Usefulness of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis of infective endocarditis in patients with adult congenital heart disease

Ayako Ishikita, Ichiro Sakamoto, Kenichiro Yamamura, Shintaro Umemoto, Hazumu Nagata, Yoshiyuki Kitamura, Yuzo Yamasaki, Hiromichi Sonoda, Hideki Tatewaki, Akira Shiose, Hiroyuki Tsutsui

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Infective endocarditis (IE) in patients with adult congenital heart disease (ACHD) remains a diagnostic challenge due to difficulties in detecting endocardial lesions by echocardiography. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/ computed tomography (PET/CT) has shown good diagnostic performance in prosthetic valve IE. This study aimed to assess its additional diagnostic value in ACHD-associated IE and to characterize its advantages. Methods and Results: Overall, 22 patients with ACHD and clinical suspicion of IE were retrospectively studied. 18F-FDG PET/CT was performed in addition to conventional assessment based on the modified Duke criteria. The final IE diagnosis was determined by an expert team during a 3-month clinical course, resulting in 18 patients diagnosed with IE. Seven patients (39%) were diagnosed with definite IE only by initial echocardiography. An 18F-FDG PET/CT assessment revealed endocardial involvement in the other 9 patients, resulting in the diagnosis of definite IE in 16 in total (88%). Right-sided endocardial lesions were more common (n=12, 67%) but rarely identified by echocardiography, whereas 18F-FDG PET/CT revealed right-sided lesions in 9 patients. A negative 18F-FDG PET/CT (n=7, 39%) assessment was associated with a native valve IE (71% vs. 0%). In 4 patients who were identified with not-IE, neither echocardiography nor 18F-FDG PET/CT detected any suspicious cardiac involvement. Conclusions: In the diagnosis of ACHD-associated IE, characterized by right-sided IE, 18F-FDG PET/CT assessment should be useful.

Original languageEnglish
Pages (from-to)1505-1513
Number of pages9
JournalCirculation Journal
Volume85
Issue number9
DOIs
Publication statusPublished - Aug 25 2021

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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