Abikhzer Gad, Martineau Patrick, Grégoire Jean, Finnerty Vincent, Harel Francois, Pelletier-Galarneau Matthieu
Department of Radiology and Nuclear Medicine, Jewish General Hospital, Montreal, QC, Canada.
Department of Radiology, University of Manitoba, Winnipeg, MB, Canada.
J Nucl Cardiol. 2022 Feb;29(1):158-165. doi: 10.1007/s12350-020-02092-6. Epub 2020 Mar 16.
We examined the use of [F]FDG-PET/CT for the diagnosis of native valve endocarditis (NVE).
PET/CT images in patients with suspected NVE were retrospectively reviewed independently by two experienced physicians blinded to all clinical information. The gold standard consisted of surgical findings, when available, or the modified Duke criteria.
Fifty four subjects were included, 31 (57%) with a diagnosis of NVE. [F]FDG-PET/CT correctly identified 21/31 (67.7%) subjects, yielding a sensitivity and specificity of 68% (95% CI 49-83%) and 100% (95% CI 85-100%), respectively. The sensitivity and specificity of the modified Duke criteria were 48% and 74%, respectively. Positive and negative predictive values of PET were 100% (95% CI 84-100%) and 70% (95% CI 51-84%), respectively. Modifying the Duke criteria to include [F]FDG-PET positivity as a major criterion increased sensitivity to 77% without affecting specificity and led to the correct reclassification of 8/18 (44.4%) subjects from Possible IE to Definite IE.
The addition of a positive [F]FDG-PET/CT as a major criterion in the modified Duke Criteria improved performance of the criteria for the diagnosis of NVE, particularly in those subjects with Possible IE.
我们研究了[F]氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（[F]FDG-PET/CT）在天然瓣膜心内膜炎（NVE）诊断中的应用。
对疑似NVE患者的PET/CT图像进行回顾性分析，由两名对所有临床信息均不知情的经验丰富的医生独立进行评估。金标准为手术结果（如有）或改良的杜克标准。
共纳入54名受试者，其中31名（57%）被诊断为NVE。[F]FDG-PET/CT正确识别出21/31（67.7%）的受试者，敏感性和特异性分别为68%（95%可信区间49-83%）和100%（95%可信区间85-100%）。改良杜克标准的敏感性和特异性分别为48%和74%。PET的阳性预测值和阴性预测值分别为100%（95%可信区间84-100%）和70%（95%可信区间51-84%）。将杜克标准修改为将[F]FDG-PET阳性作为主要标准，可将敏感性提高至77%，而不影响特异性，并使8/18（44.4%）的受试者从可能的感染性心内膜炎（IE）正确重新分类为确诊的IE。
在改良的杜克标准中增加[F]FDG-PET/CT阳性作为主要标准，可提高NVE诊断标准的性能，特别是在那些可能患有IE的受试者中。
