18F-fluorodeoxyglucose positron-emission tomography combined with computed tomography as a diagnostic tool in native valve endocarditis

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Title:	18F-fluorodeoxyglucose positron-emission tomography combined with computed tomography as a diagnostic tool in native valve endocarditis
Author(s):	Kouijzer, I.J.E. ; Berrevoets, M.A.H.; Aarntzen, E.H.J.G. ; Vries, J. de; Dijk, A.P.J. van ; Oyen, W.J.G. ; Geus-Oei, L.F. de ; Bleeker-Rovers, C.P.
Publication year:	2018
Source:	Nuclear Medicine Communications, vol. 39, iss. 8, (2018), pp. 747-752
ISSN:	0143-3636
Related links:	https://www.ncbi.nlm.nih.gov/pubmed/29762262
DOI:	https://doi.org/10.1097/MNM.0000000000000864
Publication type:	Article / Letter to editor
Please use this identifier to cite or link to this item : http://hdl.handle.net/2066/196054
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Subject:	Radboudumc 16: Vascular damage RIHS: Radboud Institute for Health Sciences Radboudumc 17: Women's cancers RIHS: Radboud Institute for Health Sciences Radboudumc 4: lnfectious Diseases and Global Health RIHS: Radboud Institute for Health Sciences Radboudumc 4: lnfectious Diseases and Global Health RIMLS: Radboud Institute for Molecular Life Sciences Radboudumc 9: Rare cancers RIMLS: Radboud Institute for Molecular Life Sciences
Organization:	Internal Medicine Radiology & Nuclear Medicine Medical Microbiology Cardiology
Journal title:	Nuclear Medicine Communications
Volume:	vol. 39
Issue:	iss. 8
Page start:	p. 747
Page end:	p. 752
Abstract:	OBJECTIVE: The aim of the study was to investigate the value of F-fluorodeoxyglucose positron-emission tomography combined with computed tomography (F-FDG-PET/CT) in diagnosing native valve endocarditis (NVE). PATIENTS AND METHODS: All patients with bacteremia and suspicion of NVE between January 2013 and June 2016 were identified from the hospitals' register and retrospectively included if echocardiography and F-FDG-PET/CT were performed within 14 days. F-FDG-PET/CT scans were scored independently by two nuclear medicine physicians. F-FDG-PET/CT was compared with the modified-Duke criteria and a multidisciplinary consensus. RESULTS: A total of 88 patients were included. In 10 patients with definite NVE according to the modified-Duke criteria, three (30.0%) patients had increased F-FDG uptake in or around the heart valves and seven (70.0%) patients had no increased F-FDG uptake. In patients without definite NVE according to the modified-Duke criteria, 89.7% (70/78) of the patients had no increased F-FDG uptake in or around the heart valves. Of all 20 patients with NVE according to multidisciplinary consensus, nine (45.0%) patients had increased F-FDG uptake in or around the heart valves and 11 (55.0%) patients had a normal F-FDG-PET/CT result. CONCLUSION: A negative F-FDG-PET/CT result should not be interpreted as an exclusion of NVE. In patients with possible or rejected NVE according to the modified-Duke criteria, F-FDG-PET/CT could be used in case of sustained suspicion of NVE owing to its high specificity in case of abnormal FDG uptake at the valve region. F-FDG-PET/CT is important for detecting metastatic infection which already warrants the need to perform F-FDG-PET/CT in all patients with suspected NVE.