The valve uptake index : improving assessment of prosthetic valve endocarditis and updating [ 18 F]FDG PET/CT(A) imaging criteria
Roque, Albert (Hospital Universitari Vall d'Hebron)
Pizzi, María N (Hospital Universitari Vall d'Hebron)
Fernández-Hidalgo, Nuria (Hospital Universitari Vall d'Hebron)
Romero-Farina, Guillermo (Hospital Universitari Vall d'Hebron)
Burcet, Gemma (Hospital Universitari Vall d'Hebron)
Reyes-Juarez, José Luis (Hospital Universitari Vall d'Hebron)
Espinet, Carina (Hospital Universitari Vall d'Hebron)
Castell-Conesa, Joan (Hospital Universitari Vall d'Hebron)
Escobar, Manuel (Hospital Universitari Vall d'Hebron)
Ferreira-Gonzalez, Ignacio (Hospital Universitari Vall d'Hebron)
Aguadé-Bruix, Santiago (Hospital Universitari Vall d'Hebron)
Cuellar-Calabria, Hug (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Diagnosis of prosthetic valve endocarditis (PVE) by positron emission computed tomography angiography (PET/CTA) is based on visual and quantitative morpho-metabolic features. However, the fluorodeoxyglucose (FDG) uptake pattern can be sometimes visually unclear and susceptible to subjectivity. This study aimed to validate a new parameter, the valve uptake index [VUI, maximum standardized uptake value (SUVmax)−mean standardized uptake value (SUVmean)/SUVmax], designed to provide a more objective indication of the distribution of metabolic activity. Secondly, to re-evaluate the utility of traditionally used PVE imaging criteria and determine the potential value of adding the VUI in the diagnostic algorithm of PVE. Retrospective analysis of 122 patients (135 prosthetic valves) admitted for suspicion of endocarditis, with a conclusive diagnosis of definite (N = 57) or rejected (N = 65) PVE, and who had undergone a cardiac PET/CTA scan as part of the diagnostic evaluation. We measured the VUI and recorded the SUVmax, SUVratio, uptake pattern, and the presence of endocarditis-related anatomic lesions. The VUI, SUVmax, and SUVratio values were 0. 54 ± 0. 1 vs. 0. 36 ± 0. 08, 7. 68 ± 3. 07 vs. 3. 72 ± 1. 11, and 4. 28 ± 1. 93 vs. 2. 16 ± 0. 95 in the 'definite' PVE group vs. the 'rejected' group, respectively (mean ± SD; P < 0. 001). A cut-off value of VUI > 0. 45 showed a sensitivity, specificity, and diagnostic accuracy for PVE of 85%, 88%, and 86. 7% and increased diagnostic ability for confirming endocarditis when combined with the standard diagnostic criteria. The VUI demonstrated good diagnostic accuracy for PVE, even increasing the diagnostic power of the traditionally used morphometabolic parameters, which also confirmed their own diagnostic performance. More research is needed to assess whether the integration of the VUI into the PVE diagnostic algorithm may clarify doubtful cases and thus improve the diagnostic yield of PET/CTA.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Infective endocarditis ; Nuclear imaging ; Positron emission tomography ; Prosthetic heart valves
Publicat a:	European Heart Journal Cardiovascular Imaging, Vol. 23 (january 2022) , p. 1260-1271, ISSN 2047-2412

DOI: 10.1093/ehjci/jeab279
PMID: 34999818

12 p, 1.5 MB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats