Clinical utility of 18F-FDG positron emission tomography/computed tomography scan vs. 99mTc-HMPAO white blood cell single-photon emission computed tomography in extra-cardiac work-up of infective endocarditis

Trine K Lauridsen; Kasper K Iversen; Nikolaj Ihlemann; Philip Hasbak; Annika Loft; Anne K Berthelsen; Anders Dahl; Danijela Dejanovic; Elisabeth Albrecht-Beste; Jann Mortensen; Andreas Kjær; Henning Bundgaard; Niels Eske Bruun

doi:10.1007/s10554-016-1047-1

Clinical utility of ¹⁸F-FDG positron emission tomography/computed tomography scan vs. ^99mTc-HMPAO white blood cell single-photon emission computed tomography in extra-cardiac work-up of infective endocarditis

Trine K Lauridsen, Kasper K Iversen, Nikolaj Ihlemann, Philip Hasbak, Annika Loft, Anne K Berthelsen, Anders Dahl, Danijela Dejanovic, Elisabeth Albrecht-Beste, Jann Mortensen, Andreas Kjær, Henning Bundgaard, Niels Eske Bruun

16 Citationer (Scopus)

Abstract

The extra-cardiac work-up in infective endocarditis (IE) comprises a search for primary and secondary infective foci. Whether18FDG-PET/CT or WBC-SPECT/CT is superior in detection of clinically relevant extra-cardiac manifestations in IE is unexplored. The objectives of this study were to identify the numbers of positive findings detected by each imaging modality, to evaluate the clinical relevance of these findings and to define the reproducibility for extra-cardiac foci in patients with definite IE. Each modality was evaluated for numbers and location of positive extra-cardiac foci in patients with definite IE. A team of 2 × 2 cardiologists evaluated each finding to determine clinical relevance. Clinical utility was determined by 4 criteria converted into an ordinal scale. Using the manifestation with highest clinical utility rating in each patient, the clinical impact of the two imaging modalities was expressed in a clinical utility score. To evaluate reproducibility for each modality, an imaging core laboratory reviewed all findings. In 55 IE patients, 91 pathological foci were found by FDG-PET/CT and 37 foci were identified by WBC-SPECT/CT (p < 0.001). The clinical utility of FDG-PET/CT was significantly higher than that of WBC-SPECT/CT when comparing clinical utility score (2.06 vs. 1.17; p = 0.01). In assessment of extra-cardiac diagnostics in IE, inter-observer reproducibility was substantial for WBC-SPECT/CT (k 0.69, 95% CI 0.49-0.89) and substantial to excellent for FDG-PET/CT (k 0.79, 95% CI 0.61-0.98). FDG-PET/CT has a significantly higher clinical utility score than WBC SPECT/CT and is potentially superior to WBC-SPECT/CT in detection of extra-cardiac pathology in patients with IE.

Originalsprog	Engelsk
Tidsskrift	International Journal of Cardiovascular Imaging
Vol/bind	33
Udgave nummer	5
Sider (fra-til)	751-760
ISSN	1569-5794
DOI	https://doi.org/10.1007/s10554-016-1047-1
Status	Udgivet - 1 maj 2017

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10.1007/s10554-016-1047-1

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Citationsformater

Lauridsen, T. K., Iversen, K. K., Ihlemann, N., Hasbak, P., Loft, A., Berthelsen, A. K., Dahl, A., Dejanovic, D., Albrecht-Beste, E., Mortensen, J., Kjær, A., Bundgaard, H., & Bruun, N. E. (2017). Clinical utility of ¹⁸F-FDG positron emission tomography/computed tomography scan vs. ^99mTc-HMPAO white blood cell single-photon emission computed tomography in extra-cardiac work-up of infective endocarditis. International Journal of Cardiovascular Imaging, 33(5), 751-760. https://doi.org/10.1007/s10554-016-1047-1

Clinical utility of ¹⁸F-FDG positron emission tomography/computed tomography scan vs. ^99mTc-HMPAO white blood cell single-photon emission computed tomography in extra-cardiac work-up of infective endocarditis. / Lauridsen, Trine K; Iversen, Kasper K; Ihlemann, Nikolaj et al.
I: International Journal of Cardiovascular Imaging, Bind 33, Nr. 5, 01.05.2017, s. 751-760.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Lauridsen, TK, Iversen, KK, Ihlemann, N, Hasbak, P, Loft, A, Berthelsen, AK, Dahl, A, Dejanovic, D, Albrecht-Beste, E , Mortensen, J , Kjær, A , Bundgaard, H & Bruun, NE 2017, 'Clinical utility of ¹⁸F-FDG positron emission tomography/computed tomography scan vs. ^99mTc-HMPAO white blood cell single-photon emission computed tomography in extra-cardiac work-up of infective endocarditis', International Journal of Cardiovascular Imaging, bind 33, nr. 5, s. 751-760. https://doi.org/10.1007/s10554-016-1047-1

Lauridsen TK, Iversen KK, Ihlemann N, Hasbak P, Loft A, Berthelsen AK et al. Clinical utility of ¹⁸F-FDG positron emission tomography/computed tomography scan vs. ^99mTc-HMPAO white blood cell single-photon emission computed tomography in extra-cardiac work-up of infective endocarditis. International Journal of Cardiovascular Imaging. 2017 maj 1;33(5):751-760. doi: 10.1007/s10554-016-1047-1

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abstract = "The extra-cardiac work-up in infective endocarditis (IE) comprises a search for primary and secondary infective foci. Whether18FDG-PET/CT or WBC-SPECT/CT is superior in detection of clinically relevant extra-cardiac manifestations in IE is unexplored. The objectives of this study were to identify the numbers of positive findings detected by each imaging modality, to evaluate the clinical relevance of these findings and to define the reproducibility for extra-cardiac foci in patients with definite IE. Each modality was evaluated for numbers and location of positive extra-cardiac foci in patients with definite IE. A team of 2 × 2 cardiologists evaluated each finding to determine clinical relevance. Clinical utility was determined by 4 criteria converted into an ordinal scale. Using the manifestation with highest clinical utility rating in each patient, the clinical impact of the two imaging modalities was expressed in a clinical utility score. To evaluate reproducibility for each modality, an imaging core laboratory reviewed all findings. In 55 IE patients, 91 pathological foci were found by FDG-PET/CT and 37 foci were identified by WBC-SPECT/CT (p < 0.001). The clinical utility of FDG-PET/CT was significantly higher than that of WBC-SPECT/CT when comparing clinical utility score (2.06 vs. 1.17; p = 0.01). In assessment of extra-cardiac diagnostics in IE, inter-observer reproducibility was substantial for WBC-SPECT/CT (k 0.69, 95% CI 0.49-0.89) and substantial to excellent for FDG-PET/CT (k 0.79, 95% CI 0.61-0.98). FDG-PET/CT has a significantly higher clinical utility score than WBC SPECT/CT and is potentially superior to WBC-SPECT/CT in detection of extra-cardiac pathology in patients with IE.",

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T1 - Clinical utility of 18F-FDG positron emission tomography/computed tomography scan vs. 99mTc-HMPAO white blood cell single-photon emission computed tomography in extra-cardiac work-up of infective endocarditis

AU - Lauridsen, Trine K

AU - Iversen, Kasper K

AU - Ihlemann, Nikolaj

AU - Hasbak, Philip

AU - Loft, Annika

AU - Berthelsen, Anne K

AU - Dahl, Anders

AU - Dejanovic, Danijela

AU - Albrecht-Beste, Elisabeth

AU - Mortensen, Jann

AU - Kjær, Andreas

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N2 - The extra-cardiac work-up in infective endocarditis (IE) comprises a search for primary and secondary infective foci. Whether18FDG-PET/CT or WBC-SPECT/CT is superior in detection of clinically relevant extra-cardiac manifestations in IE is unexplored. The objectives of this study were to identify the numbers of positive findings detected by each imaging modality, to evaluate the clinical relevance of these findings and to define the reproducibility for extra-cardiac foci in patients with definite IE. Each modality was evaluated for numbers and location of positive extra-cardiac foci in patients with definite IE. A team of 2 × 2 cardiologists evaluated each finding to determine clinical relevance. Clinical utility was determined by 4 criteria converted into an ordinal scale. Using the manifestation with highest clinical utility rating in each patient, the clinical impact of the two imaging modalities was expressed in a clinical utility score. To evaluate reproducibility for each modality, an imaging core laboratory reviewed all findings. In 55 IE patients, 91 pathological foci were found by FDG-PET/CT and 37 foci were identified by WBC-SPECT/CT (p < 0.001). The clinical utility of FDG-PET/CT was significantly higher than that of WBC-SPECT/CT when comparing clinical utility score (2.06 vs. 1.17; p = 0.01). In assessment of extra-cardiac diagnostics in IE, inter-observer reproducibility was substantial for WBC-SPECT/CT (k 0.69, 95% CI 0.49-0.89) and substantial to excellent for FDG-PET/CT (k 0.79, 95% CI 0.61-0.98). FDG-PET/CT has a significantly higher clinical utility score than WBC SPECT/CT and is potentially superior to WBC-SPECT/CT in detection of extra-cardiac pathology in patients with IE.

AB - The extra-cardiac work-up in infective endocarditis (IE) comprises a search for primary and secondary infective foci. Whether18FDG-PET/CT or WBC-SPECT/CT is superior in detection of clinically relevant extra-cardiac manifestations in IE is unexplored. The objectives of this study were to identify the numbers of positive findings detected by each imaging modality, to evaluate the clinical relevance of these findings and to define the reproducibility for extra-cardiac foci in patients with definite IE. Each modality was evaluated for numbers and location of positive extra-cardiac foci in patients with definite IE. A team of 2 × 2 cardiologists evaluated each finding to determine clinical relevance. Clinical utility was determined by 4 criteria converted into an ordinal scale. Using the manifestation with highest clinical utility rating in each patient, the clinical impact of the two imaging modalities was expressed in a clinical utility score. To evaluate reproducibility for each modality, an imaging core laboratory reviewed all findings. In 55 IE patients, 91 pathological foci were found by FDG-PET/CT and 37 foci were identified by WBC-SPECT/CT (p < 0.001). The clinical utility of FDG-PET/CT was significantly higher than that of WBC-SPECT/CT when comparing clinical utility score (2.06 vs. 1.17; p = 0.01). In assessment of extra-cardiac diagnostics in IE, inter-observer reproducibility was substantial for WBC-SPECT/CT (k 0.69, 95% CI 0.49-0.89) and substantial to excellent for FDG-PET/CT (k 0.79, 95% CI 0.61-0.98). FDG-PET/CT has a significantly higher clinical utility score than WBC SPECT/CT and is potentially superior to WBC-SPECT/CT in detection of extra-cardiac pathology in patients with IE.

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