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Impact of systematic whole-body 18F-fluorodeoxyglucose PET/CT on the management of patients suspected of infective endocarditis: the prospective multicenter TEPvENDO study
- Source :
- Clinical Infectious Diseases, Clinical Infectious Diseases, Oxford University Press (OUP), 2021, 73 (3), pp.393-403. ⟨10.1093/cid/ciaa666⟩, Clinical Infectious Diseases, 2021, 73 (3), pp.393-403. ⟨10.1093/cid/ciaa666⟩
- Publication Year :
- 2021
- Publisher :
- HAL CCSD, 2021.
-
Abstract
- BackgroundDiagnostic 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.
- Subjects :
- Microbiology (medical)
medicine.medical_specialty
[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging
18F-FDG-PET/CT
030204 cardiovascular system & hematology
Tertiary care
Duke criteria
Fluorodeoxyglucose PET
03 medical and health sciences
0302 clinical medicine
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Fluorodeoxyglucose F18
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Positron Emission Tomography Computed Tomography
diagnostic impact
medicine
Humans
030212 general & internal medicine
Prospective Studies
patient management
Prosthetic valve
Endocarditis
business.industry
infective endocarditis
medicine.disease
Diagnostic classification
3. Good health
[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Infectious Diseases
[SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging
Native valve
Infective endocarditis
Heart Valve Prosthesis
[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Radiology
Radiopharmaceuticals
Whole body
business
Subjects
Details
- Language :
- English
- ISSN :
- 10584838 and 15376591
- Database :
- OpenAIRE
- Journal :
- Clinical Infectious Diseases, Clinical Infectious Diseases, Oxford University Press (OUP), 2021, 73 (3), pp.393-403. ⟨10.1093/cid/ciaa666⟩, Clinical Infectious Diseases, 2021, 73 (3), pp.393-403. ⟨10.1093/cid/ciaa666⟩
- Accession number :
- edsair.doi.dedup.....aec2a824d2846e3f0663d11e36b68f75