Gamma camera imaging of infectious endocarditis

Infective endocarditis is associated with high morbidity and mortality. Early diagnosis is crucial for adequate patient's management, as early treatment improves the prognosis. Hardly diagnosed on the basis of a single symptom, sign or diagnostic test. Rather, the diagnosis requires a multidisciplinary discussion in addition to the integration of clinical signs, microbiology data and imaging data. The application of multimodality imaging, including molecular imaging techniques has improved the sensitivity to detect IE, also allowing for early detection of septic emboli and metastatic infections before these become clinically apparent. In this chapter, we will describe the main epidemiological, clinical and diagnostic challenges in IE with particular regard to the role of WBC SPECT/CT. In addition, the needs of proper hybrid equipment, dedicated imaging acquisition protocols, specific expertise for imaging reading and imaging interpretations in this field are discussed, emphasizing the need of a specific reference framework within a Cardiovascular Multidisciplinary Team Approach.