Standardized uptake values in FDG PET/CT for prosthetic heart valve endocarditis: a call for standardization

J Nucl Cardiol. 2018 Dec;25(6):2084-2091. doi: 10.1007/s12350-017-0932-x. Epub 2017 Jun 5.

Abstract

Background: The significance of and threshold values for the standardized uptake value (SUV) in FDG PET/CT to diagnose prosthetic heart valve (PHV) endocarditis (PVE) are unclear at present.

Methods: A literature search was performed in the PubMed and EMBASE medical databases, comprising the following terms: (FDG OR *fluorode* OR *fluoro-de*) AND (endocarditis OR prosthetic heart valve OR valve replacement). Studies reporting SUVs correlated to the diagnosis of PVE were selected for analysis.

Results: 8 studies were included, with a total of 330 PHVs assessed. SUVs for PVE varied substantially across studies due to differences in acquisition, reconstruction, and measurement protocols, with median SUVmax values for rejected PVE ranging from 0.5 to 4.9 and for definite PVE ranging from 4.2 to 7.4.

Conclusion: Reported SUV values for PVE are not interchangeable between sites, and further standardization of quantification is desirable. To this end, optimal protocols for patient preparation, image acquisition, and reconstruction and measurement methods need to be standardized across centers.

Keywords: 18F-fluorodeoxyglucose; EARL; computed tomography; endocarditis; positron emission tomography; prosthetic heart valve.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Endocarditis, Bacterial / diagnostic imaging*
  • Fluorodeoxyglucose F18 / pharmacokinetics*
  • Heart Valve Prosthesis / adverse effects*
  • Humans
  • Image Processing, Computer-Assisted / standards
  • Positron Emission Tomography Computed Tomography / methods*
  • Prosthesis-Related Infections / diagnostic imaging*
  • Radiopharmaceuticals / pharmacokinetics*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18