Prognostic value of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography in infective endocarditis

Abstract Funding Acknowledgements Type of funding sources: None. Background 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is commonly used for the diagnosis of infective endocarditis (IE), but its prognostic value remains unknown. Objectives This study sought to assess the prognostic value of 18F-FDG PET/CT in prosthetic valve endocarditis (PVE) and native valve endocarditis (NVE). Methods This study prospectively included 173 consecutive patients (109 PVE and 64 NVE) with definite left-sided IE who had an 18F-FDG PET/CT and were followed-up for 1 year. The primary endpoint was a composite of major cardiac events: death, recurrence of IE, acute cardiac failure, nonscheduled hospitalization for cardiovascular indication, and new embolic event. Results 18F-FDG PET/CT was positive in 100 (58%) patients, 83% (n = 90 of 109) in the PVE, and 16% (n = 10 of 64) in the NVE group. At a mean follow-up of 225 days (interquartile range: 199 to 251 days), the primary endpoint occurred in 94 (54%) patients: 63 (58%) in the PVE group and 31 (48%) in the NVE group. In the PVE group, positive 18F-FDG PET/CT was significantly associated with a higher rate of primary endpoint (hazard ratio [HR]: 2.7; 95% confidence interval [CI]: 1.1 to 6.7; p = 0.04). Moderate to intense 18F-FDG valvular uptake was also associated with worse outcome (HR: 2.3; 95% CI: 1.3 to 4.5; p = 0.03) and to new embolic events in PVE (HR: 7.5; 95% CI: 1.24 to 45.2; p = 0.03) and in NVE (HR: 8.8; 95% CI: 1.1 to 69.5; p = 0.02). In the NVE group, 18F-FDG PET/CT was not associated with occurrence of the primary endpoint CONCLUSIONS: In addition to its good diagnostic performance, 18F-FDG PET/CT is predictive of major cardiac events in PVE and new embolic events within the first year following IE. Primary Endpoint Occurrence: Univariate and Multivariate Analysis in PVE Univariate HR (95% CI) p Value Multivariate HR (95% CI) p Value Renal insufficiency at admission 2.16 (1.00-4.68) 0.05 CRP >100 mg/l 2.46 (1.04-5.89) 0.02 1.90 (1.10-3.40) 0.03 Staphylococcus aureus 2.70 (1.10-6.55) 0.03 Severe valvular regurgitation 2.55 (1.01-6.41) 0.05 1.20 (0.70-2.10) 0.68 Echographic complications 1.15 (0.54-2.46) 0.72 Vegetation length >10 mm 2.53 (1.19-4.60) 0.03 Positive 18F-FDG PET/CT 3.74 (1.30-10.80) 0.02 2.70 (1.10-6.70) 0.04 Moderate to intense 18FDG valvular uptake 2.70 (1.20-6.30) 0.02 2.30 (1.30-4.50) 0.03 Abstract Figure.

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P2760Prognostic value of 18-fluorodeoxyglucose positron emission tomography/computed tomography in infective endocarditis

European Heart Journal ◽

10.1093/eurheartj/ehz748.1077 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Cited By ~ 1

Author(s):

S Sovannarith ◽

E Ravis ◽

L Tessonnier ◽

M Philip ◽

S Cammilleri ◽

...

Keyword(s):

Fdg Pet ◽

Prognostic Value ◽

Emission Tomography ◽

Cardiac Events ◽

End Point ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Fluorodeoxyglucose Positron Emission

Abstract Background 18-Fluorodeoxyglucose Positron emission tomography (18F-FDG PET/CT) has been shown to be useful for the diagnosis of IE, but its prognostic value is unknown. Objectives This study sought to assess the prognostic value of 18F-FDG PET/CT in prosthetic (PVE) and native valve endocarditis (NVE). Methods We prospectively studied 173 consecutive patients (109 PVE and 64 NVE) with definite IE who underwent a 18F-FDG PET/CT study and were follow-up for one year. Primary end-point was a composite of major cardiac events i.e. death, recurrence of IE, acute cardiac failure, non-scheduled hospitalization for cardiovascular reason, and new embolic event Results 18F-FDG PET/CT was positive in 98 (57%) patients, 82% (n=88/109) in the PVE and 16% (n=10/64) in the NVE group. At a mean follow of 225±18 days, the primary end-point occurred in 94 (55%) patients, 63 (58%) in the PVE group and 31 (48%) in the NVE group. In the PVE group, positive 18F-FDG PET/CT was significantly associated with higher rate of primary end-point (OR=2.6, IC95%=1.04 to 6.6; p=0.04). Moderate to intense 18F-FDG valvular uptake was also associated with worse outcome (OR=2.1; IC95%=1.1 to 4.0; p=0.03) and to new embolic events, (OR: 8.8; IC95%= 1.1 to 69.5; p=0.02). In the NVE group, 18F-FDG PET/CT was not associated with occurrence of the primary end-point. Conclusion In addition to be an accurate diagnostic tool, 18F-FDG PET/CT is predictive of major cardiac events in PVE and to embolic events during the first year following IE episode

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POSITRON EMISSION TOMOGRAPHY WITH 18F -FDG IN THE DIAGNOSIS OF PROSTHETIC HEART VALVE ENDOCARDITIS

Emergency Cardiology and Cardiovascular Risks ◽

10.51922/2616-633x.2021.5.2.1151 ◽

2021 ◽

Vol 5 (1) ◽

pp. 1151-1160

Author(s):

A.S. Lukashevich ◽

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Fdg Pet ◽

Prosthetic Heart Valve ◽

Emission Tomography ◽

Whole Body ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Purpose. The purpose of the article is to evaluate the diagnostic significance of positron emission tomography / computed tomography with 18F -fluorodeoxyglucose (18F -FDG PET/CT) for the diagnosis of prosthetic endocarditis. Methods of research. The study included 82 patients with suspected prosthetic endocarditis in accordance with the criteria proposed by Duke University [1-5]. The patients received hospital treatment at the State Institution RSPC "Cardiology" from January 2016 to March 2021. The study was of a prospective, non-randomized, single-center cohort design. The duration of the monitor period was 12 months from the moment of patients’ inclusion in the study. Whole-body positron emission tomography / computed tomography (PET/CT) examinations were performed in 82 patients. 27 patients were selected for surgical treatment. Conservative treatment group included 16 patients. 27 patients were selected into the observation group, they were suspected to have prosthetic heart valve infection in the primary referral and underwent PET/CT scanning, according to which the diagnosis of prosthetic endocarditis was excluded. The event under the study did not develop in this group during the year of observation. Results and conclusion. The history of infective endocarditis was not statistically significant and did not increase the risk of developing prosthetic endocarditis in the sample presented. The Duke criteria are less reliable in establishing the diagnosis of prosthetic endocarditis. The median number of days from the date of the first prosthesis implantation to the onset of prosthetic endocarditis was about 4 years. This study revealed that the development of the infectious process in the area of the prosthesis was noted in a more distant postoperative period compared to literature data. Histological confirmation of infection was noted in 100% (27 patients) of cases in reoperated patients. The presence of a more formidable complication such as valve ring abscess located mainly in the projection of the aortic valve ring was quite common in both groups. Presepsin and Interleukin-6 have a statistically significant (U = 394,50 p = 0,01 and U = 94,50 p = 0.004) value in the prognosis of prosthetic endocarditis. Considering the data obtained from ROC analysis, it can be said that the cut-off point at which it is possible to diagnose prosthetic endocarditis based on PETCT is 2.85. The presented methods for the interpretation of whole-body FDG-PET/CT images of patients with suspected infectious complications after cardiac surgery, as well as with the presence of prosthetic endocarditis, show high sensitivity and specificity.

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The Value of 18 Fluorine-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Breast Cancer Staging

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.5525 ◽

2020 ◽

Vol 8 (A) ◽

pp. 970-975

Author(s):

Ahmed Tawakol ◽

Maha Khalil ◽

Yasser G. Abdelhafez ◽

Mai Hussein ◽

Mohamed Fouad Osman

Keyword(s):

Breast Cancer ◽

Computed Tomography ◽

Fdg Pet ◽

Cancer Staging ◽

Emission Tomography ◽

Breast Cancer Staging ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

BACKGROUND: Accurate staging is important for management decisions in patients with newly diagnosed breast cancer. AIM: This study was conducted to evaluate the value of 18 fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging in breast cancer staging.. METHODS: A prospective study of 80 patients (1 male and 79 female) mean age 51.13 years with histologically confirmed breast cancer. The staging procedures included history, physical examination, mammography, and CT of neck, chest, abdomen, and pelvis; then, PET/CT was performed in a time interval <30 days. The findings of PET/CT were compared with those of the other conventional methods. RESULTS: The agreement between conventional methods (mammography, breast ultrasound, contrast-enhanced CT of the neck, chest, abdomen, and pelvis) and 18F FDG-PET/CT was 0.6 for assessing the T stage, 0.39 for N stage, and 0.75 for M stage. There was moderate agreement between CT and 18F FDG-PET/CT in the detection of nodal lesions (K=0.6) and pulmonary lesions (K=0.51), while a perfect agreement was noted for detecting osseous (K=0.82) and liver lesions (K=0.81). In total, 50 patients (62.5%) were concordantly staged between the conventional imaging and 18F-FDG PET/CT, while 30 patients (37.5%) showed a different tumor, node, and metastasis stage. The changes were driven by the detection of additional findings (n=26) or exclusion of findings (n=4), mainly at the lymph nodes (LNs) and/or distant sites. Regarding N status, 18F FDG-PET/CT revealed previously unknown regional lymphatic spread in supraclavicular (n=4; 5%), infraclavicular (n=11; 13.7%), and internal mammary (n=12; 15%) lymph node groups. 18F-FDG PET/CT changed M status in a total of four patients (5%); three of them were upstaged by detecting distant metastases, while osseous deposits were excluded in one patient leading to downstaging. CONCLUSION: 18F-FDG-PET/CT is considered a valuable imaging tool in the initial staging of breast cancer, which significantly impacts the overall American Joint Committee on Cancer staging in 37.5% of our study population.

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Clinical Impact of 18F-FDG PET/CT in the Diagnostic Workup of Pancreatic Ductal Adenocarcinoma: A Systematic Review

Diagnostics ◽

10.3390/diagnostics10121042 ◽

2020 ◽

Vol 10 (12) ◽

pp. 1042

Author(s):

Annachiara Arnone ◽

Riccardo Laudicella ◽

Federico Caobelli ◽

Priscilla Guglielmo ◽

Marianna Spallino ◽

...

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Pancreatic Ductal Adenocarcinoma ◽

Fdg Pet ◽

Emission Tomography ◽

Ductal Adenocarcinoma ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

In this review, the performance of fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in the diagnostic workup of pancreatic ductal adenocarcinoma (PDAC) is evaluated. A comprehensive literature search up to September 2020 was performed, selecting studies with the presence of: sample size ≥10 patients and index test (i.e., “FDG” or “18F-FDG” AND “pancreatic adenocarcinoma” or “pancreas cancer” AND “PET” or “positron emission tomography”). The methodological quality was evaluated using the revised quality assessment of diagnostic accuracy studies (QUADAS-2) tool and presented according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Basic data (authors, year of publication, country and study design), patients’ characteristics (number of enrolled subjects and age), disease phase, type of treatment and grading were retrieved. Forty-six articles met the adopted research criteria. The articles were divided according to the considered clinical context. Namely, besides conventional anatomical imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), molecular imaging with FDG PET/CT is an important tool in PDAC, for all disease stages. Further prospective studies will be necessary to confirm the cost-effectiveness of such imaging techniques by testing its real potential improvement in the clinical management of PDAC.

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Virtual Navigator Real-Time Ultrasound Fusion Imaging with Positron Emission Tomography/Computed Tomography for Preoperative Breast Cancer

Medicina ◽

10.3390/medicina57121289 ◽

2021 ◽

Vol 57 (12) ◽

pp. 1289

Author(s):

Mio Mori ◽

Kazunori Kubota ◽

Tomoyuki Fujioka ◽

Leona Katsuta ◽

Yuka Yashima ◽

...

Keyword(s):

Breast Cancer ◽

Computed Tomography ◽

Positron Emission Tomography ◽

Fdg Pet ◽

Fusion Imaging ◽

Emission Tomography ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

We used virtual navigator real-time ultrasound (US) fusion imaging with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to identify a lesion that could not be detected on the US alone in a preoperative breast cancer patient. Of the patient’s two lesions of breast cancer, the calcified lesion could not be identified by US alone. By fusing US with 18F-FDG PET/CT, which had been performed in advance, the location of the lesion could be estimated and marked, which benefited planning an appropriate surgery. The fusion of US and 18F-FDG PET/CT was a simple and noninvasive method for identifying the lesions detected by 18F-FDG PET/CT.

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Post-transplantation Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography in Patients with Lymphoblastic Lymphoma is an Independent Prognostic Factor with an Impact on Progression-Free Survival but not Overall Survival

Technology in Cancer Research & Treatment ◽

10.1177/15330338211056478 ◽

2021 ◽

Vol 20 ◽

pp. 153303382110564

Author(s):

Na Dai ◽

Hang Liu ◽

Shengming Deng ◽

Shibiao Sang ◽

Yiwei Wu

Keyword(s):

Prognostic Factor ◽

Fdg Pet ◽

Progression Free Survival ◽

Lymphoblastic Lymphoma ◽

Emission Tomography ◽

Free Survival ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Purpose: In the present study, we mainly aimed to evaluate the prognostic value of 2-deoxy-2-[18F]fluoro-D-glucose ([18F]F-FDG) positron emission tomography (PET)/computed tomography (CT) after allogeneic stem cell transplantation (allo-SCT) in lymphoblastic lymphoma (LBL) patients using Deauville Scores (DS). Materials and Methods: A total of 63 LBL patients who benefited from 18F-FDG PET-CT after allo-SCT in our institution between April 2010 and August 2020 were enrolled in this retrospective study. These above-mentioned patients were divided into two groups based on the Deauville criteria. Diagnostic efficiency of 18F-FDG PET/CT and integrated CT in detecting lymphoma were calculated. Consistencies were evaluated by comparing 18F-FDG PET/CT and integrated CT results through kappa coefficient. Kaplan-Meier method was used in survival analysis, and the log-rank method was adopted in comparisons. Prognostic factor analysis was performed by the Cox regression model. Results: The sensitivity, specificity, positive predictive value, negative predictive value, accuracy of post-SCT 18F-FDG PET-CT were 100%(12/12), 92.2%(47/51), 75.0%(12/16), 100%(47/47) and 93.7%(59/63). The consistency of 18F-FDG PET-CT and integrated CT was moderate(Kappa = .702，P < .001). Positive post-SCT 18F-FDG PET-CT was associated with lower progression-free survival (PFS) but not overall survival (OS) (p = .000 and p = .056, respectively). The 3-year PFS of the PET-positive group and PET-negative group was 18.8% and 70.2%, respectively. Multivariate analysis showed that post-SCT PET-CT findings was an independent prognostic factor for PFS (p = .000; HR, 3.957; 95%CI, 1.839-8.514). Other factors independently affecting PFS were sex (p = .018; HR, 2.588; 95% CI, 1.181 − 5.670) and lactate dehydrogenase (LDH) (p = .005; HR, 3.246; 95% CI, 1.419 − 7.426). However, none of the above-mentioned factors were associated with OS. Conclusions: Collectively, we found that 18F-FDG PET-CT after allo-SCT was a strong indicator for PFS, but not OS, which might provide important evidence for the selection of subsequent treatment regimen for LBL patients. Trial registration number: ChiCTR2100046709.

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Value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the evaluation of pulmonary artery activity in patients with Takayasu’s arteritis

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa229 ◽

2020 ◽

Author(s):

Wei Gao ◽

Juan-Ni Gong ◽

Xiao-Juan Guo ◽

Jiao-Yan Wu ◽

Xiao-Ying Xi ◽

...

Keyword(s):

Fdg Pet ◽

Inflammatory Markers ◽

Pulmonary Angiography ◽

Emission Tomography ◽

Therapeutic Effects ◽

Radiological Imaging ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Abstract Aims To explore the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the detection of active pulmonary artery (PA) lesions in patients with Takayasu’s arteritis (TA). Methods and results Consecutive TA patients with PA involvement were prospectively recruited. Clinical activity was assessed according to the National Institutes of Health (NIH) criteria. CT pulmonary angiography (CTPA) or magnetic resonance pulmonary angiography was performed for evaluation of vascular structural characteristics, and mural thickening was considered as radiologically active. A vascular segment with 18F-FDG uptake ≥ liver was considered as PET-active. A total of 38 18F-FDG PET/CT scans were performed in 29 patients. In terms of disease activity, the sensitivity of 18F-FDG PET/CT did not significantly differ from radiological imaging (71.4% vs. 92.9%, P = 0.250), but 18F-FDG PET/CT had higher specificity (91.7% vs. 37.5%, P = 0.001) and accuracy (84.2% vs. 57.9%, P = 0.022). Although the majority of PET-active PA segments (54.9%) showed mural thickening, 14 PA segments with normal structure were also PET-active. 18F-FDG activity did not significantly differ between the PA and aorta in clinically active patients. In addition, 18F-FDG activity of the PA was positively correlated with inflammatory markers. Changes in 18F-FDG activity in PA during follow-up reflected therapeutic effects. Conclusion 18F-FDG PET/CT can effectively evaluate PA activity in TA patients, and its diagnostic performance is superior to radiological imaging. The 18F-FDG activity of PA shows a good correlation with clinical disease status and inflammatory markers and can be used to monitor therapeutic effects.

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Utility of flouro-deoxy-glucose positron emission tomography/computed tomography in the diagnostic and staging evaluation of patients with primary CNS lymphoma

CNS Oncology ◽

10.2217/cns-2019-0016 ◽

2019 ◽

Vol 8 (4) ◽

pp. CNS46 ◽

Cited By ~ 3

Author(s):

Meetakshi Gupta ◽

Tejpal Gupta ◽

Nilendu Purandare ◽

Venkatesh Rangarajan ◽

Ameya Puranik ◽

...

Keyword(s):

Fdg Pet ◽

Standardized Uptake Value ◽

Emission Tomography ◽

Whole Body ◽

Cns Lymphoma ◽

Maximum Standardized Uptake Value ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Aim: To prospectively assess the clinical utility of pretreatment flouro-deoxy-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients with primary central nervous system (CNS) lymphoma (PCNSL). Materials & methods: Patients with suspected/proven PCNSL underwent baseline whole-body 18F-FDG-PET/CT. Maximum standardized uptake value and tumor/normal tissue ratios were compared between CNS lymphoma and other histological diagnoses. Results: The mean maximum standardized uptake value (27.5 vs 18.2; p = 0.001) and mean tumor/normal tissue ratio (2.34 vs 1.53; p < 0.001) of CNS lymphoma was significantly higher than other histologic diagnoses. Five of 50 (10%) patients with biopsy-proven CNS lymphomas had pathologically increased FDG-uptake at extraneuraxial sites uncovering systemic lymphoma. Conclusion: Pretreatment whole-body 18F-FDG-PET/CT provides valuable complementary information in the diagnostic and staging evaluation of patients with PCNSL to guide therapeutic decision-making.

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[68Ga]Ga-Pentixafor for PET Imaging of Vascular Expression of CXCR-4 as a Marker of Arterial Inflammation in HIV-Infected Patients: A Comparison with 18F[FDG] PET Imaging

Biomolecules ◽

10.3390/biom10121629 ◽

2020 ◽

Vol 10 (12) ◽

pp. 1629

Author(s):

Ismaheel O. Lawal ◽

Gbenga O. Popoola ◽

Johncy Mahapane ◽

Jens Kaufmann ◽

Cindy Davis ◽

...

Keyword(s):

Computed Tomography ◽

Fdg Pet ◽

Emission Tomography ◽

Positron Emission ◽

Pet Ct ◽

Immunodeficiency Virus ◽

Arterial Inflammation ◽

18F Fdg ◽

Fdg Pet Ct ◽

Level Of Agreement

People living with human immunodeficiency virus (PLHIV) have excess risk of atherosclerotic cardiovascular disease (ASCVD). Arterial inflammation is the hallmark of atherogenesis and its complications. In this study we aimed to perform a head-to-head comparison of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) and Gallium-68 pentixafor positron emission tomography/computed tomography [68Ga]Ga-pentixafor PET/CT for quantification of arterial inflammation in PLHIV. We prospectively recruited human immunodeficiency virus (HIV)-infected patients to undergo [18F]FDG PET/CT and [68Ga]Ga-pentixafor PET/CT within two weeks of each other. We quantified the levels of arterial tracer uptake on both scans using maximum standardized uptake value (SUVmax) and target–background ratio. We used Bland and Altman plots to measure the level of agreement between tracer quantification parameters obtained on both scans. A total of 12 patients were included with a mean age of 44.67 ± 7.62 years. The mean duration of HIV infection and mean CD+ T-cell count of the study population were 71.08 ± 37 months and 522.17 ± 260.33 cells/µL, respectively. We found a high level of agreement in the quantification variables obtained using [18F]FDG PET and [68Ga]Ga-pentixafor PET. There is a good level of agreement in the arterial tracer quantification variables obtained using [18F]FDG PET/CT and [68Ga]Ga-pentixafor PET/CT in PLHIV. This suggests that [68Ga]Ga-pentixafor may be applied in the place of [18F]FDG PET/CT for the quantification of arterial inflammation.

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