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Multicenter Study
. 2022 Feb;15(2):299-308.
doi: 10.1016/j.jcmg.2021.07.015. Epub 2021 Sep 15.

Diagnostic Value of 18F-Fluorodeoxyglucose Positron Emission Tomography Computed Tomography in Prosthetic Pulmonary Valve Infective Endocarditis

Maëlys Venet  1 , Zakaria Jalal  2 , Reaksmei Ly  3 , Sophie Malekzadeh-Milani  3 , Sebastien Hascoët  4 , Emmanuelle Fournier  4 , Caroline Ovaert  5 , Anne Claire Casalta  5 , Clément Karsenty  6 , Alban Elouen Baruteau  7 , Laurianne Le Gloan  7 , Maëlle Selegny  8 , Stéphanie Douchin  9 , Hélène Bouvaist  10 , Yaniss Belaroussi  11 , Fabrice Camou  12 , Ghoufrane Tlili  13 , Jean-Benoît Thambo  2
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Free article
Multicenter Study

Diagnostic Value of 18F-Fluorodeoxyglucose Positron Emission Tomography Computed Tomography in Prosthetic Pulmonary Valve Infective Endocarditis

Maëlys Venet et al. JACC Cardiovasc Imaging. 2022 Feb.
Free article

Abstract

Objectives: The aim of this study was to assess the diagnostic performances of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) in congenital heart disease (CHD) patients with pulmonary prosthetic valve or conduit endocarditis (PPVE) suspicion.

Background: PPVE is a major issue in the growing CHD population. Diagnosis is challenging, and usual imaging tools are not always efficient or validated in this specific population. Particularly, the diagnostic yield of 18F-FDG PET/CT remains poorly studied in PPVE.

Methods: A retrospective multicenter study was conducted in 8 French tertiary centers. Children and adult CHD patients who underwent 18F-FDG PET/CT in the setting of PPVE suspicion between January 2010 and May 2020 were included. The cases were initially classified as definite, possible, or rejected PPVE regarding the modified Duke criteria and finally by the Endocarditis Team consensus. The result of 18F-FDG PET/CT had been compared with final diagnosis consensus used as gold-standard in our study.

Results: A total of 66 cases of PPVE suspicion involving 59 patients (median age 23 years, 73% men) were included. Sensitivity, specificity, positive predictive value, and negative predictive value of 18F-FDG PET/CT in PPVE suspicion were respectively: 79.1% (95% CI: 68.4%-91.4%), 72.7% (95% CI: 60.4%-85.0%), 91.9% (95% CI: 79.6%-100.0%), and 47.1% (95% CI: 34.8%-59.4%). 18F-FDG PET/CT findings would help to correctly reclassify 57% (4 of 7) of possible PPVE to definite PPVE.

Conclusions: Using 18F-FDG PET/CT improves the diagnostic accuracy of the Duke criteria in CHD patients with suspected PPVE. Its high positive predictive value could be helpful in routine to shorten diagnosis and treatment delays and improve clinical outcomes.

Keywords: (18)F-FDG PET/CT; congenital heart disease; infective endocarditis; pulmonary valve.

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Conflict of interest statement

Funding Support and Author Disclosures Drs Venet, Jalal, and Thambo were supported by the French Government as part of the “Investments of the future” program managed by the National Research Agency (grant reference ANR-10-IAHU-04). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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