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Cardiac 18F-FDG PET/CT With Heparin Detects Infective Vegetation in a Patient With Mechanical Valve Replacement

Klaipetch, Alisa MD*; Manabe, Osamu MD, PhD; Oyama-Manabe, Noriko MD, PhD; Chiba, Satoru MD, PhD§; Naya, Masanao MD, PhD§; Yamada, Shiro MD§; Hirata, Kenji MD, PhD; Tsutsui, Hiroyuki MD, PhD§; Tamaki, Nagara MD, PhD

doi: 10.1097/RLU.0b013e318251e3f4
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We report the usefulness of 18F-FDG PET/CT for the detection and therapy evaluation of the infective vegetation. A 64-year-old man with history of aortic valve replacement presented with 2 months of fever without identifiable cause. Echocardiogram showed no inflammation vegetation or abnormality of mechanical valve function. FDG PET/CT with 50 IU/kg IV heparin revealed focal uptakes near the mechanical aortic valve. After antibiotics therapy, fever was ameliorated, and FDG PET/CT findings showed markedly decreased uptake of the lesions. FDG PET/CT is a powerful tool to detect endocarditis even in patients with no anatomical abnormalities.

From the *Department of Radiology, Faculty of Medicine Chiang Mai University, Chiang Mai, Thailand; †Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine; and Departments of ‡Diagnostic and Interventional Radiology and §Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan.

Received for publication December 21, 2011; revision accepted February 21, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Noriko Oyama-Manabe, MD, PhD, Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo 060-8638, Japan. E-mail:

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.