![Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography FDG-PET/CT](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F3777.jpg&w=3840&q=50)
Characterization of 18F-Fluorodeoxyglucose Uptake Pattern in Noninfected Prosthetic Heart Valves
Cédric Mathieu1, Nidaa Mikaïl1, Khadija Benali1
1From the Department of Nuclear Medicine, Bichat Hospital, Assistance Publique-Hôpitaux de Paris (APHP) and DHU FIRE, France (C.M., N.M., K.B., F.H., D.L.G., F.R.); Paris-Diderot University, France (N.M., K.B., B.I., X.D., P.N., G.J., F.H., D.L.G., F.R.); Inserm Unité Mixte de Recherche U1148, LVTS (N.M., K.B., B.I., P.N., G.J., F.H., D.L.G., F.R.); Department of Cardiology, Bichat Hospital, Assistance Publique Hôpitaux de Paris (APHP) and DHU FIRE, France (B.I., G.J.); Inserm Clinical Investigation Center 1425, Bichat Hospital, Assistance Publique Hôpitaux de Paris (APHP), France; IAME Inserm 1137 (X.D.); and Department of Cardiac Surgery; Bichat Hospital, Assistance Publique Hôpitaux de Paris (APHP) and DHU FIRE, France (P.N.).
Background:
18F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has been recently acknowledged as a diagnostic tool for prosthetic valve endocarditis, but its specificity is limited by uptake on noninfected valves. The objective of this study was to outline the main features of FDG uptake on PET/CT in patients with noninfected prosthetic heart valve (PHV).
Methods And Results:
Our institution's PET/CT database was reviewed to identify patients with PHV, excluding those suspected of infection or who had received antibiotic treatment. PET indication, valve location, and type (biological/mechanical) and time from implantation were collected for each patient. Images with and without attenuation correction were considered for interpretation. The pattern of FDG uptake (absent, homogeneous, or heterogeneous) was recorded. Fifty-four PHVs (51 patients) were identified, including 32 biological valves. Indications for PET were oncology (n=26), suspicion of prosthetic valve endocarditis subsequently excluded (n=17), and history of vasculitis (n=11). A periprosthetic FDG uptake was present in 47 (87%) and 30 (56%) PHVs with and without attenuation correction, respectively, and the pattern was homogeneous in all but 4 (7%) and 3 (6%) PHVs, respectively. On quantitative analysis, maximum standardized uptake values was greater in mechanical than in biological valves (4.0 [2.4-8.0] versus 3.3 [2.1-6.1]; P=0.01) and in patients with vasculitis than in those referred for other indications. The uptake intensity did not differ before and 3 months after valve replacement.
Conclusions:
Noninfected PHVs frequently display homogeneous FDG uptake, which remains steady over time. Caution is, therefore, needed when interpreting FDG PET/CT in suspected prosthetic valve endocarditis, with specific attention to uptake pattern.
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