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Duval, Xavier; Le Moing, Vincent; Tubiana, Sarah; Esposito-Farèse, Marina; Ilic-Habensus, Emila; Leclercq, Florence; Bourdon, Aurélie; Goehringer, François; Selton-Suty, Christine; Chevalier, Elodie; Boutoille, David; Piriou, Nicolas; Le Tourneau, Thierry; Chirouze, Catherine; Seronde, Marie-France; Morel, Olivier; Piroth, Lionel; Eicher, Jean-Christophe; Humbert, Olivier; Revest, Matthieu; Thébault, Elise; Devillers, Anne; Delahaye, François; Boibieux, André; [...]

Impact of Systematic Whole-body 18F-Fluorodeoxyglucose PET/CT on the Management of Patients Suspected of Infective Endocarditis: The Prospective Multicenter TEPvENDO Study

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  • Media type: E-Article
  • Title: Impact of Systematic Whole-body 18F-Fluorodeoxyglucose PET/CT on the Management of Patients Suspected of Infective Endocarditis: The Prospective Multicenter TEPvENDO Study
  • Contributor: Duval, Xavier; Le Moing, Vincent; Tubiana, Sarah; Esposito-Farèse, Marina; Ilic-Habensus, Emila; Leclercq, Florence; Bourdon, Aurélie; Goehringer, François; Selton-Suty, Christine; Chevalier, Elodie; Boutoille, David; Piriou, Nicolas; Le Tourneau, Thierry; Chirouze, Catherine; Seronde, Marie-France; Morel, Olivier; Piroth, Lionel; Eicher, Jean-Christophe; Humbert, Olivier; Revest, Matthieu; Thébault, Elise; Devillers, Anne; Delahaye, François; Boibieux, André; [...]
  • imprint: Oxford University Press (OUP), 2021
  • Published in: Clinical Infectious Diseases
  • Language: English
  • DOI: 10.1093/cid/ciaa666
  • ISSN: 1058-4838; 1537-6591
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Diagnostic and patients’ management modifications induced by whole-body 18F-FDG-PET/CT had not been evaluated so far in prosthetic valve (PV) or native valve (NV) infective endocarditis (IE)-suspected patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>In sum, 140 consecutive patients in 8 tertiary care hospitals underwent 18F-FDG-PET/CT. ESC-2015-modified Duke criteria and patients’ management plan were established jointly by 2 experts before 18F-FDG-PET/CT. The same experts reestablished Duke classification and patients’ management plan immediately after qualitative interpretation of 18F-FDG-PET/CT. A 6-month final Duke classification was established.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among the 70 PV and 70 NV patients, 34 and 46 were classified as definite IE before 18F-FDG-PET/CT. Abnormal perivalvular 18F-FDG uptake was recorded in 67.2% PV and 24.3% NV patients respectively (P &amp;lt; .001) and extracardiac uptake in 44.3% PV and 51.4% NV patients. IE classification was modified in 24.3% and 5.7% patients (P = .005) (net reclassification index 20% and 4.3%). Patients’ managements were modified in 21.4% PV and 31.4% NV patients (P = .25). It was mainly due to perivalvular uptake in PV patients and to extra-cardiac uptake in NV patients and consisted in surgery plan modifications in 7 patients, antibiotic plan modifications in 22 patients and both in 5 patients. Altogether, 18F-FDG-PET/CT modified classification and/or care in 40% of the patients (95% confidence interval: 32–48), which was most likely to occur in those with a noncontributing echocardiography (P &amp;lt; .001) or IE classified as possible at baseline (P = .04), while there was no difference between NV and PV.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Systematic 18F-FDG-PET/CT did significantly and appropriately impact diagnostic classification and/or IE management in PV and NV-IE suspected patients.</jats:p></jats:sec><jats:sec><jats:title>Clinical Trials Registration</jats:title><jats:p>NCT02287792.</jats:p></jats:sec>
  • Access State: Open Access