Apport de la tomographie par émission de positons au 18-FDG dans l’endocardite infectieuse sur valves et dispositifs implantables : à propos d’une série rétrospective monocentrique de 35 patients

Abstract

IntroductionInfective endocarditis (IE) is a serious disease whose diagnosis is often difficult. PET 18F-FDG has great potential in this indication, since it has already shown its contributions in the field of inflammation and infection. The objective of this study is to assess the contribution of PET in suspicion of IE in patients with prosthetic heart valve or implantable intracardiac devices. Patients and methodsThis is a single-center, retrospective study in nuclear medicine department of Georges-Pompidou European hospital in Paris between May 2012 and May 2015. Patients were included for suspicion of IE of prosthetic heart valve or implantable intracardiac devices. The diagnosis of IE was based on histological data or monitoring up to 6 months. The clinical, laboratory, ultrasound and microbiological data were collected and analyzed for each patient. The results of PET by visual and semi-quantitative analysis were compared to the final diagnoses. ResultsThirty-five patients were included in the study, with 23 suspected of infection on cardiac valve and 12 suspected of infection on intracardiac device. The final diagnosis of IE was confirmed in 13 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of IE were respectively 92%, 77%, 71%, 94% and 83%. There was a significant difference for the SUVmax ratio (infected site/surrounding noice) for IE groups confirmed vs unconfirmed IE. It was not revealed other factors that could potentially influence the diagnostic performance. ConclusionPET provides a very good sensitivity and a rather good specificity in diagnosis of IE. The results are consistent with the findings of the current literature. The validity of this imaging technique should be confirmed in a prospective clinical study with a larger number of patients.