Abstract
Purpose. To investigate the semi-quantitative assessment of 18F-fluorodeoxyglucose PET/CT in patients with prosthetic valve infectious endocarditis (PV IE) and without it. Material and methods. The analysis included results of 18F-FDG PET/CT examinations performed in 50 patients with PV – with surgically confirmed IE (n=30) and with malignancies used as control group (n=20). PET/CT results were assessed visually and semiquantitatively with calculation of parameters of 18F-FDG uptake intensity in the PV area – SUVmax and SUVratio. SUVratio was calculated as SUVmax in the CIED to SUVmean in the reference zone – aortic blood pool and liver parenchyma. Results. Visual analysis of PET/CT results revealed abnormal 18Ffluorodeoxyglucose uptake in all patients with IE (n=30); in the control group the uptake was normal in all cases (n=20). In semiquantitative analysis all parameters in the PV zone, SUVmax and two types of SUVratios, were higher in patients with confirmed IE, compared to patients without it (p<0.001). ROC-curve analysis for thresholds of SUVmax and two types of SUVratios for the diagnosis of PV IE by PET/CT with optimal sensitivity and specificity was determined: SUVmax = 3.35 (86% and 90%, respectively), SUVratio using aorta = 1.95 (89% and 85%), SUVratio using liver = 1.45 (82% and 85%). Conclusion. According to the obtained data, both visual analysis and semiquantitative assessment of 18F-fluorodeoxyglucose PET/CT images showed a good diagnostic performance in the detection of PV IE. The optimal parameter for the diagnosis of IE PV is the SUVratio using aorta with threshold of 1.95 (AUC=0.961).
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