title: (18)F-FDG PET/CT for early detection of embolism and metastatic infection in patients with infective endocarditis.
abstract: 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.
authors.affiliation: Department of Nuclear Medicine, University Hospital KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
authors.forename: Jelle
authors.initials: J
authors.lastname: Van Riet
authors.forename: Evelyn E
authors.initials: EE
authors.lastname: Hill
authors.forename: Olivier
authors.initials: O
authors.lastname: Gheysens
authors.forename: Steven
authors.initials: S
authors.lastname: Dymarkowski
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Herregods
authors.forename: Paul
authors.initials: P
authors.lastname: Herijgers
authors.forename: Willy E
authors.initials: WE
authors.lastname: Peetermans
authors.forename: Luc
authors.initials: L
authors.lastname: Mortelmans
mesh_terms: 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
chemical_list: D019788:Fluorodeoxyglucose F18