Expanding utility of cardiac computed tomography in infective endocarditis: A contemporary review

Table 2 Strengths and limitations of various imaging modalities for assessing infective endocarditis

Modality	CCT	TTE	TEE	PET/CT
Strengths	Ability to image the entire thorax; Improved detection of perivalvular complications; CAD Assessment; Pre-Operative planning; Detection of extra-cardiac emboli	Good Spatial resolution; Availability and portable; Low cost; Lack of radiation; Lack of contrast; Chamber quantification; Assess hemodynamics	Improved spatial and temporal resolution over TTE; Availability and low cost; Lack of radiation; Lack of contrast; Better sensitivity than TTE in PVE; Assess Hemodynamics	Improved detection of perivalvular complications; Improved diagnostic accuarcy in PVE detection of embolic events
Weaknesses	Higher cost; Radiation exposure; Nephrotoxicity; Lower sensitivity for small vegetations and leaflet perforation; Availability may be limited	Limited value in PVE; No tissue characterization; Low sensitivity for peri-valvular complications	No tissue characterization; May miss some peri-valvular complications; Invasive procedure requiring sedation (cannot be performed in some patients with esophageal issues)	Limited availability; Higher cost; Radiation exposure

CCT: Cardiac computed tomography; TEE: Transesophageal echocardiography; TTE: Transthoracic echocardiography; PET: Positron emission tomography; PVE: Prosthetic valve endocarditis; CAD: Coronary artery disease.