title: 18F-FDG positron emission tomography/computed tomography in infective endocarditis.
abstract: The diagnosis of infective endocarditis (IE), especially the diagnosis of prosthetic valve endocarditis (PVE) is challenging since echocardiographic findings are often scarce in the early phase of the disease. We studied the use of 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in IE.
  
  
  
  Sixteen patients with suspected PVE and 7 patients with NVE underwent visual evaluation of18F-FDG-PET/CT.18F-FDG uptake was measured also semiquantitatively as maximum standardized uptake value (SUVmax) and target-to-background ratio (TBR). The modified Duke criteria were used as a reference.
  
  
  
  There was strong, focal18F-FDG uptake in the area of the affected valve in all 6 cases of definite PVE, in 3 of 5 possible PVE cases, and in 2 of 5 rejected cases. In all patients with definite PVE, SUVmaxof the affected valve was higher than 4 and TBR higher than 1.8. In contrast to PVE, only 1 of 7 patients with NVE had uptake of18F-FDG by PET/CT in the valve area. Embolic infectious foci were detected in 58% of the patients with definite IE.
  
  
  
  18F-FDG-PET/CT appears to be a sensitive method for the detection of paravalvular infection associated with PVE. Instead, the sensitivity of PET/CT is limited in NVE.
authors.affiliation: Division of Medicine, University of Turku and Turku University Hospital, P.O. Box 52, 20521, Turku, Finland.
authors.forename: Soile Pauliina
authors.initials: SP
authors.lastname: Salomäki
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.|Heart Center, University of Turku and Turku University Hospital, Turku, Finland.|Faculty of Medicine, Department of Clinical Medicine, University of Turku, Turku, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Saraste
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.|Department of Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Jukka
authors.initials: J
authors.lastname: Kemppainen
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Juhani
authors.initials: J
authors.lastname: Knuuti
authors.affiliation: Division of Medicine, University of Turku and Turku University Hospital, P.O. Box 52, 20521, Turku, Finland.|Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.|Faculty of Medicine, Department of Clinical Medicine, University of Turku, Turku, Finland.
authors.forename: Pirjo
authors.initials: P
authors.lastname: Nuutila
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.|Department of Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Marko
authors.initials: M
authors.lastname: Seppänen
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Roivainen
authors.affiliation: Heart Center, University of Turku and Turku University Hospital, Turku, Finland.|Faculty of Medicine, Department of Clinical Medicine, University of Turku, Turku, Finland.
authors.forename: Juhani
authors.initials: J
authors.lastname: Airaksinen
authors.affiliation: Division of Medicine, University of Turku and Turku University Hospital, P.O. Box 52, 20521, Turku, Finland.
authors.forename: Laura
authors.initials: L
authors.lastname: Pirilä
authors.affiliation: Division of Medicine, University of Turku and Turku University Hospital, P.O. Box 52, 20521, Turku, Finland.|Faculty of Medicine, Department of Clinical Medicine, University of Turku, Turku, Finland.
authors.forename: Jarmo
authors.initials: J
authors.lastname: Oksi
authors.affiliation: Division of Medicine, University of Turku and Turku University Hospital, P.O. Box 52, 20521, Turku, Finland. ulla.hohenthal@tyks.fi.
authors.forename: Ulla
authors.initials: U
authors.lastname: Hohenthal
mesh_terms: D000368:Aged; D004696:Endocarditis / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging* / Q000209:etiology; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-fluorodeoxyglucose; Infective endocarditis; echocardiography; positron emission tomography; prosthetic valve endocarditis