Multimodality Imaging in the Diagnosis of Prosthetic Valve Endocarditis: A Brief Review

Area of Science:

• Cardiology
• Infectious Diseases
• Radiology

Background:

• Infective endocarditis (IE) is a serious condition with high mortality.
• The modified Duke criteria (MDC), integrating clinical, microbiological, and echocardiographic data, are standard for IE diagnosis.
• Echocardiography often yields non-diagnostic results in prosthetic valve endocarditis (PVE), reducing MDC sensitivity.

Purpose of the Study:

• To evaluate the role of advanced multimodality imaging techniques in improving the diagnosis of PVE.
• To assess the diagnostic accuracy and potential benefits of leukocyte scintigraphy, FDG-PET, MDCTA, and CMRI in PVE.

Main Methods:

• Review of current literature and guidelines regarding PVE diagnosis.
• Analysis of evidence supporting the use of various advanced imaging modalities.
• Discussion of the limitations and potential future directions for each technique.

Main Results:

• Advanced imaging modalities, including leukocyte scintigraphy, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), multidetector computed tomographic angiography (MDCTA), and cardiac magnetic resonance imaging (CMRI), show potential to enhance PVE diagnosis.
• These techniques may improve diagnostic accuracy where echocardiography is limited.
• Further research is needed to define the optimal role and integration of these modalities.

Conclusions:

• Multimodality imaging offers promising adjunctive strategies for diagnosing PVE.
• These techniques may aid in determining PVE diagnosis, prognosis, and guiding patient management.
• Standardized guidelines and further validation studies are required to establish the definitive role of these evolving imaging techniques in PVE care.