6533b85cfe1ef96bd12bcb13
RESEARCH PRODUCT
Impact of systematic whole-body 18F-fluorodeoxyglucose PET/CT on the management of patients suspected of infective endocarditis: the prospective multicenter TEPvENDO study
Duval XavierLe Moing VincentTubiana SarahEsposito-farèse MarinaIlic-habensus EmilaLeclercq FlorenceBourdon AurélieGoehringer FrançoisSelton-suty ChristineChevalier ElodieBoutoille DavidPiriou NicolasLe Tourneau ThierryChirouze CatherineSeronde Marie-franceMorel OlivierPiroth LionelEicher Jean-christopheHumbert OlivierRevest MatthieuThébault EliseDevillers AnneDelahaye FrançoisBoibieux AndréGrégoire BastienHoen BrunoLaouenan CédricBernard IungRouzet FrançoisRogier Ophéliesubject
Microbiology (medical)medicine.medical_specialty[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging18F-FDG-PET/CT030204 cardiovascular system & hematologyTertiary careDuke criteriaFluorodeoxyglucose PET03 medical and health sciences0302 clinical medicine[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular systemFluorodeoxyglucose F18[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseasesPositron Emission Tomography Computed Tomographydiagnostic impactmedicineHumans030212 general & internal medicineProspective Studiespatient managementProsthetic valveEndocarditisbusiness.industryinfective endocarditismedicine.diseaseDiagnostic classification3. Good health[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular systemInfectious Diseases[SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/ImagingNative valveInfective endocarditisHeart Valve Prosthesis[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseasesRadiologyRadiopharmaceuticalsWhole bodybusinessdescription
AbstractBackgroundDiagnostic and patients’ management modifications induced by whole-body 18F-FDG-PET/CT had not been evaluated so far in prosthetic valve (PV) or native valve (NV) infective endocarditis (IE)-suspected patients.MethodsIn sum, 140 consecutive patients in 8 tertiary care hospitals underwent 18F-FDG-PET/CT. ESC-2015-modified Duke criteria and patients’ management plan were established jointly by 2 experts before 18F-FDG-PET/CT. The same experts reestablished Duke classification and patients’ management plan immediately after qualitative interpretation of 18F-FDG-PET/CT. A 6-month final Duke classification was established.ResultsAmong the 70 PV and 70 NV patients, 34 and 46 were classified as definite IE before 18F-FDG-PET/CT. Abnormal perivalvular 18F-FDG uptake was recorded in 67.2% PV and 24.3% NV patients respectively (P < .001) and extracardiac uptake in 44.3% PV and 51.4% NV patients. IE classification was modified in 24.3% and 5.7% patients (P = .005) (net reclassification index 20% and 4.3%). Patients’ managements were modified in 21.4% PV and 31.4% NV patients (P = .25). It was mainly due to perivalvular uptake in PV patients and to extra-cardiac uptake in NV patients and consisted in surgery plan modifications in 7 patients, antibiotic plan modifications in 22 patients and both in 5 patients. Altogether, 18F-FDG-PET/CT modified classification and/or care in 40% of the patients (95% confidence interval: 32–48), which was most likely to occur in those with a noncontributing echocardiography (P < .001) or IE classified as possible at baseline (P = .04), while there was no difference between NV and PV.ConclusionsSystematic 18F-FDG-PET/CT did significantly and appropriately impact diagnostic classification and/or IE management in PV and NV-IE suspected patients.Clinical Trials RegistrationNCT02287792.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-08-02 |