationaha.115.015316
  12. Mahmood M., Kendi A.T., Ajmal S., Farid S., O'Horo J.C., Chareonthaitawee P. et al. Metaanalysis of 18F-FDG PET/CT in the diagnosis of infective endocarditis. J. Nucl. Cardiol. 2019; 26 (3): 922–35. DOI: 10.1007/s12350-017-1092-8
  13. Fagman E., van Essen M., Freden Lindqvist J., Snygg-Martin U., Bech-Hanssen O., Svensson G. 18F-FDG PET/CT in the diagnosis of prosthetic valve endocarditis. Int. J. Cardiovasc. Imaging. 2015; 32: 679–86. DOI: 10.1007/s10554-015-0814-8
  14. Swart L.E., Gomes A., Scholtens A.M., Sinha B., Tanis W., Lam M.G. et al. Improving the diagnostic performance of 18F-fluorodeoxyglucose positron- emission tomography/computed tomography in prosthetic heart valve endocarditis. Circulation. 2018; 138 (14): 1412–27. DOI: 10.1161/CIRCULATIONAHA.118.035032
  15. Mathieu C., Mikail N., Benali K., Iung B., Duval X., Nataf P. et al. Characterization of 18F-fluorodeoxyglucose uptake pattern in noninfected prosthetic heart valves. Circ. Cardiovasc. Imaging. 2017; 10: e005585. DOI: 10.1161/CIRCIMAGING.116.005585
  16. Salomäki S.P., Saraste A., Kemppainen J., Bax J.J., Knuuti J., Nuutila P. et al. 18F-FDG positron emission tomography/computed tomography in infective endocarditis. J. Nucl. Cardiol. 2017; 24 (1): 195–206. DOI: 10.1007/s12350-015-0325-y
  17. Adams M.C., Turkington T.G., Wilson J.M., Wong T.Z. A systematic review of the factors affecting accuracy of SUV measurements. Am. J. Roentgenol. 2010; 195 (2): 310–20. DOI: 10.2214/AJR.10.4923

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

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Sort by