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Massalha S, Kennedy J, Hussein E, Mahida B, Keidar Z. Cardiovascular Imaging in Women. Semin Nucl Med 2024; 54:191-205. [PMID: 38395672 DOI: 10.1053/j.semnuclmed.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 01/28/2024] [Indexed: 02/25/2024]
Abstract
Multimodality cardiovascular imaging is a cornerstone diagnostic tool in the diagnosis, risk stratification, and management of cardiovascular diseases, whether those involving the coronary tree, myocardial, or pericardial diseases in general and particularly in women. This manuscript aims to shed some light and summarize the very features of cardiovascular disease in women, explore their unique characteristics and discuss the role of cardiovascular imaging in ischemic heart disease and cardiomyopathies. The role of four imaging modalities will be discussed including nuclear medicine, echocardiography, noninvasive coronary angiography, and cardiac magnetic resonance.
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Affiliation(s)
- Samia Massalha
- Department of Cardiology, Rambam Health Care Campus, Haifa. Israel; Department of Nuclear Medicine, Rambam Health Care Campus, Haifa. Israel.
| | - John Kennedy
- Department of Cardiology, Rambam Health Care Campus, Haifa. Israel; Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Essam Hussein
- Department of Nuclear Medicine, Rambam Health Care Campus, Haifa. Israel
| | - Besma Mahida
- Nuclear Medicine BICHAT Hospital Assistance Publique Hôpitaux de Paris, Paris. France; LVTS, Inserm U1148, Équipe 4 (Imagerie Cardio-Vasculaire), Paris, France
| | - Zohar Keidar
- Department of Cardiology, Rambam Health Care Campus, Haifa. Israel; Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
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Grambow-Velilla J, Mahida B, Benali K, Deconinck L, Chong-Nguyen C, Cimadevilla C, Duval X, Iung B, Rouzet F, Hyafil F. Prognosis and follow-up of patients with prosthetic valve endocarditis treated conservatively in relation to WBC-SPECT imaging. J Nucl Cardiol 2023; 30:2633-2643. [PMID: 37430176 DOI: 10.1007/s12350-023-03335-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/08/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Our objective was to evaluate in patients with prosthetic valve endocarditis (PVE) treated conservatively, the prognostic value of white blood cell (WBC) signal intensity on SPECT and to describe the evolution of the WBC signal under antibiotics. METHODS Patients with PVE treated conservatively and positive WBC-SPECT imaging were identified retrospectively. Signal intensity was classified as intense if equal to or higher, or mild if lower, than the liver signal. Clinical, biological, imaging and follow-up information were collected from medical files. RESULTS Among 47 patients, WBC signal was classified as intense in 10 patients and as mild, in 37. The incidence of the primary composite endpoint (death, late cardiac surgery, or relapse) was significantly higher in patients with intense vs. mild signal (90% vs. 11%). Twenty-five patients underwent a second WBC-SPECT imaging during follow-up. The prevalence of WBC signal decreased progressively from 89% between 3 and 6 weeks to 42% between 6 and 9 weeks and 8% more than 9 weeks after initiation of antibiotics. CONCLUSIONS In patients with PVE treated conservatively, intense WBC signal was associated with poor outcome. WBC-SPECT imaging appears as an interesting tool for risk stratification and to monitor locally the efficacy of antibiotic treatment.
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Affiliation(s)
- Julia Grambow-Velilla
- Department of Nuclear Medicine, AP-HP, European Hospital Georges-Pompidou, University of Paris-Cité, 75015, Paris, France
- INSERM U970, European Hospital Georges-Pompidou, University of Paris-Cité, 75015, Paris, France
| | - Besma Mahida
- Department of Nuclear Medicine, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France
| | - Khadija Benali
- Department of Nuclear Medicine, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France
| | - Laurene Deconinck
- Department of Infectious Diseases, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France
| | - Caroline Chong-Nguyen
- Department of Cardiology, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France
| | - Claire Cimadevilla
- Department of Cardiology, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France
- Department of Cardiac Surgery, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France
| | - Xavier Duval
- Department of Infectious Diseases, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France
- Department of Cardiology, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France
- Department of Cardiac Surgery, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France
- Center for Clinical Investigation, AP-HP, Bichat University Hospital, University of Paris-CIté, 75018, Paris, France
| | - Bernard Iung
- Department of Cardiology, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France
| | - François Rouzet
- Department of Nuclear Medicine, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France
| | - Fabien Hyafil
- Department of Nuclear Medicine, AP-HP, European Hospital Georges-Pompidou, University of Paris-Cité, 75015, Paris, France.
- INSERM U970, European Hospital Georges-Pompidou, University of Paris-Cité, 75015, Paris, France.
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Régis C, Thy M, Mahida B, Deconinck L, Tubiana S, Iung B, Duval X, Rouzet F. Absence of infective endocarditis relapse when end-of-treatment fluorodeoxyglucose positron emission tomography/computed tomography is negative. Eur Heart J Cardiovasc Imaging 2023; 24:1480-1488. [PMID: 37307564 DOI: 10.1093/ehjci/jead138] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/19/2023] [Accepted: 05/14/2023] [Indexed: 06/14/2023] Open
Abstract
AIMS In non-operated infective endocarditis (IE), relapse may impair the outcome of the disease. The aim of the study was to evaluate the relationship between end-of-treatment (EOT) fluorodeoxyglucose positron emission tomography/computed tomography FDG-PET/CT results and relapse in non-operated IE either on native or prosthetic valve. METHODS AND RESULTS We included 62 patients who underwent an EOT FDG-PET/CT for non-operated IE performed between 30 and 180 days of antibiotic therapy initiation. Qualitative valve assessment categorized initial and EOT FDG-PET/CT as negative or positive. Quantitative analyses were also conducted. Clinical data from medical charts were collected, including endocarditis team decision for IE diagnosis and relapse. Forty-one (66%) patients were male with a median age of 68 years (57; 80) and 42 (68%) had prosthetic valve IE. End-of-treatment FDG-PET/CT was negative in 29 and positive in 33 patients. The proportion of positive scans decreased significantly compared with initial FDG-PET/CT (53% vs. 77%, respectively, P < 0.0001). All relapses (n = 7, 11%) occurred in patients with a positive EOT FDG-PET/CT with a median delay after EOT FDG-PET/CT of 10 days (0; 45). The relapse rate was significantly lower in negative (0/29) than in positive (7/33) EOT FDG-PET/CT (P = 0.01). CONCLUSION In this series of 62 patients with non-operated IE who underwent EOT FDG-PET/CT, those with a negative scan (almost half of the study population) did not develop IE relapse after a median follow-up of 10 months. These findings need to be confirmed by prospective and larger studies.
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Affiliation(s)
- Claudine Régis
- Nuclear Medicine Department, Hôpital Bichat-Claude Bernard, AP-HP, 46 rue Henri-Huchard, Paris 75018, France
- Department of Medical Imaging, Institut de cardiologie de Montréal, Université de Montréal, 5000 rue Bélanger, Montréal, Québec H1T 1C8, Canada
| | - Michael Thy
- Infectious Disease Department, Hôpital Bichat-Claude Bernard, AP-HP, 46 rue Henri-Huchard, Paris 75018, France
- Université Paris Cité, 45 Rue des Saints-Pères, Paris 75006, France
| | - Besma Mahida
- Nuclear Medicine Department, Hôpital Bichat-Claude Bernard, AP-HP, 46 rue Henri-Huchard, Paris 75018, France
- Laboratory for Vascular Translational Science, Inserm U1148, 46 rue Henri-Huchard, Paris 75018, France
| | - Laurène Deconinck
- Infectious Disease Department, Hôpital Bichat-Claude Bernard, AP-HP, 46 rue Henri-Huchard, Paris 75018, France
| | - Sarah Tubiana
- Université Paris Cité, 45 Rue des Saints-Pères, Paris 75006, France
- Clinical Investigation Center, Hôpital Bichat-Claude Bernard, AP-HP, 46 rue Henri-Huchard, Paris 75018, France
| | - Bernard Iung
- Université Paris Cité, 45 Rue des Saints-Pères, Paris 75006, France
- Laboratory for Vascular Translational Science, Inserm U1148, 46 rue Henri-Huchard, Paris 75018, France
- Cardiology Department, Hôpital Bichat-Claude Bernard, AP-HP, 46 rue Henri-Huchard, 75018, 46 rue Henri-Huchard, Paris 75018, France
| | - Xavier Duval
- Université Paris Cité, 45 Rue des Saints-Pères, Paris 75006, France
- Clinical Investigation Center, Hôpital Bichat-Claude Bernard, AP-HP, 46 rue Henri-Huchard, Paris 75018, France
| | - François Rouzet
- Nuclear Medicine Department, Hôpital Bichat-Claude Bernard, AP-HP, 46 rue Henri-Huchard, Paris 75018, France
- Université Paris Cité, 45 Rue des Saints-Pères, Paris 75006, France
- Laboratory for Vascular Translational Science, Inserm U1148, 46 rue Henri-Huchard, Paris 75018, France
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Casadepax-Soulet C, Benali K, Crestani B, Piekarski E, Mahida B, Ebstein E, Juge PA, Forien M, Dieudé P, Ottaviani S. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in polymyalgia rheumatica: an observational study. Clin Exp Rheumatol 2022:19099. [DOI: 10.55563/clinexprheumatol/kqyki5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/17/2022] [Indexed: 12/23/2022]
Affiliation(s)
| | - Khadija Benali
- Service de Médecine Nucléaire, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Bruno Crestani
- Service de Pneumologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Eve Piekarski
- Service de Médecine Nucléaire, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Besma Mahida
- Service de Médecine Nucléaire, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Esther Ebstein
- Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Pierre-Antoine Juge
- Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Marine Forien
- Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Philippe Dieudé
- Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Sébastien Ottaviani
- Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
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Piekarski E, Mahida B, Rouzet F, Le Guludec D. FDG PET/CT in CIEDs infection: Don't wait any longer! J Nucl Cardiol 2022; 29:609-611. [PMID: 33057970 DOI: 10.1007/s12350-020-02377-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/04/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Eve Piekarski
- Nuclear Medicine Department, Bichat Hospital, APHP, 46 rue Henri Huchard, 75018, Paris, France
- Université de Paris, 75018, Paris, France
- INSERM, UMR 1148 (LVTS), Paris, France
| | - Besma Mahida
- Nuclear Medicine Department, Bichat Hospital, APHP, 46 rue Henri Huchard, 75018, Paris, France
- Université de Paris, 75018, Paris, France
- INSERM, UMR 1148 (LVTS), Paris, France
| | - François Rouzet
- Nuclear Medicine Department, Bichat Hospital, APHP, 46 rue Henri Huchard, 75018, Paris, France
- Université de Paris, 75018, Paris, France
- INSERM, UMR 1148 (LVTS), Paris, France
| | - Dominique Le Guludec
- Nuclear Medicine Department, Bichat Hospital, APHP, 46 rue Henri Huchard, 75018, Paris, France.
- Université de Paris, 75018, Paris, France.
- INSERM, UMR 1148 (LVTS), Paris, France.
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Kooshki N, Grambow-Velilla J, Mahida B, Benali K, Nguyen C, Cimadevilla C, Braham W, Pisani A, Iung B, Raffoul R, Rouzet F, Hyafil F. Diagnostic performance of White Blood Cell SPECT imaging against intra-operative findings in patients with a suspicion of prosthetic valve endocarditis. J Nucl Cardiol 2022; 29:528-534. [PMID: 34085167 DOI: 10.1007/s12350-021-02674-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 05/04/2021] [Indexed: 01/03/2023]
Abstract
AIM The objective of this study was to evaluate the diagnostic performance of white blood cells (WBC)-SPECT imaging in patients with suspicion of prosthetic valve endocarditis (PVE) against intra-operative findings. METHODS 36 consecutive patients who underwent cardiac surgery 30 days after WBC-SPECT imaging were identified retrospectively. Clinical, imaging, and biological results were collected from reports. WBC-SPECT results were classified as positive or negative and, if positive, the intensity of signal graded as intense or mild. Lesions observed during cardiac surgery were collected from surgeons' reports. RESULTS The 20 patients with positive WBC-SPECT study had confirmed PVE intra-operatively. Patients with intense signal on WBC-SPECT had high prevalence of abscesses (83%) compared to patients with only mild signal (12%). The three patients with negative WBC-SPECT but confirmed PVE had longer duration of antibiotic treatment before imaging and had no perivalvular abscess. Sensitivity, specificity, positive predictive and negative values, and accuracy of WBC-SPECT were measured at 87%, 100%, 100%, 81%, and 92%, respectively. Addition of WBC-SPECT results to the modified Duke score helped re-classify correctly 25% of patients from possible to definite PVE. CONCLUSION In patients with suspicion of PVE, WBC-SPECT imaging provides excellent diagnostic performance against intra-operative findings.
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Affiliation(s)
- Navid Kooshki
- Department of Nuclear Medicine, Bichat University Hospital, DMU DREAM, Assistance Publique -Hôpitaux de Paris, University of Paris, 75018, Paris, France
| | - Julia Grambow-Velilla
- Department of Nuclear Medicine, Bichat University Hospital, DMU DREAM, Assistance Publique -Hôpitaux de Paris, University of Paris, 75018, Paris, France
| | - Besma Mahida
- Department of Nuclear Medicine, Bichat University Hospital, DMU DREAM, Assistance Publique -Hôpitaux de Paris, University of Paris, 75018, Paris, France
| | - Khadija Benali
- Department of Nuclear Medicine, Bichat University Hospital, DMU DREAM, Assistance Publique -Hôpitaux de Paris, University of Paris, 75018, Paris, France
| | - Caroline Nguyen
- Department of Cardiology, Bichat University Hospital, DMU DREAM, Assistance Publique-Hôpitaux de Paris, University of Paris, 75018, Paris, France
| | - Claire Cimadevilla
- Department of Cardiology, Bichat University Hospital, DMU DREAM, Assistance Publique-Hôpitaux de Paris, University of Paris, 75018, Paris, France
| | - Wael Braham
- Department of Cardiac Surgery, Bichat University Hospital, DMU DREAM, Assistance Publique -Hôpitaux de Paris, University of Paris, 75018, Paris, France
| | - Angelo Pisani
- Department of Cardiac Surgery, Bichat University Hospital, DMU DREAM, Assistance Publique -Hôpitaux de Paris, University of Paris, 75018, Paris, France
| | - Bernard Iung
- Department of Cardiology, Bichat University Hospital, DMU DREAM, Assistance Publique-Hôpitaux de Paris, University of Paris, 75018, Paris, France
| | - Richard Raffoul
- Department of Cardiac Surgery, Bichat University Hospital, DMU DREAM, Assistance Publique -Hôpitaux de Paris, University of Paris, 75018, Paris, France
| | - François Rouzet
- Department of Nuclear Medicine, Bichat University Hospital, DMU DREAM, Assistance Publique -Hôpitaux de Paris, University of Paris, 75018, Paris, France
| | - Fabien Hyafil
- Department of Nuclear Medicine, Hôpital Européen Georges-Pompidou, DMU IMAGINA, Assistance Publique -Hôpitaux de Paris, University of Paris, 20 Rue Leblanc, 75015, Paris, France.
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Mahida B, Rouzet F. Gamma camera imaging of cardiac implantable electronic devices infection. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00084-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Boursier C, Duval X, Mahida B, Hoen B, Goehringer F, Selton-Suty C, Chevalier E, Roch V, Lamiral Z, Bourdon A, Piriou N, Pallardy A, Morel O, Rouzet F, Marie PY. Hypermetabolism of the spleen or bone marrow is an additional albeit indirect sign of infective endocarditis at FDG-PET. J Nucl Cardiol 2021; 28:2533-2542. [PMID: 32043240 DOI: 10.1007/s12350-020-02050-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/08/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE This study aimed at determining the diagnostic implications of indirect signs of infection at FDG-PET-i.e., hypermetabolisms of the spleen and/or bone marrow (HSBM)-when documented in patients with known or suspected infective endocarditis (IE). METHODS HSBM were defined by higher mean standardized uptake values comparatively to that of the liver on FDG-PET images from patients with a high likelihood of IE and prospectively included in a multicenter study. RESULTS Among the 129 included patients, IE was ultimately deemed as definite in 88 cases. HSBM was a predictor of definite IE (P = 0.014; odds ratio (OR) 3.2), independently of the criterion of an abnormal cardiac FDG uptake (P = 0.0007; OR 9.68), and a definite IE was documented in 97% (29/30) of patients showing both HSBM and abnormal cardiac uptake, 78% (7/9) of patients with only abnormal cardiac uptake, 67% (42/63) of patients with only HSBM, and 37% (10/27) of patients with neither one. CONCLUSION In this cohort with a high likelihood of IE, HSBM is an additional albeit indirect sign of IE, independently of the criterion of an abnormal cardiac uptake, and could reinforce the suspicion of IE in the absence of any other infectious, inflammatory, or malignant disease.
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Affiliation(s)
- Caroline Boursier
- Université de Lorraine, 54000, Nancy, France.
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, 54000, Nancy, France.
| | - Xavier Duval
- Université Paris Diderot, INSERM, UMR 1137 (IAME), 75000, Paris, France
- INSERM, CIC 1425, AP-HP, Hôpital Bichat Claude Bernard, 75000, Paris, France
- Department of Infectious Diseases, AP-HP, Hôpital Bichat Claude Bernard, 75000, Paris, France
| | - Besma Mahida
- Department of Nuclear Medicine, AP-HP, Hôpital Bichat Claude Bernard, 75000, Paris, France
| | - Bruno Hoen
- Université de Lorraine, 54000, Nancy, France
- Department of Infectious Diseases, CHRU-Nancy, 54000, Nancy, France
| | | | | | - Elodie Chevalier
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, 54000, Nancy, France
| | - Véronique Roch
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, 54000, Nancy, France
| | - Zohra Lamiral
- Université de Lorraine, CHRU-Nancy, INSERM, CIC 1433, 54000, Nancy, France
| | - Aurélie Bourdon
- Department of Nuclear Medicine, Montpellier University Hospital, 34000, Montpellier, France
| | - Nicolas Piriou
- Department of Nuclear Medicine, CHU de Nantes, 44000, Nantes, France
| | - Amandine Pallardy
- Department of Nuclear Medicine, CHU de Nantes, 44000, Nantes, France
| | - Olivier Morel
- CHU-Besançon, Université de Franche-Comté, Service de Médecine Nucléaire, 25000, Besançon, France
| | - François Rouzet
- Department of Nuclear Medicine, AP-HP, Hôpital Bichat Claude Bernard, 75000, Paris, France
- Université Paris Diderot, INSERM, UMR 1148 (LVTS), 75000, Paris, France
| | - Pierre-Yves Marie
- Université de Lorraine, 54000, Nancy, France
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, 54000, Nancy, France
- Université de Lorraine, INSERM, UMR 1116, 54000, Nancy, France
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Mahida B, Benyounes H, Jin S, Shen W. Pressure-swing distillation process for separating ternary azeotropic mixture of acidic aqueous solution. CHEM ENG COMMUN 2021. [DOI: 10.1080/00986445.2021.1925653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- B. Mahida
- Laboratoire de Chimie Physique de Matériaux, Catalyse et Environnement, UST. Oran, Oran, Algérie
| | - H. Benyounes
- Laboratoire de Chimie Physique de Matériaux, Catalyse et Environnement, UST. Oran, Oran, Algérie
| | - S. Jin
- School of Chemistry and Chemical Engineering, Chongqing University, Chongqing, P. R. China
| | - W. Shen
- School of Chemistry and Chemical Engineering, Chongqing University, Chongqing, P. R. China
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Calais J, Touati A, Grall N, Laouénan C, Benali K, Mahida B, Vigne J, Hyafil F, Iung B, Duval X, Lepage L, Le Guludec D, Rouzet F. Diagnostic Impact of
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F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and White Blood Cell SPECT/Computed Tomography in Patients With Suspected Cardiac Implantable Electronic Device Chronic Infection. Circ Cardiovasc Imaging 2019; 12:e007188. [DOI: 10.1161/circimaging.117.007188] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background:
Cardiac implantable electronic devices (CIEDs) chronic infection diagnosis is challenging because the clinical presentation is frequently misleading and echocardiography may be inconclusive. The aim of this study was to evaluate the diagnostic value of
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F-fluorodeoxyglucose positron emission tomography/computed tomography (CT) and radiolabeled white blood cells single photon emission CT/CT in a cohort of patients who underwent both scans for suspicion of CIED infection and inconclusive routine investigations.
Methods:
Forty-eight consecutive patients with suspicion of CIED infection who underwent both
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F-fluorodeoxyglucose positron emission tomography/CT and white blood cell single photon emission CT/CT in a time span ≤30 days were retrospectively included. The final diagnosis of CIED infection by the endocarditis expert team was based on the modified Duke-Li classification at the end of follow-up.
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F-Fluorodeoxyglucose positron emission tomography/CT and white blood cell single photon emission CT/CT scans were independently analyzed blinded to the patients’ medical record.
Results:
In the overall study population, the diagnostic sensitivity, specificity, positive predictive value, and negative predictive value were respectively 80%, 91%, 80%, and 91% for
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F-fluorodeoxyglucose positron emission tomography/CT and 60%, 100%, 100%, and 85% for white blood cell single photon emission CT/CT. Addition of a positive nuclear imaging scan as a major criterion markedly improved the Duke-Li classification at admission. Semiquantitative parameters did not allow to discriminate between definite and rejected CIED infection. Prolonged antibiotic therapy before imaging tended to decrease the sensitivity for both techniques.
Conclusions:
Nuclear imaging can improve the diagnostic performances of the Duke-Li score at admission in a selected population of patients with suspected CIED infection, particularly when the infection was initially graded as possible. Whenever possible, imaging should be performed before or early after antibiotic initiation.
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Affiliation(s)
- Jérémie Calais
- Department of Nuclear Medicine, AP-HP, Bichat Hospital and DHU FIRE, Paris, France (J.C., A.T., K.B., B.M., J.V., F.H., D.L.G., F.R.)
- Université de Paris, F-75018, France (J.C., A.T., C.L., K.B., B.M., J.V., F.H., B.I., X.D., D.L.G., F.R.)
| | - Aziza Touati
- Department of Nuclear Medicine, AP-HP, Bichat Hospital and DHU FIRE, Paris, France (J.C., A.T., K.B., B.M., J.V., F.H., D.L.G., F.R.)
- Université de Paris, F-75018, France (J.C., A.T., C.L., K.B., B.M., J.V., F.H., B.I., X.D., D.L.G., F.R.)
| | - Nathalie Grall
- INSERM, UMR 1137 (IAME), Paris, France (N.G., C.L., X.D.)
- Microbiology Laboratory (N.G.), AP-HP, Bichat Hospital, Paris, France
| | - Cédric Laouénan
- Université de Paris, F-75018, France (J.C., A.T., C.L., K.B., B.M., J.V., F.H., B.I., X.D., D.L.G., F.R.)
- INSERM, UMR 1137 (IAME), Paris, France (N.G., C.L., X.D.)
- Department of Biostatistics (C.L.), AP-HP, Bichat Hospital, Paris, France
| | - Khadija Benali
- Department of Nuclear Medicine, AP-HP, Bichat Hospital and DHU FIRE, Paris, France (J.C., A.T., K.B., B.M., J.V., F.H., D.L.G., F.R.)
- Université de Paris, F-75018, France (J.C., A.T., C.L., K.B., B.M., J.V., F.H., B.I., X.D., D.L.G., F.R.)
- INSERM UMR 1148 (LVTS), Paris, France (K.B., B.M., J.V., F.H., D.L.G., F.R.)
| | - Besma Mahida
- Department of Nuclear Medicine, AP-HP, Bichat Hospital and DHU FIRE, Paris, France (J.C., A.T., K.B., B.M., J.V., F.H., D.L.G., F.R.)
- Université de Paris, F-75018, France (J.C., A.T., C.L., K.B., B.M., J.V., F.H., B.I., X.D., D.L.G., F.R.)
- INSERM UMR 1148 (LVTS), Paris, France (K.B., B.M., J.V., F.H., D.L.G., F.R.)
| | - Jonathan Vigne
- Department of Nuclear Medicine, AP-HP, Bichat Hospital and DHU FIRE, Paris, France (J.C., A.T., K.B., B.M., J.V., F.H., D.L.G., F.R.)
- Université de Paris, F-75018, France (J.C., A.T., C.L., K.B., B.M., J.V., F.H., B.I., X.D., D.L.G., F.R.)
- INSERM UMR 1148 (LVTS), Paris, France (K.B., B.M., J.V., F.H., D.L.G., F.R.)
| | - Fabien Hyafil
- Department of Nuclear Medicine, AP-HP, Bichat Hospital and DHU FIRE, Paris, France (J.C., A.T., K.B., B.M., J.V., F.H., D.L.G., F.R.)
- Université de Paris, F-75018, France (J.C., A.T., C.L., K.B., B.M., J.V., F.H., B.I., X.D., D.L.G., F.R.)
- INSERM UMR 1148 (LVTS), Paris, France (K.B., B.M., J.V., F.H., D.L.G., F.R.)
| | - Bernard Iung
- Université de Paris, F-75018, France (J.C., A.T., C.L., K.B., B.M., J.V., F.H., B.I., X.D., D.L.G., F.R.)
- Department of Cardiology (B.I.), AP-HP, Bichat Hospital, DHU FIRE, Paris, France
| | - Xavier Duval
- Université de Paris, F-75018, France (J.C., A.T., C.L., K.B., B.M., J.V., F.H., B.I., X.D., D.L.G., F.R.)
- INSERM, UMR 1137 (IAME), Paris, France (N.G., C.L., X.D.)
- INSERM, Clinical Investigation Centre, Bichat (X.D.)
| | - Laurent Lepage
- Department of Cardiac surgery (L.L.), AP-HP, Bichat Hospital, DHU FIRE, Paris, France
| | - Dominique Le Guludec
- Department of Nuclear Medicine, AP-HP, Bichat Hospital and DHU FIRE, Paris, France (J.C., A.T., K.B., B.M., J.V., F.H., D.L.G., F.R.)
- Université de Paris, F-75018, France (J.C., A.T., C.L., K.B., B.M., J.V., F.H., B.I., X.D., D.L.G., F.R.)
- INSERM UMR 1148 (LVTS), Paris, France (K.B., B.M., J.V., F.H., D.L.G., F.R.)
| | - François Rouzet
- Department of Nuclear Medicine, AP-HP, Bichat Hospital and DHU FIRE, Paris, France (J.C., A.T., K.B., B.M., J.V., F.H., D.L.G., F.R.)
- Université de Paris, F-75018, France (J.C., A.T., C.L., K.B., B.M., J.V., F.H., B.I., X.D., D.L.G., F.R.)
- INSERM UMR 1148 (LVTS), Paris, France (K.B., B.M., J.V., F.H., D.L.G., F.R.)
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Sinigaglia M, Mahida B, Piekarski E, Chequer R, Mikail N, Benali K, Hyafil F, Le Guludec D, Rouzet F. FDG atrial uptake is associated with an increased prevalence of stroke in patients with atrial fibrillation. Eur J Nucl Med Mol Imaging 2019; 46:1268-1275. [DOI: 10.1007/s00259-019-4274-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 01/15/2019] [Indexed: 01/28/2023]
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Piekarski E, Chequer R, Algalarrondo V, Eliahou L, Mahida B, Vigne J, Adams D, Slama MS, Le Guludec D, Rouzet F. Cardiac denervation evidenced by MIBG occurs earlier than amyloid deposits detection by diphosphonate scintigraphy in TTR mutation carriers. Eur J Nucl Med Mol Imaging 2018; 45:1108-1118. [PMID: 29511839 DOI: 10.1007/s00259-018-3963-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/24/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE Cardiac involvement in familial transthyretin (TTR) amyloidosis is of major prognostic value, and the development of early-diagnostic tools that could trigger the use of new disease-modifying treatments is crucial. The aim of our study was to compare the respective contributions of 99mTc-diphosphonate scintigraphy (DPD, detecting amyloid deposits) and 123I-MIBG (MIBG, assessing cardiac sympathetic denervation) in patients with genetically proven TTR mutation referred for the assessment of cardiac involvement. METHODS We prospectively studied 75 consecutive patients (classified as symptomatic or asymptomatic carriers), using clinical evaluation, biomarkers (troponin and BNP), echocardiography, and nuclear imaging. Patients were classified as having normal heart-to-mediastinum (HMR) MIBG uptake ratio 4 h after injection (defined by HM4 ≥ 1.85) or abnormal HM4 < 1.85, and positive DPD uptake (grade ≥ 1 of Perugini classification) or negative DPD uptake. RESULTS Among 75 patients, 49 (65%) presented with scintigraphic sympathetic cardiac denervation and 29 (39%) with myocardial diphosphonate uptake. When MIBG was normal, DPD was negative except for two patients. Age was an independent predictor of abnormal scintigraphic result of both MIBG and DPD (HR 1.08 and 1.15 respectively), whereas echocardiographic-derived indicators of increased left ventricular filling pressure (E/e' ratio) was an independent predictor of abnormal MIBG (HR 1.33) and global longitudinal strain of positive DPD (HR 1.45). In asymptomatic patients (n = 31), MIBG was abnormal in 48% (n = 15) among whom 50% had a normal DPD; all those with a normal MIBG (n = 16) had a normal DPD. CONCLUSIONS In TTR mutation carriers, cardiac sympathetic denervation evidenced by decreased MIBG uptake is detected earlier than amyloid burden evidenced by DPD. These results raise the possibility of a diagnostic role for MIBG scintigraphy at an early stage of cardiac involvement in TTR-mutated carriers, in addition to its well-established prognostic value.
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Affiliation(s)
- Eve Piekarski
- Nuclear Medicine Department, Bichat Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), DHU FIRE, Inserm UMR-S 1148, Paris Diderot University, Paris, France
| | - Renata Chequer
- Nuclear Medicine Department, Bichat Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), DHU FIRE, Inserm UMR-S 1148, Paris Diderot University, Paris, France
| | - Vincent Algalarrondo
- Cardiology Department, Antoine Béclère Hospital, AP-HP, Paris-Sud University, Clamart, France
- French Referent Center for Rare Diseases for FAP (Familial Amyloid Polyneuropathy) (CRMR-NNERF), Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Ludivine Eliahou
- Cardiology Department, Antoine Béclère Hospital, AP-HP, Paris-Sud University, Clamart, France
- French Referent Center for Rare Diseases for FAP (Familial Amyloid Polyneuropathy) (CRMR-NNERF), Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Besma Mahida
- Nuclear Medicine Department, Bichat Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), DHU FIRE, Inserm UMR-S 1148, Paris Diderot University, Paris, France
| | - Jonathan Vigne
- Nuclear Medicine Department, Bichat Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), DHU FIRE, Inserm UMR-S 1148, Paris Diderot University, Paris, France
| | - David Adams
- French Referent Center for Rare Diseases for FAP (Familial Amyloid Polyneuropathy) (CRMR-NNERF), Bicêtre Hospital, Le Kremlin-Bicêtre, France
- Neurology Department, AP-HP, Paris-Sud University, Le Kremlin-Bicêtre, France
| | - Michel S Slama
- Cardiology Department, Antoine Béclère Hospital, AP-HP, Paris-Sud University, Clamart, France
- French Referent Center for Rare Diseases for FAP (Familial Amyloid Polyneuropathy) (CRMR-NNERF), Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Dominique Le Guludec
- Nuclear Medicine Department, Bichat Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), DHU FIRE, Inserm UMR-S 1148, Paris Diderot University, Paris, France
| | - Francois Rouzet
- Nuclear Medicine Department, Bichat Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), DHU FIRE, Inserm UMR-S 1148, Paris Diderot University, Paris, France.
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Bleibtreu A, Mahida B, Bouscarat F, Rioux C. Asymmetric relapse of an HIV-associated Kaposi sarcoma. Eur J Nucl Med Mol Imaging 2016; 44:555-556. [PMID: 27832310 DOI: 10.1007/s00259-016-3567-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 10/28/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Alexandre Bleibtreu
- Service des maladies infectieuses et tropicales, Hopital Bichat Claude Bernard, Assistance Publique - Hopitaux de Paris, Paris, Paris, France.
| | - Besma Mahida
- Service des maladies infectieuses et tropicales, Hopital Bichat Claude Bernard, Assistance Publique - Hopitaux de Paris, Paris, Paris, France
| | - Fabrice Bouscarat
- Service des maladies infectieuses et tropicales, Hopital Bichat Claude Bernard, Assistance Publique - Hopitaux de Paris, Paris, Paris, France
| | - Christophe Rioux
- Service des maladies infectieuses et tropicales, Hopital Bichat Claude Bernard, Assistance Publique - Hopitaux de Paris, Paris, Paris, France
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Ridouh M, Megueni AZ, Krim M, Mahida B, Berber N. Méningiome intra-osseux : cause de faux positifs dans la recherche de métastases osseuses par scintigraphie aux biphosphonates. Rev Neurol (Paris) 2015. [DOI: 10.1016/j.neurol.2015.01.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Regaieg H, De Paola Chequer R, Azzouna R, Algalarrondo V, Mahida B, Slama M, Le Guludec D, Rouzet F. Disphosphonates cardiac uptake in familial amyloid neuropathy: Comparison between DPD and HMDP. Orphanet J Rare Dis 2015. [PMCID: PMC4642140 DOI: 10.1186/1750-1172-10-s1-p41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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