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CASSIA (cardiology software suite for image analysis): a potential new tool for the evaluation of [(18)F]FDG PET/CT in the setting of infective endocarditis

PURPOSE: Due to the high morbidity and mortality of infective endocarditis (IE), medical imaging techniques are combined to ensure a correct diagnosis. [(18)F]FDG PET/CT has demonstrated the ability to improve diagnostic accuracy compared with the conventional modified Duke criteria in patients with...

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Autores principales: Palomino-Fernández, David, Gómez-Grande, Adolfo, Fernández-Igarza, Mirene, Pilkington, Patrick, Seiffert, Alexander P., Bueno, Héctor, Gómez, Enrique J., Sánchez-González, Patricia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9883360/
https://www.ncbi.nlm.nih.gov/pubmed/36053441
http://dx.doi.org/10.1007/s11548-022-02729-6
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author Palomino-Fernández, David
Gómez-Grande, Adolfo
Fernández-Igarza, Mirene
Pilkington, Patrick
Seiffert, Alexander P.
Bueno, Héctor
Gómez, Enrique J.
Sánchez-González, Patricia
author_facet Palomino-Fernández, David
Gómez-Grande, Adolfo
Fernández-Igarza, Mirene
Pilkington, Patrick
Seiffert, Alexander P.
Bueno, Héctor
Gómez, Enrique J.
Sánchez-González, Patricia
author_sort Palomino-Fernández, David
collection PubMed
description PURPOSE: Due to the high morbidity and mortality of infective endocarditis (IE), medical imaging techniques are combined to ensure a correct diagnosis. [(18)F]FDG PET/CT has demonstrated the ability to improve diagnostic accuracy compared with the conventional modified Duke criteria in patients with suspected IE, especially those with prosthetic valve infective endocarditis (PVIE). The aim of this study is to provide an adjunctive diagnostic tool to improve the diagnostic accuracy in cardiovascular infections, specifically PVIE. METHODS: A segmentation tool to extract quantitative measures of [(18)F]FDG PET/CT image studies of prosthetic heart valve regions was developed and validated in 20 cases of suspected PVIE, of which 9 were confirmed. For that, Valvular Heterogeneity Index (VHI) and Ring-to-Center Ratio (RCR) were defined. RESULTS: Results show an overall increase in the metabolic uptake of the prosthetic valve ring in the studies with confirmed PVIE diagnosis (SUV(max) from 1.70 to 3.20; SUV(mean) from 0.86 to 1.50). The VHI and RCR showed areas under the curve of 0.727 and 0.808 in the receiver operating characteristics curve analyses, respectively, for PVIE diagnosis. Mann–Whitney U tests showed statistically significant differences between groups for RCR (p = 0.02). Visual analyses and clinical reports were concordant with the extracted quantitative metrics. CONCLUSION: The proposed new method and presented software solution (CASSIA) provide the capability to assess quantitatively myocardial metabolism along the prosthetic valve region in routine [(18)F]FDG PET/CT scans for evaluating heart valve infectious processes. VHI and RCR are proposed as new potential adjunctive measures for PVIE diagnosis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11548-022-02729-6.
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spelling pubmed-98833602023-01-29 CASSIA (cardiology software suite for image analysis): a potential new tool for the evaluation of [(18)F]FDG PET/CT in the setting of infective endocarditis Palomino-Fernández, David Gómez-Grande, Adolfo Fernández-Igarza, Mirene Pilkington, Patrick Seiffert, Alexander P. Bueno, Héctor Gómez, Enrique J. Sánchez-González, Patricia Int J Comput Assist Radiol Surg Original Article PURPOSE: Due to the high morbidity and mortality of infective endocarditis (IE), medical imaging techniques are combined to ensure a correct diagnosis. [(18)F]FDG PET/CT has demonstrated the ability to improve diagnostic accuracy compared with the conventional modified Duke criteria in patients with suspected IE, especially those with prosthetic valve infective endocarditis (PVIE). The aim of this study is to provide an adjunctive diagnostic tool to improve the diagnostic accuracy in cardiovascular infections, specifically PVIE. METHODS: A segmentation tool to extract quantitative measures of [(18)F]FDG PET/CT image studies of prosthetic heart valve regions was developed and validated in 20 cases of suspected PVIE, of which 9 were confirmed. For that, Valvular Heterogeneity Index (VHI) and Ring-to-Center Ratio (RCR) were defined. RESULTS: Results show an overall increase in the metabolic uptake of the prosthetic valve ring in the studies with confirmed PVIE diagnosis (SUV(max) from 1.70 to 3.20; SUV(mean) from 0.86 to 1.50). The VHI and RCR showed areas under the curve of 0.727 and 0.808 in the receiver operating characteristics curve analyses, respectively, for PVIE diagnosis. Mann–Whitney U tests showed statistically significant differences between groups for RCR (p = 0.02). Visual analyses and clinical reports were concordant with the extracted quantitative metrics. CONCLUSION: The proposed new method and presented software solution (CASSIA) provide the capability to assess quantitatively myocardial metabolism along the prosthetic valve region in routine [(18)F]FDG PET/CT scans for evaluating heart valve infectious processes. VHI and RCR are proposed as new potential adjunctive measures for PVIE diagnosis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11548-022-02729-6. Springer International Publishing 2022-09-02 2023 /pmc/articles/PMC9883360/ /pubmed/36053441 http://dx.doi.org/10.1007/s11548-022-02729-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Palomino-Fernández, David
Gómez-Grande, Adolfo
Fernández-Igarza, Mirene
Pilkington, Patrick
Seiffert, Alexander P.
Bueno, Héctor
Gómez, Enrique J.
Sánchez-González, Patricia
CASSIA (cardiology software suite for image analysis): a potential new tool for the evaluation of [(18)F]FDG PET/CT in the setting of infective endocarditis
title CASSIA (cardiology software suite for image analysis): a potential new tool for the evaluation of [(18)F]FDG PET/CT in the setting of infective endocarditis
title_full CASSIA (cardiology software suite for image analysis): a potential new tool for the evaluation of [(18)F]FDG PET/CT in the setting of infective endocarditis
title_fullStr CASSIA (cardiology software suite for image analysis): a potential new tool for the evaluation of [(18)F]FDG PET/CT in the setting of infective endocarditis
title_full_unstemmed CASSIA (cardiology software suite for image analysis): a potential new tool for the evaluation of [(18)F]FDG PET/CT in the setting of infective endocarditis
title_short CASSIA (cardiology software suite for image analysis): a potential new tool for the evaluation of [(18)F]FDG PET/CT in the setting of infective endocarditis
title_sort cassia (cardiology software suite for image analysis): a potential new tool for the evaluation of [(18)f]fdg pet/ct in the setting of infective endocarditis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9883360/
https://www.ncbi.nlm.nih.gov/pubmed/36053441
http://dx.doi.org/10.1007/s11548-022-02729-6
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