Evolution of Positron Emission Computed Tomography (PET) Fixation With Fluorodeoxyglucose (FDG) at the End of Antibiotic Treatment of Infective Endocarditis on Valvular Prosthesis

What this Trial Is About

Researchers are studying patients with prosthetic valve endocarditis (PVE) who have shown abnormal FDG uptake on initial FDG-PET scans and were not referred for valve replacement surgery during the acute phase. This study aims to determine if FDG-PET can identify those at higher risk of PVE relapse after antibiotic treatment. The goal is to improve patient management by identifying persistent infection or cure, which could guide decisions on surgery, suppressive antibiotic therapy, or follow-up strategies. The study involves a single-center prospective cohort of 50 adults with definite PVE based on ESC 2015 criteria. Participants have pathological FDG uptake on the prosthetic valve at the start of antibiotic treatment and are medically treated without acute phase surgery. FDG-PET scans are performed at the end of antibiotic treatment to assess changes in valvular and extracardiac FDG uptake. The study also evaluates artificial intelligence analysis to predict relapse risk. Participants will undergo FDG-PET imaging before and after curative antibiotic treatment. Researchers will measure valvular and extracardiac FDG uptake intensity and monitor for PVE relapse within six months. The study will assess the impact of end-of-treatment PET-FDG findings on antibiotic therapy decisions. Follow-up includes clinical monitoring for relapse, with data collected on antibiotic treatment duration and diagnostic accuracy of AI prediction methods.

Evolution of PET Fixation With FDG at the End of Antibiotic Treatment of Infective Endocarditis on Valvular Prosthesis