| Title: |
Impact of Systematic Whole-body 18F-Fluorodeoxyglucose PET/CT on the Management of Patients Suspected of Infective Endocarditis: The Prospective Multicenter TEPvENDO Study |
| Authors: |
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; Grégoire, Bastien; Hoen, Bruno; Laouenan, Cédric; Iung, Bernard; Rouzet, François; Rouzet, Francois; Albayrak, Tubanur; Bernard, Yvette; Boulahdour, Hatem; Briand, Florent; Faucher, Jean-François; Guignier, Alexandre; Hustache-Mathieu, Laurent; Illes-Hajnal, Gabriela; Moreau, Joséphine; Behechti, Niloufar; Blot, Mathieu; Buisson, Marielle; Cochet, Alexandre |
| Contributors: |
French Ministry of Health |
| Source: |
Clinical Infectious Diseases ; volume 73, issue 3, page 393-403 ; ISSN 1058-4838 1537-6591 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2020 |
| Description: |
Background 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. Methods 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. Results 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 < .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 < .001) or IE classified as possible at baseline (P = .04), while there was no difference between NV and PV. Conclusions Systematic 18F-FDG-PET/CT did significantly and appropriately impact diagnostic classification and/or IE management in PV and NV-IE suspected patients. Clinical Trials Registration NCT02287792. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/cid/ciaa666 |
| DOI: |
10.1093/cid/ciaa666/33725196/ciaa666.pdf |
| Availability: |
https://doi.org/10.1093/cid/ciaa666; http://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciaa666/33725196/ciaa666.pdf; http://academic.oup.com/cid/article-pdf/73/3/393/39508268/ciaa666.pdf |
| Rights: |
https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model |
| Accession Number: |
edsbas.EA0D0AE2 |
| Database: |
BASE |