New semiquantitative parameters in digital [¹⁸F]FDG PET/CT improve diagnostic accuracy in suspected infective endocarditis.

EJNMMI reports Pub Date : 2025-06-23 DOI:10.1186/s41824-025-00256-6

Carola Maria Bregenzer, Luisa Maria Knappe, Alexander Weissensee, Nasir Gözlügöl, Ali Afshar-Oromieh, Clemens Mingels, Christoph Gräni, Axel Rominger, Federico Caobelli

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Abstract

Background: The purpose of this study was to identify semiquantitative parameters of [¹⁸F]FDG PET/CT using a digital PET scanner, which may increase diagnostic accuracy and readers' confidence in the diagnosis of infective endocarditis (IE).

Results: Images of 82 patients undergoing [¹⁸F]FDG PET/CT for suspected IE were visually and semiquantitatively analyzed. Standardized uptake values (SUV) of suspected foci, also normalized to liver, mediastinum and surrounding activity were calculated. For each, best thresholds were identified to diagnose endocarditis. Final diagnosis was reached by consensus in a multidisciplinary board. Semiquantitative analysis (SUV_max/SUV_max mediastinum, SUV_max/SUV_max liver, SUV_peak/SUV_peak mediastinum, SUV_peak/SUV_peak liver, SUV_max/SUV_mean liver, SUV_max/SUV_mean mediastinum, SUV_max focus/SUV_mean focus, SUV_peak/SUV_peak surrounding) added to visual interpretation increased sensitivity (57-86%), specificity (83-93%), PPV (64-86%), NPV (79-93%) and diagnostic accuracy (74-90%) when using best SUVs thresholds (all p < 0.05).

Conclusions: Combining visual and semiquantitative analysis allows for a more accurate diagnosis of IE, and might be implemented into clinical routine.

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数字式[18F]FDG PET/CT新的半定量参数提高了疑似感染性心内膜炎的诊断准确性。

背景：本研究的目的是利用数字PET扫描仪确定[18F]FDG PET/CT的半定量参数，这可能会提高诊断的准确性和读者对感染性心内膜炎（IE）诊断的信心。结果：对82例疑似IE的患者行[18F]FDG PET/CT影像学及半定量分析。计算疑似病灶的标准化摄取值（SUV），并将其归一化至肝脏、纵隔和周围活动。对于每一种，确定了诊断心内膜炎的最佳阈值。最终诊断是在多学科委员会达成共识。半定量分析（SUVmax/SUVmax纵隔，SUVmax/SUVmax肝脏，SUVmax/SUVmax纵隔，SUVmax/ SUVpeak肝脏，SUVmax/SUVmean肝脏，SUVmax焦点/SUVmean焦点，SUVmax焦点/SUVmean焦点，SUVpeak/SUVpeak周围）添加到视觉解释时，使用最佳suv阈值可提高灵敏度（57-86%），特异性（83-93%），PPV (64-86%)， NPV（79-93%）和诊断准确性（74-90%）。结合视觉和半定量分析可以更准确地诊断IE，并可应用于临床常规。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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EJNMMI reports

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