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Dual-time-point FDG PET/CT imaging in prosthetic heart valve endocarditis

Authors
  • Scholtens, A. M.
  • Swart, L. E.
  • Verberne, H. J.
  • Budde, R. P. J.
  • Lam, M. G. E. H.
Type
Published Article
Journal
Journal of Nuclear Cardiology
Publisher
Springer-Verlag
Publication Date
May 04, 2017
Volume
25
Issue
6
Pages
1960–1967
Identifiers
DOI: 10.1007/s12350-017-0902-3
Source
Springer Nature
Keywords
License
Green

Abstract

PurposeFDG PET/CT has been of increasing interest in the diagnostic workup of prosthetic heart valve endocarditis (PVE). Some reports advocate later imaging time points to improve the diagnostic accuracy for PVE. In this study, we compared standard and late FDG PET/CT images in patients with a clinical suspicion of PVE.Materials and MethodsFourteen scans in 13 patients referred for FDG PET/CT for suspicion of PVE performed at standard (60 min post injection) and late (150 min post injection) time points were scored based on visual interpretation and semi-quantitatively with SUVmax and target-to-background ratio (TBR, defined as [SUVmax valve/SUVmean blood pool]). Final diagnosis was based on surgical findings in all cases of infection (n = 6) and unremarkable follow-up in all others (n = 8).ResultsLate images were more prone to false positive interpretation for both visual and semi-quantitative analyses. Visual analysis of the standard images yielded 1 false negative and 1 false positive result. On the late images, no scans were false negative but 5 scans were false positive.ConclusionLate FDG PET/CT imaging for PVE seems prone to false positive results. Therefore, late imaging should be interpreted with caution.

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