Module 16. Infection PET Imaging with 18F-FDG Clinical Data-Infection PET Imaging with 18F-FDG Clinical Data (Slides)

Infection PET Imaging with 18F-FDG Clinical Data (Slides)

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Part 6 of the Non-Perfusion Imaging Module titled "Infection PET Imaging with 18F-FDG Clinical Data" discusses the clinical value and applications of infection imaging using 18F-fluorodeoxyglucose (FDG) PET. It explores the limitations of traditional diagnostic criteria for infective endocarditis (IE) in patients with intracardiac devices or prosthetic valves, and the need for new diagnostic tools. Recent advances in imaging techniques including cardiac/whole-body CT scan, cerebral MRI, radiolabeled leucocyte SPECT/CT, and 18F-FDG PET/CT have shown promising results in diagnosing IE.<br /><br />PET with 18F-FDG is a potentially useful technique as inflammatory leukocytes express a high density of glucose transporters and are metabolically active. Studies have reported encouraging results in patients with intracardiac devices and prosthetic valves, allowing for the diagnosis of embolic events. However, there is heterogeneity between studies in terms of acquisition protocols and diagnostic criteria.<br /><br />Patient preparation for 18F-FDG PET imaging includes fasting for at least 12 hours and following a low-carbohydrate diet. Intravenous heparin may be used, and the tracer is injected 60 minutes prior to image acquisition. Whole-body acquisition is recommended.<br /><br />Image interpretation involves qualitative and quantitative assessments, including visual analysis of attenuation-corrected and non-attenuation corrected images, as well as measuring SUV maximum and SUV ratio. However, there are no standardized parameters, and confounding factors such as prior antibiotic treatment and artifacts can affect the accuracy of the interpretation.<br /><br />Case studies presented demonstrate the use of 18F-FDG PET/CT in diagnosing prosthetic valve and pacemaker/device-related infective endocarditis. PET/CT provided valuable information before morphological abnormalities were observed on echocardiography.<br /><br />In conclusion, 18F-FDG PET imaging offers potential benefits in diagnosing infective endocarditis, reducing misdiagnoses, and detecting peripheral embolic and metastatic infectious events. However, further research is needed to establish standardized protocols and criteria to improve the accuracy of diagnosis.

Keywords

Infection PET Imaging

18F-FDG Clinical Data

infective endocarditis

intracardiac devices

prosthetic valves

diagnostic tools

imaging techniques

patient preparation

image interpretation

misdiagnoses