18F-FDG PET/CT in cardiovascular infection and inflammation

In Nuclear Cardiology, the diagnosis of cardiovascular infection and inflammation by [F-18]FDG PET/CT is of growing interest, because this technique has improved the certainty in the diagnosis of infective endocarditis in patients with prosthetic valves respect to echocardiography, in patients with cardiac implantable devices, with increasing frequency of implantation because of the progressive ageing of the population, as well as in patients with suspected large vessel vasculitis. They are serious clinical situations, where it is necessary to establish as soon as possible the correct diagnosis and appropriate treatment, because they can cause severe complications, high mortality and also increased health care costs. We review the use of [F-18]FDG PET/CT in cardiovascular infection and inflammation, including the clinical point of view and the contribution of other image modalities, focusing on the conditions for the appropriate methodology of this exploration, patient preparation, images acquisition, their correct interpretation and the quantification possibilities, defining the specific characteristics of the diagnosis in patients with prosthetic valves, cardiac implantable devices and large vessel vasculitis, in initial diagnosis as well as in the follow-up, to assess the treatment response. We analyze the possible causes of false positive and false negative results and we emphasize the special value in these cases of a multidisciplinary team for optimal management of patients. (C) 2021 Sociedad Espanola de Medicina Nuclear eImagen Molecular. Published by Elsevier Espana, S.L.U. All rights reserved.