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Value of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Identifying Osteoarticular Septic Grafts in Suspected Infective Endocarditis: Results from a Large Monocentric Cohort.

Authors :
Luczak, Cédric
Lerman, Lionel
Pina Vegas, Laura
Emsen, Berivan
Hugues, Benjamin
Lepeule, Raphaël
Ternacle, Julien
Huguet, Raphaëlle
Lim, Pascal
Decousser, Jean-Winoc
Fiore, Antonio
Itti, Emmanuel
Chevalier, Xavier
Abilizi, Mukedaisi
Eymard, Florent
Source :
Journal of Clinical Medicine. Sep2024, Vol. 13 Issue 18, p5419. 13p.
Publication Year :
2024

Abstract

Background: 18F-fluorodeoxyglucose positron emission tomography–CT (FDG-PET/CT) is useful for identifying infective endocarditis (IE) but also the detection of other concomitant septic foci. Previously, we found that FDG-PET/CT identified an osteoarthritic septic graft (OASG) in 19.1% of IE patients, frequently asymptomatic. These preliminary results encouraged us to extend our analyses to a larger population, including all patients initially explored for suspected IE, to assess the prevalence, characteristics, and OASG locations brought out by FDG-PET/CT and to identify predictive factors. Methods: From a single-center cohort of patients referred for a clinical and/or biological suspicion of IE, we included all patients who underwent FDG-PET/CT, mainly performed to confirm a prosthesis heart valve or a foreign cardiac device infection. We excluded those who did not meet the 2015 modified Duke Criteria and those for whom another infectious diagnosis was finally retained or for whom all bacterial samples were negative. Demographic, clinical, bacteriological, imaging, and therapeutic data were collected. FDG-PET/CT images were retrospectively analyzed by three blinded nuclear medicine specialists to identify OASGs. Results: We identified 72 distinct OASG locations by FDG-PET/CT in 48 of 174 patients (27.6%), mainly located in the spine (21 OASGs in 20 patients); 14 patients (8.0%) had several OASG locations. In total, 43.8% of OASG locations were asymptomatic. In multivariate analysis, the presence of OASGs was associated with musculoskeletal pain (p < 0.001) and tricuspid valve involvement (p = 0.002). Conclusions: FDG-PET/CT is useful for identifying OASGs in patients with suspected IE, especially those with tricuspid IE or musculoskeletal pain. The identification of OASGs could impact antibiotic therapy and would allow adapted orthopedic management to be proposed. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20770383
Volume :
13
Issue :
18
Database :
Academic Search Index
Journal :
Journal of Clinical Medicine
Publication Type :
Academic Journal
Accession number :
180017414
Full Text :
https://doi.org/10.3390/jcm13185419