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The valve uptake index: a new measure in [18F]FDG PET/CT for the diagnosis of prosthetic valve endocarditis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Diagnosis of PVE by PET/CTA is based on visual and quantitative evaluation of morpho-metabolic features. The FDG uptake pattern is a main diagnostic criterion, but can be visually unclear and susceptible to subjectivity. The valve uptake index (VUI) is a new measure designed to provide a more objective indication of the distribution of metabolic activity.
Purpose
To validate the diagnostic accuracy of the valve uptake index (VUI) (SUVmax-SUVmean)/SUVmax, in patients with suspicion of prosthetic valve endocarditis (PVE). To establish a cut-off value that allows diagnosis of infection. Finally, to determine the incremental value of adding the VUI to the classic parameters for the diagnostis of PVE by PET/CT.
Methods
Retrospective analysis of 122 patients, with a conclusive diagnosis of definite or rejected PVE and who had undergone a cardiac PET/CTA scan. We measured the VUI and recorded the SUVmax, SUVratio, uptake pattern and the presence of endocarditis-related anatomic lesions. The diagnostic accuracy of these parameters was calculated.
Results
The VUI values were 0.54±0.1 vs. 0.36±0.08 in the definite PVE group vs. the rejected group, respectively (mean±SD; p<0.001). A cut-off value of VUI>0.45 showed a sensitivity, specificity and diagnostic accuracy for PVE of 85%, 90.3% and 87.4%, and significantly increased diagnostic ability for confirming endocarditis when combined with the standard diagnostic criteria.
Conclusions
The VUI had good diagnostic accuracy for PVE. The diagnostic power of currently used morphometabolic parametersis significantly increased by the addition of the VUI. Integration of the VUI in the diagnostic algorithm may clarify doubtful cases, and improve the diagnostic yield of PET/CTA.
Funding Acknowledgement
Type of funding sources: None.
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194Initial assessment of the clinical impact and confirmation of the diagnostic ability of the 18F-FDG-PET/CTA prosthetic valve endocarditis. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez144.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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3118F-FDG-PET/CTA of prosthetic heart valves: Postsurgical inflammatory patterns and its temporal evolution. Can we question the 3-month limit of the current guidelines? Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez142.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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P2472The association between vegetation size and surgical treatment on 6-month mortality in left-sided infective endocarditis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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524918F-FDG-PET/CTA of prosthetic cardiac valves: postsurgical inflammatory patterns and its temporal evolution. Can we question the 3-month limit of the current guidelines? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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P2274First assessment of the clinical impact and confirmation of the diagnostic ability of the 18F-FDG-PET/CTA prosthetic valve endocarditis. New data supports initial results. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Moderated Poster Session 2: Sunday 3 May 2015, 15:30-16:30 * Room: Moderated Poster Area. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Effectiveness of Antibiotic-Lock Therapy for Long-term Catheter-Related Bacteremia Due to Gram-Negative Bacilli: A Prospective Observational Study. Clin Infect Dis 2011; 53:e129-32. [DOI: 10.1093/cid/cir551] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Internal and external validation of a model to predict adverse outcomes in patients with left-sided infective endocarditis. Heart 2011; 97:1138-42. [DOI: 10.1136/hrt.2010.200295] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Evaluation of linezolid, vancomycin, gentamicin and ciprofloxacin in a rabbit model of antibiotic-lock technique for Staphylococcus aureus catheter-related infection. J Antimicrob Chemother 2010; 65:525-30. [DOI: 10.1093/jac/dkp499] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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