학술논문
Improved [[sup.18]F]FDG PET/CT Diagnostic Accuracy for Infective Endocarditis Using Conventional Cardiac Gating or Combined Cardiac and Respiratory Motion Correction (CardioFreeze[sup.TM])
Document Type
Academic Journal
Source
Diagnostics. October 2023, Vol. 13 Issue 19
Subject
Language
English
ISSN
2075-4418
Abstract
Author(s): D. ten Hove (corresponding author) [1,2,*]; B. Sinha [2]; J. H. van Snick [1]; R. H. J. A. Slart [1,3]; A. W. J. M. Glaudemans [1] 1. Introduction Infective [...]
Infective endocarditis (IE) is a serious and diagnostically challenging condition. [[sup.18]F]FDG PET/CT is valuable for evaluating suspected IE, but it is susceptible to motion-related artefacts. This study investigated the potential benefits of cardiac motion correction for [[sup.18]F]FDG PET/CT. In this prospective study, patients underwent [[sup.18]F]FDG PET/CT for suspected IE, combined with a conventional cardiac gating sequence, a data-driven cardiac and respiratory gating sequence (CardioFreeze[sup.TM]), or both. Scans were performed in adherence to EANM guidelines and assessors were blinded to patients’ clinical contexts. Final diagnosis of IE was established based on multidisciplinary consensus after a minimum of 4 months follow-up and surgical findings, whenever performed. Seven patients participated in the study, undergoing both an ungated [[sup.18]F] FDG-PET/CT and a scan with either conventional cardiac gating, CardioFreeze[sup.TM], or both. Cardiac motion correction improved the interpretability of [[sup.18]F]FDG PET/CT in four out of five patients with valvular IE lesions, regardless of the method of motion correction used, which was statistically significant by Wilcoxon’s signed rank test: p = 0.046. In one patient the motion-corrected sequence confirmed the diagnosis of endocarditis, which had been missed on non-gated PET. The performance of the two gating sequences was comparable. In conclusion, in this exploratory study, cardiac motion correction of [[sup.18]F]FDG PET/CT improved the interpretability of [[sup.18]F]FDG PET/CT. This may improve the sensitivity of PET/CT for suspected IE. Further larger comparative studies are necessary to confirm the additive value of these cardiac motion correction methods.
Infective endocarditis (IE) is a serious and diagnostically challenging condition. [[sup.18]F]FDG PET/CT is valuable for evaluating suspected IE, but it is susceptible to motion-related artefacts. This study investigated the potential benefits of cardiac motion correction for [[sup.18]F]FDG PET/CT. In this prospective study, patients underwent [[sup.18]F]FDG PET/CT for suspected IE, combined with a conventional cardiac gating sequence, a data-driven cardiac and respiratory gating sequence (CardioFreeze[sup.TM]), or both. Scans were performed in adherence to EANM guidelines and assessors were blinded to patients’ clinical contexts. Final diagnosis of IE was established based on multidisciplinary consensus after a minimum of 4 months follow-up and surgical findings, whenever performed. Seven patients participated in the study, undergoing both an ungated [[sup.18]F] FDG-PET/CT and a scan with either conventional cardiac gating, CardioFreeze[sup.TM], or both. Cardiac motion correction improved the interpretability of [[sup.18]F]FDG PET/CT in four out of five patients with valvular IE lesions, regardless of the method of motion correction used, which was statistically significant by Wilcoxon’s signed rank test: p = 0.046. In one patient the motion-corrected sequence confirmed the diagnosis of endocarditis, which had been missed on non-gated PET. The performance of the two gating sequences was comparable. In conclusion, in this exploratory study, cardiac motion correction of [[sup.18]F]FDG PET/CT improved the interpretability of [[sup.18]F]FDG PET/CT. This may improve the sensitivity of PET/CT for suspected IE. Further larger comparative studies are necessary to confirm the additive value of these cardiac motion correction methods.