18F-FDG-PET/CT Angiography for the Diagnosis of Infective Endocarditis

Curr Cardiol Rep. 2017 Feb;19(2):15. doi: 10.1007/s11886-017-0824-3.

Abstract

Purpose of review: This article reviews the current imaging role of 18F-fluordeoxyglucose positron emission computed tomography (18F-FDG-PET/CT) combined with cardiac CT angiography (CTA) in infective endocarditis and discusses the strengths and limitations of this technique.

Recent findings: The diagnosis of infective endocarditis affecting prosthetic valves and intracardiac devices is challenging because echocardiography and, therefore, the modified Duke criteria have well-recognized limitations in this clinical scenario. The high sensitivity of 18F-FDG-PET/CT for the detection of infection associated with the accurate definition of structural damage by gated cardiac CTA in a combined technique (PET/CTA) has provided a significant increase in diagnostic sensitivity for the detection of IE. PET/CTA has proven to be a useful diagnostic tool in patients with suspected infective endocarditis. The additional information provided by this technique improves diagnostic performance in prosthetic valve endocarditis when it is used in combination with the Duke criteria. The findings obtained in PET/CTA studies have been included as a major criterion in the recently updated diagnostic algorithm in infective endocarditis guidelines.

Keywords: 18F–FDG-PET/CT; Cardiac computed tomography; Cardiac devices; Infective endocarditis; Prosthetic valves.

Publication types

  • Review

MeSH terms

  • Computed Tomography Angiography
  • Diagnosis, Differential
  • Endocarditis / diagnostic imaging*
  • Endocarditis / etiology
  • Fluorodeoxyglucose F18
  • Heart Valve Prosthesis / adverse effects
  • Humans
  • Positron Emission Tomography Computed Tomography*
  • Prosthesis-Related Infections / diagnostic imaging*
  • Radiopharmaceuticals

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18