(18)F-FDG PET/CT for early detection of embolism and metastatic infection in patients with infective endocarditis.
OBJECTIVE
In the acute setting of endocarditis it is very important to assess both the vegetation itself, as well as potential life-threatening complications, in order to decide whether antibiotic therapy will be sufficient or urgent surgery is indicated. A single whole-body scan investigating inflammatory changes could be very helpful to achieve a swift and efficient assessment.


METHODS
In this study we assessed whether (18)F-FDG can be used to detect and localize peripheral embolism or distant infection. Twenty-four patients with 25 episodes of endocarditis, enrolled between March 2006 and February 2008, underwent (18)F-FDG PET/CT imaging on a dedicated PET/CT scanner.


RESULTS
PET/CT imaging revealed a focus of peripheral embolization and/or metastatic infection in 11 episodes (44%). One episode had a positive PET/CT scan result for both embolism and metastatic infection. PET/CT detected seven positive cases (28%) in which there was no clinical suspicion. Valve involvement of endocarditis was seen only in three patients (12%).


CONCLUSIONS
PET/CT may be an important diagnostic tool for tracing peripheral embolism and metastatic infection in the acute setting of infective endocarditis, since a PET/CT scan detected a clinically occult focus in nearly one third of episodes.
Van Riet
Jelle
J
Department of Nuclear Medicine, University Hospital KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
Hill
Evelyn E
EE
Gheysens
Olivier
O
Dymarkowski
Steven
S
Herregods
Marie-Christine
MC
Herijgers
Paul
P
Peetermans
Willy E
WE
Mortelmans
Luc
L
D000038:Abscess / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D000368:Aged; D042241:Early Diagnosis; D004617:Embolism / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004696:Endocarditis / Q000150:complications*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007239:Infections / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18