Background:
Infective endocarditis (IE) is an infection of the heart’s endocardial surface. In recent years,
nuclear imaging methods have gained importance in the diagnosis of IE. The present study aims to investigate the imaging
potential of 99mTc-labeled vancomycin (
99mTc-Vancomycin) as a new agent that would enable the diagnosis of IE in its
early stages when it is difficult to diagnose or has small vegetation, in the experimental rat model.
Methods:
99mTc-Vancomycin scintigraphy was evaluated for its accumulation in IE with Staphylococcus aureus
performed in an experimental rat model. Serial planar scintigraphic and biodistribution analysis of infected vegetations are
compared to rats with sterile vegetations. The heart was identified as an infected organ, the liver was identified as a noninfected organ and the heart/liver uptake ratio (T / NT ratio) was compared between infective endocarditis and sterile
endocarditis groups.
Results:
Planar scintigrams (in vivo measurements) showed more uptake in the heart of rats in the infective endocarditis
group, compared to the uptake in the heart of rats in the sterile endocarditis group but this difference was not statistically
significant (p>0.05). From the ex vivo measurements, the 99mTc-Vancomycin heart uptake increased significantly (p =
0.016), liver uptake was significantly decreased (p = 0.045) and the T/NT ratio was significantly higher (p = 0.014) in the
infective endocarditis group compared to the sterile endocarditis group.
Conclusions:
In this experimental study, 99mTc-Vancomycin scintigraphy ensured the detection of ex vivo infected tissue
in a rat model of IE. In addition, the absence of significant 99mTc-Vancomycin uptake in the sterile endocarditis group indicates that this agent targeted the infected tissue instead of the sterile inflammatory tissue. Finally, this agent should
also be evaluated with animal-specific imaging devices.
In vivo 1H-MR spectroscopy of the human heart
