Improved [¹⁸F]FDG PET/CT Diagnostic Accuracy for Infective Endocarditis Using Conventional Cardiac Gating or Combined Cardiac and Respiratory Motion Correction (CardioFreeze^TM)

Infective endocarditis (IE) is a serious and diagnostically challenging condition. [18F]FDG PET/CT is valuable for evaluating suspected IE, but it is susceptible to motion-related artefacts. This study investigated the potential benefits of cardiac motion correction for [18F]FDG PET/CT. In this prospective study, patients underwent [18F]FDG PET/CT for suspected IE, combined with a conventional cardiac gating sequence, a data-driven cardiac and respiratory gating sequence (CardioFreezeTM), or both. Scans were performed in adherence to EANM guidelines and assessors were blinded to patients’ clinical contexts. Final diagnosis of IE was established based on multidisciplinary consensus after a minimum of 4 months follow-up and surgical findings, whenever performed. Seven patients participated in the study, undergoing both an ungated [18F] FDG-PET/CT and a scan with either conventional cardiac gating, CardioFreezeTM, or both. Cardiac motion correction improved the interpretability of [18F]FDG PET/CT in four out of five patients with valvular IE lesions, regardless of the method of motion correction used, which was statistically significant by Wilcoxon’s signed rank test: p = 0.046. In one patient the motion-corrected sequence confirmed the diagnosis of endocarditis, which had been missed on non-gated PET. The performance of the two gating sequences was comparable. In conclusion, in this exploratory study, cardiac motion correction of [18F]FDG PET/CT improved the interpretability of [18F]FDG PET/CT. This may improve the sensitivity of PET/CT for suspected IE. Further larger comparative studies are necessary to confirm the additive value of these cardiac motion correction methods.</p

E2 properties of nuclei far from stability and the proton-halo problem of 8B

E2 properties of A=6--10 nuclei, including those of nuclei far from stability, are studied by a $(0+2)\hbar\omega$ shell-model calculation which includes E2 core-polarization effects explicitly. The quadrupole moments and the E2 transition strengths in A=6--10 nuclei are described quite well by the present calculation. This result indicates that the relatively large value of the quadrupole moment of $^8$B can be understood without introducing the proton-halo in $^8$B. An interesting effect of the $2\hbar\omega$ core-polarization is found for effective charges used in the $0\hbar\omega$ shell model; although isoscalar effective-charges are almost constant as a function of nucleus, appreciable variations are needed for isovector effective-charges which play important roles in nuclei with high isospin-values.Comment: (LaTeX, 23 pages

Estimating the nuclear level density with the Monte Carlo shell model

A method for making realistic estimates of the density of levels in even-even nuclei is presented making use of the Monte Carlo shell model (MCSM). The procedure follows three basic steps: (1) computation of the thermal energy with the MCSM, (2) evaluation of the partition function by integrating the thermal energy, and (3) evaluating the level density by performing the inverse Laplace transform of the partition function using Maximum Entropy reconstruction techniques. It is found that results obtained with schematic interactions, which do not have a sign problem in the MCSM, compare well with realistic shell-model interactions provided an important isospin dependence is accounted for.Comment: 14 pages, 3 postscript figures. Latex with RevTex. Submitted as a rapid communication to Phys. Rev.

F-18-FDG PET/CT in Infective Endocarditis:Indications and Approaches for Standardization

Purpose of Review: Additional imaging modalities, such as FDG-PET/CT, have been included into the workup for patients with suspected infective endocarditis, according to major international guidelines published in 2015. The purpose of this review is to give an overview of FDG-PET/CT indications and standardized approaches in the setting of suspected infective endocarditis. Recent Findings: There are two main indications for performing FDG-PET/CT in patients with suspected infective endocarditis: (i) detecting intracardiac infections and (ii) detection of (clinically silent) disseminated infectious disease. The diagnostic performance of FDG-PET/CT for intracardiac lesions depends on the presence of na

Long axial field of view PET/CT in critically ill patients:lessons from a case report

The introduction of new long axial field of view (LAFOV) scanners is a major milestone in positron emission tomography/computed tomography (PET/CT) imaging. With these new systems a revolutionary reduction in scan time can be achieved, concurrently lowering tracer dose. Therefore, PET/CT has come within reach for groups of patients in whom PET/CT previously was undesirable. In this case report we discuss the procedure of a continuous bed motion (CBM) total-body [18F]FDG PET/CT scan in an intensive care patient. We emphasize the clinical and technical possibilities with this new camera system, a matched clinical protocol, and the added value of a dedicated team.</p

Statistical Theory of Parity Nonconservation in Compound Nuclei

We present the first application of statistical spectroscopy to study the root-mean-square value of the parity nonconserving (PNC) interaction matrix element M determined experimentally by scattering longitudinally polarized neutrons from compound nuclei. Our effective PNC interaction consists of a standard two-body meson-exchange piece and a doorway term to account for spin-flip excitations. Strength functions are calculated using realistic single-particle energies and a residual strong interaction adjusted to fit the experimental density of states for the targets, ^{238} U for A\sim 230 and ^{104,105,106,108} Pd for A\sim 100. Using the standard Desplanques, Donoghue, and Holstein estimates of the weak PNC meson-nucleon coupling constants, we find that M is about a factor of 3 smaller than the experimental value for ^{238} U and about a factor of 1.7 smaller for Pd. The significance of this result for refining the empirical determination of the weak coupling constants is discussed.Comment: Latex file, no Fig

Relationship between 18F-FDG Uptake in the Oral Cavity, Recent Dental Treatments, and Oral Inflammation or Infection: A Retrospective Study of Patients with Suspected Endocarditis

[18F]-fluorodeoxyglucose positron emission tomography ([18F]FDG PET/CT) has proven to be a useful diagnostic tool in patients with suspected infective endocarditis (IE), but is conflicting in relation to dental procedures. Questions: Is there a correlation between [18F]FDG PET/CT findings, recent dental treatment, and an affected oral cavity? (2) Is there a correlation between infective endocarditis (IE), oral health status, and (extra)cardiac findings on [18F]FDG PET/CT? Methods: This retrospective study included 52 patients. All [18F]FDG PET/CT scans were examined visually by pattern recognition using a three-point scale and semi-quantified within the volume of interest (VOI) using SUVmax. Results: 19 patients were diagnosed with IE (group 1), 14 with possible IE (group 2), and 19 without IE based on the modified Duke criteria (group 3). No correlation was found between visual PET and SUVmax and sites of oral inflammation and infection. The visual PET scores and SUVmax were not significantly different between all groups. A significant difference in the SUVmax of the valve between all groups was observed. Conclusions: This study suggests that no correlation exists between the PET findings in the oral cavity and dental treatments or inflammation/infection. No correlation between IE, actual oral health status, and extra-cardiac findings was demonstrated. Additional research is needed to conclude whether [18F]FDG PET/CT imaging is a reliable diagnostic modality for oral inflammation and infection sites