FDG-PET/CT Incidental Detection of Cancer in Patients Investigated for Infective Endocarditis

Frederique Gouriet (1, 2) , Herve Tissot-Dupont (2, 1) , Jean-Paul Casalta (1) , Sandrine Hubert (3) , Serge Cammilleri (4) , Alberto Riberi (5, 2) , Hubert Lepidi (2, 6) , Gilbert Habib (2, 7) , Didier Raoult (2, 1)

1 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
2 MEPHI - Microbes évolution phylogénie et infections
3 APHM - Assistance Publique - Hôpitaux de Marseille
4 FRESNEL - Institut FRESNEL
5 Département de Cardiologie [Hôpital de la Timone - APHM]
6 ACPNP - Service d'Anatomo-Cyto-Pathologie et de NeuroPathologie [Hôpital de la Timone - APHM]
7 Service de cardiologie

Background:Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is an imaging technique largely used in the management of infective endocarditis and in the detection and staging of cancer. We evaluate our experience of incidental cancer detection by PET/CT during IE investigations and follow-up. Methods and Findings:Between 2009 and 2018, our center, which includes an ``endocarditis team,'' managed 750 patients with IE in a prospective cohort. PET/CT became available in 2011 and was performed in 451 patients. Incidental diagnosis of cancer by PET/CT was observed in 36 patients and confirmed in 34 of them (7.5%) (colorectaln= 17; lungn= 7; lymphoman= 2; melanoman= 2; ovariann= 2; prostaten= 1; bladdern= 1; ear, nose, and throatn= 1; brainn= 1). A significant association has been found between colorectal cancer andStreptococcus gallolyticusand/orEnterococcus faecalis[12/26 vs. 6/33 for other cancers,p= 0.025, odds ratio = 3.86 (1.19-12.47)]. Two patients had a negative PET/CT (a colon cancer and a bladder cancer), and two patients, with positive PET/CT, had a benign colorectal tumor. PET/CT had a sensitivity of 94-100% for the diagnosis of cancer in this patient. Conclusions:Whole-body PET/CT confirmed the high incidence of cancer in patients with IE and could now be proposed in these cases.

Mots clés: infective endocarditis; cancer; PET/CT; incidental; diagnosis

Domaines: Sciences du Vivant [q-bio]

Frederique Gouriet, Herve Tissot-Dupont, Jean-Paul Casalta, Sandrine Hubert, Serge Cammilleri, et al.. FDG-PET/CT Incidental Detection of Cancer in Patients Investigated for Infective Endocarditis. Frontiers in Medicine, 2020, 7, ⟨10.3389/fmed.2020.00535⟩. ⟨hal-03149707⟩