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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This document discusses the clinical use of 18F-FDG PET imaging for the detection of infections, specifically in patients with intracardiac devices or prosthetic valves. The traditional diagnostic criteria for infective endocarditis (IE) are limited in these patients, leading to the need for new diagnostic tools. PET with 18F-FDG has been found to be a potentially useful technique, as inflammatory leukocytes express a high density of glucose transporters and are highly metabolically active. Studies have reported encouraging results in patients with intracardiac devices and prosthetic valves, allowing for the diagnosis of embolic events.<br /><br />The patient preparation for 18F-FDG PET imaging involves a fasting period and a low-carbohydrate diet to reduce the amount of glucose available for myocardial metabolism. The injection of 18F-FDG is done 60 minutes prior to image acquisition. The imaging process involves a whole-body PET/CT scan, and co-registration with a CT angiography (CTA) is preferable. The interpretation of the images includes qualitative analysis of bright or hot spots, as well as visual analysis of attenuation and non-attenuation corrected images. Quantitative assessment involves the measurement of standardized uptake values (SUV), although there are no standardized parameters for this. Various factors can confound the results, such as recent procedures, inadequate suppression of myocardial glucose metabolism, prolonged antibiotic therapy, and isolated, small, or mobile vegetations.<br /><br />Case studies are presented to illustrate the use of 18F-FDG PET imaging in different scenarios, including patients with suspected prosthetic valve or cardiac device IE. The PET/CT scans are shown to demonstrate infection before morphological abnormalities are seen on echocardiography, which highlights the potential of this imaging technique in early diagnosis.<br /><br />In conclusion, 18F-FDG PET imaging has shown promise in the detection of infections, particularly in patients with intracardiac devices or prosthetic valves. However, further research and standardization of diagnostic criteria are needed to fully utilize its clinical value.

Keywords

18F-FDG PET imaging

infections

intracardiac devices

prosthetic valves

infective endocarditis

diagnostic tools

inflammatory leukocytes

embolic events

quantitative assessment

early diagnosis