Title:The Role of 18FDG PET/CT in the Assessment of Endocarditis, Myocarditis and Pericarditis
Volume: 14
Issue: 3
Author(s): Assuero Giorgetti*, Dario Genovesi and Michele Emdin
Affiliation:
- Fondazione CNR/Regione Toscana “Gabriele Monasterio”, Pisa,Italy
Keywords:
PET/CT, inflammatory, molecular imaging, cardiologists, myocarditis, echocardiography.
Abstract: Endocarditis, myocarditis and pericarditis are a heterogeneous group of phenotypic syndromes
where the culprit area of inflammation is the heart. Inflammation may be determined by an
infective agent, toxins, drugs or an activated immune system. Clinical manifestations can be subtle
and diagnosis remains a challenge for cardiologists, requiring high level of suspicion and advanced
multimodal cardiac imaging to avoid life-threatening consequences. The purpose of this review is
to report the recent advances of PET/CT imaging with 18FDG in helping the management of patients
affected by inflammatory heart disease. Two independent reviewers searched in PubMed articles
published before or in June 2019 and final decisions on the inclusion of references were done
in consensus with a third reviewer. At the end of the selection process 23/206 articles on “cardiac
inflammation”; 26/235 articles on “endocarditis”, “prosthetic heart valve”, “pacemaker”, “implantable
cardiac device”; 7/103 articles on “myocarditis”; 13/330 articles on sarcoidosis” and 2/19
articles on “pericarditis” were included. Compared with the conventional methods, molecular imaging
has the advantage to non-invasively and directly trace the inflammatory process, and to identify
earlier the presence and the extent of intra-cardiac and extra-cardiac involvement, to enable quantification
of disease activity, guide therapeutic interventions, and monitor treatment success.