Saby L., Laas O., Habib G., Cammilleri S., Mancini J., Tessonnier L., Casalta J. P., Gouriet F., Riberi A., Avierinos J. F., Collart F., Mundler O., Raoult Didier, Thuny F. (2013). Positron emission tomography/computed tomography for diagnosis of prosthetic valve endocarditis. Journal of the American College of Cardiology, 61 (23), p. 2374-2382. ISSN 0735-1097.
Titre du document
Positron emission tomography/computed tomography for diagnosis of prosthetic valve endocarditis
Année de publication
2013
Auteurs
Saby L., Laas O., Habib G., Cammilleri S., Mancini J., Tessonnier L., Casalta J. P., Gouriet F., Riberi A., Avierinos J. F., Collart F., Mundler O., Raoult Didier, Thuny F.
Source
Journal of the American College of Cardiology, 2013,
61 (23), p. 2374-2382 ISSN 0735-1097
Objectives This study sought to determine the value of F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for diagnosing prosthetic valve endocarditis (PVE). Background The diagnosis of PVE remains challenging. In PVE cases, initial echocardiography is normal or inconclusive in almost 30%, leading to a decreased diagnostic accuracy for the modified Duke criteria. Methods We prospectively studied 72 consecutive patients suspected of having PVE. All of the patients were subjected to clinical, microbiological, and echocardiographic evaluation. Cardiac PET/CT was performed at admission. The final diagnosis was defined according to the clinical and/or pathological modified Duke criteria determined during a 3-month follow-up. Results Thirty-six patients (50%) exhibited abnormal FDG uptake around the site of the prosthetic valve. The sensitivity, specificity, positive predictive value, negative predictive value, and global accuracy were as follows (95% confidence interval): 73% (54% to 87%), 80% (56% to 93%), 85% (64% to 95%), 67% (45% to 84%), and 76% (63% to 86%), respectively. Adding abnormal FDG uptake around the prosthetic valve as a new major criterion significantly increased the sensitivity of the modified Duke criteria at admission (70% [52% to 83%] vs. 97% [83% to 99%], p = 0.008). This result was due to a significant reduction (p < 0.0001) in the number of possible PVE cases from 40 (56%) to 23 (32%). Conclusions The use of F-18-FDG PET/CT was helpful for diagnosing PVE. The results of this study support the addition of abnormal FDG uptake as a novel major criterion for PVE.
Plan de classement
Santé : généralités [050]
Identifiant IRD
PAR00010626
