Abstract
BackgroundThe significance of and threshold values for the standardized uptake value (SUV) in FDG PET/CT to diagnose prosthetic heart valve (PHV) endocarditis (PVE) are unclear at present. MethodsA literature search was performed in the PubMed and EMBASE medical databases, comprising the following terms: (FDG OR *fluorode* OR *fluoro-de*) AND (endocarditis OR prosthetic heart valve OR valve replacement). Studies reporting SUVs correlated to the diagnosis of PVE were selected for analysis. Results8 studies were included, with a total of 330 PHVs assessed. SUVs for PVE varied substantially across studies due to differences in acquisition, reconstruction, and measurement protocols, with median SUVmax values for rejected PVE ranging from 0.5 to 4.9 and for definite PVE ranging from 4.2 to 7.4. ConclusionReported SUV values for PVE are not interchangeable between sites, and further standardization of quantification is desirable. To this end, optimal protocols for patient preparation, image acquisition, and reconstruction and measurement methods need to be standardized across centers.
Highlights
In recent years, 18F-fluorodeoxyglucose positron emission tomography with computed tomography-based attenuation correction (FDG PET/CT) has been used increasingly in the setting of infection detection in general and prosthetic heart valve (PHV) endocarditis (PVE) in particular
Four studies were performed on European Association of Nuclear Medicine Research Ltd. (EARL)-accredited systems.[6,8,9,11]
SUVmax was measured as the average of 3 measurements from 3 volumes of interest (VOI) of 5 mm[3] at equal distances from each other
Summary
18F-fluorodeoxyglucose positron emission tomography with computed tomography-based attenuation correction (FDG PET/CT) has been used increasingly in the setting of infection detection in general and prosthetic heart valve (PHV) endocarditis (PVE) in particular. FDG PET/CT is able to semi-quantitatively measure the amount of metabolic activity of a lesion in the form of the standardized uptake value (SUV). This concept is appealing since it might offer objective cutoff values to discriminate normal from pathological uptake levels, relying less on subjective interpretation. The significance of and threshold values for the standardized uptake value (SUV) in FDG PET/CT to diagnose prosthetic heart valve (PHV) endocarditis (PVE) are unclear at present
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