title: ¹⁸F-FDG PET/CT diagnosis of unexpected extracardiac septic embolisms in patients with suspected cardiac endocarditis.
abstract: OBJECTIVE
  Acute infective endocarditis is a potentially life-threatening disease. Its outcome strongly depends on systemic embolization and extracardiac infections. When present, these conditions usually lead to a more aggressive therapeutic approach. However, the diagnosis of peripheral septic embolism is very challenging. (18)F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has proven to be accurate for the detection of inflammatory diseases and occult infections. The aim of this study was to assess the added value of (18)F-FDG PET/CT in the detection of extracardiac embolisms in the evaluation of patients with suspected valvular endocarditis (VE).
  
  
  METHODS
  Seventy-one patients with suspected infective endocarditis, enrolled between June 2010 and December 2012, underwent (18)F-FDG PET/CT with the standard procedure on a dedicated PET/CT scanner. Extracardiac findings were subsequently evaluated with other imaging procedures.
  
  
  RESULTS
  Of the 71 patients with suspicion of infective endocarditis, we found unexpected extracardiac findings in 17 patients (24%) without any clinical suspicion. Extracardiac findings were subsequently evaluated with other imaging procedures.
  
  
  CONCLUSIONS
  PET/CT detected unexpected extra sites of infection in 24% of cases, leading to changes in therapeutic management in a very relevant percentage of patients. These findings may have important therapeutic implications.
authors: Nuclear Medicine, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy.
authors: Rachele
authors: R
authors: Bonfiglioli
authors: Cristina
authors: C
authors: Nanni
authors: Joshua James
authors: JJ
authors: Morigi
authors: Maddalena
authors: M
authors: Graziosi
authors: Filippo
authors: F
authors: Trapani
authors: Michele
authors: M
authors: Bartoletti
authors: Fabio
authors: F
authors: Tumietto
authors: Valentina
authors: V
authors: Ambrosini
authors: Alice
authors: A
authors: Ferretti
authors: Domenico
authors: D
authors: Rubello
authors: Claudio
authors: C
authors: Rapezzi
authors: Pier Luigi
authors: PL
authors: Viale
authors: Stefano
authors: S
authors: Fanti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004617:Embolism / Q000175:diagnosis*; D004697:Endocarditis, Bacterial / Q000175:diagnosis*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D018805:Sepsis / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18
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