TY - JOUR
T1 - Molecular Imaging for the diagnosis of infective endocarditis
T2 - A systematic literature review and meta-analysis
AU - Juneau, Daniel
AU - Golfam, Mohammad
AU - Hazra, Samir
AU - Erthal, Fernanda
AU - Zuckier, Lionel S.
AU - Bernick, Jordan
AU - Wells, George A.
AU - Beanlands, Rob S.B.
AU - Chow, Benjamin J.W.
N1 - Funding Information:
RSB is or has been a consultant for- and receives grant funding from GE Healthcare, Lantheus Medical Imaging, and Jubilant DraxImage. BJC receives research and educational support from TeraRecon Inc and a research grant from CV Diagnostix. All other authors have no conflict of interest or disclosure.
Funding Information:
DJ is a Cardiac Imaging Fellow at the University of Ottawa Heart Institute and is supported by the UOHI Foundation and the Vered-Beanlands Fellowship in Cardiology Research as well as a grant from the CHUM and CHUM Fondation . RSB is a career investigator supported by the Heart and Stroke Foundation of Ontario, a Tier 1 Research Chair supported by the University of Ottawa , and the University of Ottawa Heart Institute Vered Chair in Cardiology. BJC holds the Saul and Edna Goldfarb Chair in Cardiac Imaging Research.
Publisher Copyright:
© 2017 Elsevier Ireland Ltd
PY - 2018/2/15
Y1 - 2018/2/15
N2 - Background Infective endocarditis (IE) is a serious, potentially life-threatening condition. Currently, the modified Duke criteria is used to assist with the diagnosis of IE, but it can still remain difficult. Growing data supports the potential use of molecular imaging to assist in the diagnosis of IE. Our objective was to understand the potential utility of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT), 67Ga citrate and radiolabeled white blood cell (WBC) scintigraphy in the diagnosis of IE. Methods and results A systematic review of the literature and meta-analysis on the use of all 3 modalities in IE was conducted. The literature search identified 2753 articles. A total of 14 studies met the inclusion criteria (10 for 18F-FDG, 3 for WBC and 1 for both modalities). No 67Ga citrate study met the inclusion criteria. Pooled sensitivity of 18F-FDG studies with adequate cardiac preparation for the diagnosis of IE was 81% (95% CI, 73%–86%) and pooled specificity was 85% (95% CI, 78%–91%). There was good overall accuracy with an area under the curve (AUC) of 0.897. Pooled sensitivity of WBC for the diagnosis of IE was 86% (95% CI, 77%–92%) and pooled specificity was 97% (95% CI, 92%–99%). The overall accuracy of WBC was excellent with an AUC of 0.957. Conclusions Both 18F-FDG and WBC have good sensitivity, specificity and accuracy for the diagnosis of IE. Both modalities are useful in the investigation of IE, and should be considered in cases where the diagnosis is uncertain.
AB - Background Infective endocarditis (IE) is a serious, potentially life-threatening condition. Currently, the modified Duke criteria is used to assist with the diagnosis of IE, but it can still remain difficult. Growing data supports the potential use of molecular imaging to assist in the diagnosis of IE. Our objective was to understand the potential utility of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT), 67Ga citrate and radiolabeled white blood cell (WBC) scintigraphy in the diagnosis of IE. Methods and results A systematic review of the literature and meta-analysis on the use of all 3 modalities in IE was conducted. The literature search identified 2753 articles. A total of 14 studies met the inclusion criteria (10 for 18F-FDG, 3 for WBC and 1 for both modalities). No 67Ga citrate study met the inclusion criteria. Pooled sensitivity of 18F-FDG studies with adequate cardiac preparation for the diagnosis of IE was 81% (95% CI, 73%–86%) and pooled specificity was 85% (95% CI, 78%–91%). There was good overall accuracy with an area under the curve (AUC) of 0.897. Pooled sensitivity of WBC for the diagnosis of IE was 86% (95% CI, 77%–92%) and pooled specificity was 97% (95% CI, 92%–99%). The overall accuracy of WBC was excellent with an AUC of 0.957. Conclusions Both 18F-FDG and WBC have good sensitivity, specificity and accuracy for the diagnosis of IE. Both modalities are useful in the investigation of IE, and should be considered in cases where the diagnosis is uncertain.
KW - Fluor-18-fluorodeoxyglucose
KW - Infective endocarditis
KW - Labeled white blood cell scintigraphy
KW - Positron emission tomography
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U2 - 10.1016/j.ijcard.2017.10.116
DO - 10.1016/j.ijcard.2017.10.116
M3 - Article
C2 - 29137818
AN - SCOPUS:85033559921
VL - 253
SP - 183
EP - 188
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -