To what extent does prior antimicrobial therapy affect the diagnostic performance of radiolabeled leukocyte scintigraphy in infective endocarditis? View Full Text


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Article Info

DATE

2022-07-11

AUTHORS

Katarzyna Holcman, Paweł Rubiś, Bogdan Ćmiel, Andrzej Ząbek, Krzysztof Boczar, Wojciech Szot, Zuzanna Kalarus, Katarzyna Graczyk, Maksymilian Hanarz, Barbara Małecka, Piotr Podolec, Magdalena Kostkiewicz

ABSTRACT

AimsThis prospective, single-center study sought to assess to what extent there is interference between the hybrid technique of single-photon emission tomography-computed tomography with technetium99m-hexamethylpropyleneamine oxime–labeled leukocytes (99mTc-HMPAO-SPECT/CT) and antimicrobial therapy in patients with infective endocarditis (IE).Methods and resultsDuring the years 2015–2019, we enrolled 205 consecutive adults with suspected IE, all underwent 99mTc-HMPAO-SPECT/CT. The study population was divided into those who had received antimicrobial therapy up to 30 days prior to 99mTc-HMPAO-SPECT/CT (group 1, n = 96) and those who had not (group 2, n = 109). Patients were prospectively observed for 12 ± 10 months. Group 1 presented higher positive predictive values (91.89% vs. 60.00%, = 0.001), and decreased negative predictive values (77.97% vs. 90.54%, P = 0.04). Patients treated with antimicrobial therapy displayed false-negative 99mTc-HMPAO-SPECT/CT results more often [odds ratio (OR), 4.63; 95% confidence interval (CI), 1.41–15.23, P = .01], particularly when intravenous (OR 5.37; 95% CI 1.73–16.62, P = .004), definite (OR 9.43; 95% CI 2.65–33.51, P = .001), and combination antibiotic regimens (OR 8.1; 95% CI 2.57–25.64, P = .001) had been administered.ConclusionPrior antibiotic therapy affects 99mTc-HMPAO-SPECT/CT diagnostic properties. Patients treated with antimicrobial therapy display false-negative 99mTc-HMPAO-SPECT/CT results more often, especially if intravenous, definite, or combination regimens are administered.Graphical abstract More... »

PAGES

1-11

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URI

http://scigraph.springernature.com/pub.10.1007/s12350-022-03048-8

DOI

http://dx.doi.org/10.1007/s12350-022-03048-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1149410779

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35819715


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