title: 18-Fluoro-2-deoxyglucose positron emission tomography-computed tomography: an additional tool in the diagnosis of prosthetic valve endocarditis.
abstract: OBJECTIVE
  To evaluate the role of 18-fluoro-2-deoxyglucose positron emission tomography-computed tomography ((18)F-FDG-PET-CT) in the diagnosis of infectious endocarditis (IE).
  
  
  METHODS
  We retrospectively examined 27 consecutive patients who were admitted to the Infectious Diseases Department of Tor Vergata University Hospital between 2009 and 2013 with a suspicion of IE. The final IE diagnosis was defined according to the modified Duke criteria, and the microbiological and diagnostic results were collected for each patient.
  
  
  RESULTS
  Twenty out of 27 patients had a suspected prosthetic valve endocarditis (PVE) and seven had a suspected native valve endocarditis (NVE). Twenty-five out of 27 patients (92%) had a confirmed diagnosis of IE (18/25 PVE and 7/25 NVE); 16 had a positive echocardiography evaluation and 16 had positive (18)F-FDG-PET-CT findings. Echocardiography showed a higher sensitivity as a diagnostic tool for the detection of IE compared to (18)F-FDG-PET-CT (80% vs. 55%). However, a greater number of PVE had positive (18)F-FDG-PET-CT results compared to those with positive echocardiography findings (11/13 vs. 9/13), and overall 89% (16/18) of confirmed PVE resulted (18)F-FDG-PET-CT positive. Analyzing only the cases who underwent transoesophageal echocardiography, (18)F-FDG-PET-CT showed a sensitivity of 85% in PVE (vs. 69% for echocardiography and 77% for the Duke criteria). All seven patients with NVE had a positive echocardiography and negative (18)F-FDG-PET-CT findings (p<0.001).
  
  
  CONCLUSIONS
  The results of this study further highlight the limitations of echocardiography in the diagnosis of PVE and the potential advantages of (18)F-FDG-PET-CT in these cases.
authors.affiliation: Clinical Infectious Diseases, Tor Vergata University, V. Montpellier 1, 00133, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ricciardi
authors.affiliation: Clinical Infectious Diseases, Tor Vergata University, V. Montpellier 1, 00133, Rome, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Sordillo
authors.affiliation: Clinical Infectious Diseases, Tor Vergata University, V. Montpellier 1, 00133, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Ceccarelli
authors.affiliation: Clinical Infectious Diseases, Tor Vergata University, V. Montpellier 1, 00133, Rome, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Maffongelli
authors.affiliation: Department of Virology, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Calisti
authors.affiliation: Department of Biopathology and Diagnostic Imaging, Tor Vergata University, Rome, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Di Pietro
authors.affiliation: Department of Biopathology and Diagnostic Imaging, Tor Vergata University, Rome, Italy.
authors.forename: Cristiana Ragano
authors.initials: CR
authors.lastname: Caracciolo
authors.affiliation: Department of Biopathology and Diagnostic Imaging, Tor Vergata University, Rome, Italy.
authors.forename: Orazio
authors.initials: O
authors.lastname: Schillaci
authors.affiliation: Cardiac Surgery Unit, Tor Vergata University, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pellegrino
authors.affiliation: Cardiac Surgery Unit, Tor Vergata University, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Chiariello
authors.affiliation: Clinical Infectious Diseases, Tor Vergata University, V. Montpellier 1, 00133, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Andreoni
authors.affiliation: Clinical Infectious Diseases, Tor Vergata University, V. Montpellier 1, 00133, Rome, Italy. Electronic address: sarmati@med.uniroma2.it.
authors.forename: Loredana
authors.initials: L
authors.lastname: Sarmati
mesh_terms: D000328:Adult; D000368:Aged; D004696:Endocarditis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000382:microbiology*; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: (18)F-FDG-PET–CT; Cardiac imaging; Echocardiography; Infective endocarditis; Prosthetic valve endocarditis