title: The role of FDG-PET/CT imaging in early detection of extra-cardiac complications of infective endocarditis.
abstract: The exact incidence of extra-cardiac complications (ECC) in patients with infective endocarditis (IE) is unknown but presumed to be high. These patients, although mostly asymptomatic, may require a more aggressive therapeutic approach. (18)fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used for the diagnosis of infections, but its role in the early diagnosis of IE complications is still unclear. This study aimed to evaluate the role of FDG-PET/CT in the early diagnosis of ECC in IE and its implications for medical management. We prospectively studied 40 consecutive patients with a confirmed diagnosis of IE (according to the modified Duke criteria) who underwent a whole body FDG-PET/CT study within 14 days from diagnosis. The FDG-PET/CT demonstrated ECC in 17 (42.5%) patients, while 8 (38.1%) of them were asymptomatic. The most frequent embolic sites were musculoskeletal and splenic. Owing to the FDG-PET/CT findings, treatment planning was modified in 14 (35%) patients. This included antibiotic treatment prolongation (27.5%), referral to surgical procedures (15%) and, most substantially, prevention of unnecessary device extraction (17.7%). According to our experiences, FDG-PET/CT imaging was useful in the detection of embolic and metastatic infections in IE. This clinical information had a significant diagnostic and therapeutic impact in managing IE disease.
authors: Cardiology Department, Rabin Medical Centre, Petach Tikva, Israel; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: katiaorvin@gmail.com.
authors: K
authors: K
authors: Orvin
authors: The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Infectious Disease Unit, Rabin Medical Centre, Petach Tikva, Israel.
authors: E
authors: E
authors: Goldberg
authors: The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Nuclear Medicine Department, Rabin Medical Centre, Petach Tikva, Israel.
authors: H
authors: H
authors: Bernstine
authors: The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Nuclear Medicine Department, Rabin Medical Centre, Petach Tikva, Israel.
authors: D
authors: D
authors: Groshar
authors: Cardiology Department, Rabin Medical Centre, Petach Tikva, Israel; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: A
authors: A
authors: Sagie
authors: Cardiology Department, Rabin Medical Centre, Petach Tikva, Israel; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: R
authors: R
authors: Kornowski
authors: The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Infectious Disease Unit, Rabin Medical Centre, Petach Tikva, Israel.
authors: J
authors: J
authors: Bishara
mesh_terms: D000328:Adult; D000368:Aged; D004696:Endocarditis / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D013923:Thromboembolism / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: (18)fluorodeoxyglucose–positron emission tomography/computed tomography; complications; embolic events; endocarditis; extra-cardiac