Diagnostic value of SPECT for endocarditis: a systematic review and meta-analysis

Area of Science:

• Nuclear Medicine
• Cardiology
• Infectious Diseases

Background:

• Early identification and treatment of infective endocarditis (IE) are crucial for reducing mortality and complications.
• Scintigraphy's ability to locate inflammatory lesions can enhance diagnostic efficiency for IE.
• The diagnostic performance of SPECT for IE requires comprehensive assessment.

Purpose of the Study:

• To systematically review and meta-analyze the diagnostic performance of SPECT in patients with IE.
• To evaluate the accuracy of SPECT in detecting IE and cardiac device-related endocarditis (CDRE).

Main Methods:

• Systematic review and meta-analysis conducted following PRISMA and QUADAS-2 guidelines.
• Searched Medline, Embase, and Cochrane databases for relevant studies published until 2024.
• Included 25 studies for systematic review and 21 studies for meta-analysis from 1099 identified records.

Main Results:

• SPECT demonstrated high diagnostic accuracy for IE detection, with 75.8% sensitivity and 87.4% specificity (AUROC = 0.816).
• 99mTc-HMPAO-WBC SPECT showed higher diagnostic performance for CDRE, with 82.9% sensitivity and 91.4% specificity.
• SPECT imaging proves effective in identifying inflammatory lesions associated with IE.

Conclusions:

• Scintigraphy, particularly SPECT, exhibits high diagnostic accuracy for IE and is especially valuable for CDRE diagnosis.
• SPECT may be particularly useful in cases where traditional imaging modalities yield inconclusive results for IE.
• Further multicenter studies are necessary to define SPECT's role in the comprehensive diagnostic framework for IE.