Abstract：
BACKGROUND: 18F-FDG-PET/CT is recommended to improve the diagnosis of prosthetic valve infective endocarditis (PVIE) and is a major criterion in the ESC-2015 classification. However, there is little evidence for its usefulness in the follow-up of medically treated PVIE patients.
METHODS: A monocentric retrospective analysis of patients hospitalized for PVIE between January 2013 and December 2019 who were not treated with surgery and who had at least two 18F-FDG-PET/CT examinations during their medical management.
RESULTS: Among 170 patients with PVIE, 117 were treated with antibiotic therapy but no surgery. Of these, 36 (31%) had at least two 18F-FDG-PET/CT examinations. At initial imaging, 28 patients had heterogeneous FDG uptake on their prosthetic valve and eight on their associated aortic graft. Hypermetabolism of spleen and bone marrow (HSBM) was observed in 18 and 19 patients, respectively. At the first follow-up 18F-FDG-PET/CT, 21 (58%) patients still had heterogeneous uptake, indicating persistent active endocarditis. HSBM was still present at the last follow-up imaging in four of the six patients with recurrent PVIE.
CONCLUSIONS: 18F-FDG-PET/CT monitoring of medically treated patients with PVIE provides valuable additional information and prospective multicentric study should be conducted to assess its usefulness.
METHODS: A monocentric retrospective analysis of patients hospitalized for PVIE between January 2013 and December 2019 who were not treated with surgery and who had at least two 18F-FDG-PET/CT examinations during their medical management.
RESULTS: Among 170 patients with PVIE, 117 were treated with antibiotic therapy but no surgery. Of these, 36 (31%) had at least two 18F-FDG-PET/CT examinations. At initial imaging, 28 patients had heterogeneous FDG uptake on their prosthetic valve and eight on their associated aortic graft. Hypermetabolism of spleen and bone marrow (HSBM) was observed in 18 and 19 patients, respectively. At the first follow-up 18F-FDG-PET/CT, 21 (58%) patients still had heterogeneous uptake, indicating persistent active endocarditis. HSBM was still present at the last follow-up imaging in four of the six patients with recurrent PVIE.
CONCLUSIONS: 18F-FDG-PET/CT monitoring of medically treated patients with PVIE provides valuable additional information and prospective multicentric study should be conducted to assess its usefulness.
摘要：
背景：18F-FDG-PET/CT被推荐用于改善人工瓣膜感染性心内膜炎（PVIE）的诊断，并且是ESC-2015分类中的主要标准。然而,在接受药物治疗的PVIE患者的随访中,几乎没有证据表明其有用性.
方法：对2013年1月至2019年12月因PVIE住院的患者进行单中心回顾性分析，这些患者在医疗管理期间未接受手术治疗且至少接受过两次18F-FDG-PET/CT检查。
结果：在170例PVIE患者中，117例接受了抗生素治疗，但没有手术。其中,36（31％）进行了至少两次18F-FDG-PET/CT检查。在初始成像时，28例患者在其人工瓣膜上有不均匀的FDG摄取，在其相关的主动脉移植物上有8例。在18和19例患者中观察到脾和骨髓高代谢（HSBM），分别。首次随访18F-FDG-PET/CT,21例(58%)患者仍有异质摄取，提示持续性活动性心内膜炎.在6例复发性PVIE患者中，有4例在最后一次随访成像中仍存在HSBM。
结论：对接受药物治疗的PVIE患者进行18F-FDG-PET/CT监测提供了有价值的额外信息，应进行前瞻性多中心研究以评估其有效性。
方法：对2013年1月至2019年12月因PVIE住院的患者进行单中心回顾性分析，这些患者在医疗管理期间未接受手术治疗且至少接受过两次18F-FDG-PET/CT检查。
结果：在170例PVIE患者中，117例接受了抗生素治疗，但没有手术。其中,36（31％）进行了至少两次18F-FDG-PET/CT检查。在初始成像时，28例患者在其人工瓣膜上有不均匀的FDG摄取，在其相关的主动脉移植物上有8例。在18和19例患者中观察到脾和骨髓高代谢（HSBM），分别。首次随访18F-FDG-PET/CT,21例(58%)患者仍有异质摄取，提示持续性活动性心内膜炎.在6例复发性PVIE患者中，有4例在最后一次随访成像中仍存在HSBM。
结论：对接受药物治疗的PVIE患者进行18F-FDG-PET/CT监测提供了有价值的额外信息，应进行前瞻性多中心研究以评估其有效性。
