Imaging infective endocarditis : Adherence to a diagnostic flowchart and direct comparison of imaging techniques
BACKGROUND: Multimodality imaging is recommended to diagnose infective endocarditis. Value of additional imaging to echocardiography in patients selected by a previously proposed flowchart has not been evaluated.
METHODS: An observational single-center study was performed. Adult patients suspected of endocarditis/device infection were prospectively and consecutively enrolled from March 2016 to August 2017. Adherence to a diagnostic imaging-in-endocarditis-flowchart was evaluated in 176 patients. Imaging techniques were compared head-to-head in 46 patients receiving echocardiography (transthoracic plus transesophageal), multi-detector computed tomography angiography (MDCTA), and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET/CT).
RESULTS: 69% of patients (121/176) adhered to the flowchart. Sensitivity of echocardiography, MDCTA, FDG-PET/CT in patients without prosthesis was 71%, 57%, 29% (86% when combined), while specificity was 100%, 75%, 100%, respectively. Sensitivity in patients with prosthesis was 75%, 75%, 83%, respectively (100% when combined), while specificity was 86% for all three modalities. Echocardiography performed best in the assessment of vegetations, morphological valve abnormalities/dehiscence, septum defects, and fistula formation. MDCTA performed best in the assessment of abscesses and ventricular assist device infection. FDG-PET/CT performed best in the assessment of cardiac device infection, extracardiac infectious foci, and alternative diagnoses.
CONCLUSIONS: This study demonstrates that the evaluated imaging-in-endocarditis-flowchart is applicable in daily clinical practice. Echocardiography, MDCTA, and FDG-PET/CT provide relevant complementary diagnostic information, particularly in patients with intracardiac prosthetic material.
| Errataetall: |
CommentIn: J Nucl Cardiol. 2020 Apr;27(2):609-611. - PMID 30209755 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
|---|---|
| Enthalten in: |
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology - 27(2020), 2 vom: 18. Apr., Seite 592-608 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Gomes, Anna [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 09.08.2021 Date Revised 30.01.2024 published: Print-Electronic CommentIn: J Nucl Cardiol. 2020 Apr;27(2):609-611. - PMID 30209755 Citation Status MEDLINE |
|---|
| doi: |
10.1007/s12350-018-1383-8 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM28706011X |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM28706011X | ||
| 003 | DE-627 | ||
| 005 | 20240130231909.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s12350-018-1383-8 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1275.xml |
| 035 | |a (DE-627)NLM28706011X | ||
| 035 | |a (NLM)30066279 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Gomes, Anna |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Imaging infective endocarditis |b Adherence to a diagnostic flowchart and direct comparison of imaging techniques |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 09.08.2021 | ||
| 500 | |a Date Revised 30.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Nucl Cardiol. 2020 Apr;27(2):609-611. - PMID 30209755 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Multimodality imaging is recommended to diagnose infective endocarditis. Value of additional imaging to echocardiography in patients selected by a previously proposed flowchart has not been evaluated | ||
| 520 | |a METHODS: An observational single-center study was performed. Adult patients suspected of endocarditis/device infection were prospectively and consecutively enrolled from March 2016 to August 2017. Adherence to a diagnostic imaging-in-endocarditis-flowchart was evaluated in 176 patients. Imaging techniques were compared head-to-head in 46 patients receiving echocardiography (transthoracic plus transesophageal), multi-detector computed tomography angiography (MDCTA), and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) | ||
| 520 | |a RESULTS: 69% of patients (121/176) adhered to the flowchart. Sensitivity of echocardiography, MDCTA, FDG-PET/CT in patients without prosthesis was 71%, 57%, 29% (86% when combined), while specificity was 100%, 75%, 100%, respectively. Sensitivity in patients with prosthesis was 75%, 75%, 83%, respectively (100% when combined), while specificity was 86% for all three modalities. Echocardiography performed best in the assessment of vegetations, morphological valve abnormalities/dehiscence, septum defects, and fistula formation. MDCTA performed best in the assessment of abscesses and ventricular assist device infection. FDG-PET/CT performed best in the assessment of cardiac device infection, extracardiac infectious foci, and alternative diagnoses | ||
| 520 | |a CONCLUSIONS: This study demonstrates that the evaluated imaging-in-endocarditis-flowchart is applicable in daily clinical practice. Echocardiography, MDCTA, and FDG-PET/CT provide relevant complementary diagnostic information, particularly in patients with intracardiac prosthetic material | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a CT | |
| 650 | 4 | |a Echo | |
| 650 | 4 | |a PET | |
| 650 | 4 | |a diagnostic and prognostic application | |
| 650 | 4 | |a infection | |
| 650 | 4 | |a valvular heart disease | |
| 650 | 7 | |a Radiopharmaceuticals |2 NLM | |
| 650 | 7 | |a Fluorodeoxyglucose F18 |2 NLM | |
| 650 | 7 | |a 0Z5B2CJX4D |2 NLM | |
| 700 | 1 | |a van Geel, Peter Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Santing, Michiel |e verfasserin |4 aut | |
| 700 | 1 | |a Prakken, Niek H J |e verfasserin |4 aut | |
| 700 | 1 | |a Ruis, Mathilde L |e verfasserin |4 aut | |
| 700 | 1 | |a van Assen, Sander |e verfasserin |4 aut | |
| 700 | 1 | |a Slart, Riemer H J A |e verfasserin |4 aut | |
| 700 | 1 | |a Sinha, Bhanu |e verfasserin |4 aut | |
| 700 | 1 | |a Glaudemans, Andor W J M |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology |d 1994 |g 27(2020), 2 vom: 18. Apr., Seite 592-608 |w (DE-627)NLM087703971 |x 1532-6551 |7 nnns |
| 773 | 1 | 8 | |g volume:27 |g year:2020 |g number:2 |g day:18 |g month:04 |g pages:592-608 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s12350-018-1383-8 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 27 |j 2020 |e 2 |b 18 |c 04 |h 592-608 | ||