Article Text

other Versions

PDF
Original research article
Usefulness of positron emission tomography/computed tomography in patients with valve-tube graft infection
  1. Daniel García-Arribas1,
  2. Isidre Vilacosta1,
  3. Aida Ortega Candil2,
  4. Cristina Rodríguez Rey2,
  5. Carmen Olmos1,
  6. María Jesús Pérez Castejón2,
  7. David Vivas1,
  8. Carlos Nicolás Pérez-García1,
  9. Manuel Carnero-Alcázar1,
  10. Cristina Fernández-Pérez2,3,
  11. Luis Maroto1,
  12. José Luis Carreras2
  1. 1Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
  2. 2Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
  3. 3Servicio de Medicina Preventiva, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdSSC), Universidad Complutense de Madrid, Madrid, Spain
  1. Correspondence to Dr Daniel García-Arribas, Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid 28040, Spain; danigara_1{at}hotmail.com

Abstract

Objective Infection of valved aortic grafts is a rare entity whose diagnosis remains challenging. Positron emission tomography (PET)/CT has become a criterion for the diagnosis of infective endocarditis (IE) in prosthetic valves, but its role on ascending aortic graft infections remains unclear. This study aims to assess the diagnostic value of PET/CT in patients with valved aortic graft infection.

Methods 12 episodes with a valved aortic graft who had undergone a PET/CT due to suspicion of IE were prospectively included (group I) and compared with five controls free of infection who underwent PET/CT for other reasons (group II). Pathological uptake of 18F-fluorodeoxyglucose (FDG) and its pattern at the prosthetic valve and aortic graft were studied.

Results Diagnosis of IE was confirmed in 9 out of 12 episodes of group I. 18F-FDG uptake was detectable in eight out of nine cases with a final diagnosis of IE. The most repeated pattern of uptake was homogeneous around the valve and heterogeneous around the tube. There was one false-negative study. Of the three patients in which IE was ruled out, there were two false positives and one true negative. In group II, there were three patients with a positive PET/CT study, two of them had active aortitis and the third was considered false positive.

Conclusions 18F-FDG PET/CT shows high sensitivity in the detection of infected aortic grafts. Thus, this technique should be considered in the diagnostic work-up of patients with suspicion of aortic graft infection. However, further validation of this approach is needed.

  • endocarditis
  • cardiac computer tomographic (ct) imaging
  • positron emission tomographic (pet) imaging
  • valve disease surgery
  • aortic surgery

Statistics from Altmetric.com

Footnotes

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Comité de Ética para la Asistencia Sanitaria del Hospital Clínico San Carlos.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.