AUTHOR=Gouriet Frédérique , Tissot-Dupont Hervé , Casalta Jean-Paul , Hubert Sandrine , Cammilleri Serge , Riberi Alberto , Lepidi Hubert , Habib Gilbert , Raoult Didier 

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

JOURNAL=Frontiers in Medicine

VOLUME=7

YEAR=2020

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2020.00535

DOI=10.3389/fmed.2020.00535

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> 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.</p><p><bold>Methods and Findings:</bold> 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%) (colorectal <italic>n</italic> = 17; lung <italic>n</italic> = 7; lymphoma <italic>n</italic> = 2; melanoma <italic>n</italic> = 2; ovarian <italic>n</italic> = 2; prostate <italic>n</italic> = 1; bladder <italic>n</italic> = 1; ear, nose, and throat <italic>n</italic> = 1; brain <italic>n</italic> = 1). A significant association has been found between colorectal cancer and <italic>Streptococcus gallolyticus</italic> and/or <italic>Enterococcus faecalis</italic> [12/26 vs. 6/33 for other cancers, <italic>p</italic> = 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.</p><p><bold>Conclusions:</bold> Whole-body PET/CT confirmed the high incidence of cancer in patients with IE and could now be proposed in these cases.</p>