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Role of 18F-FDG PET/CT in the diagnosis of cardiovascular implantable electronic device infections: A meta-analysis

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Objective

We performed a meta-analysis evaluating the use of fluorine-18-fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET)/computed tomography (CT) in the diagnosis of cardiovascular implantable electronic device (CIED) infections.

Background

PET/CT may be helpful in the diagnosis of CIED infection, particularly in patients with the absence of localizing signs or definitive echocardiographic findings.

Methods

PubMed, Embase, Cochrane library, CINAHL, Web of Knowledge, and www.clinicaltrials.gov from January 1990 to April 2017 were searched for studies evaluating the accuracy of PET/CT in the diagnosis of CIED infections.

Results

Overall, 14 studies involving 492 patients were included in the meta-analysis. The pooled sensitivity of PET/CT for diagnosis of CIED infection was 83% (95% CI 78%-86%) and the pooled specificity was 89% (95% CI 84%-94%). PET/CT demonstrated a higher sensitivity of 96% (95% CI 86%-99%) and specificity of 97% (95% CI 86%-99%) for diagnosis of pocket infections. Diagnostic accuracy for lead infections or CIED-IE was lower with pooled sensitivity of 76% (95% CI 65%-85%) and specificity of 83% (95% CI 72%-90%).

Conclusion

Use of PET/CT in the evaluation of CIED infection has both a high sensitivity (83%) and specificity (89%) and deserves consideration in the management of selected patients with suspected CIED infections.

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Abbreviations

CIED:

Cardiovascular implantable electronic device

18F-FDG:

Fluorine 18 fluorodeoxyglucose

PET:

Positron-emission tomography

CT:

Computed tomography

IE:

Infective endocarditis

TEE:

Transesophageal echocardiogram

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Authors Contribution

L.M.B.: UpToDate, Inc. Royalty payments for authorship duties. M.R.S.: Honoraria/Consulting fee: Medtronic Inc., Spectranetics, and Boston Scientific Corporation (All <US$10K). Research Grant: Medtronic Inc. P.A.F.: Research support from St. Jude Medical; owning intellectual property rights with Aegis Medical, NeoChord, Preventice, and Sorin; and receiving speaker or consultant fees from Medtronic Inc. and LeadEx. G.B.J.: Research support from Pfizer, and Medtronic Inc. P.C., M.M., S.A., S.F., and A.T.K.: No relationship with industry.

Disclosure

The authors have indicated that they have no financial conflict of interest.

Author information

Authors and Affiliations

  1. Division of Infectious Disease, Department of Medicine, Mayo Clinic College of Medicine and Science, 200 1st Street SW, Rochester, MN, 55905, USA

    Maryam Mahmood MBChB, Saira Farid MD, Saira Ajmal MD, Larry M. Baddour MD & M. Rizwan Sohail MD

  2. Division of Nuclear Medicine, Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA

    Ayse Tuba Kendi MD & Geoffrey B. Johnson MD PhD

  3. Department of Immunology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA

    Geoffrey B. Johnson MD PhD

  4. Department of Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA

    Larry M. Baddour MD, Panithaya Chareonthaitawee MD, Paul A. Friedman MD & M. Rizwan Sohail MD

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  1. Maryam Mahmood MBChB
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  2. Ayse Tuba Kendi MD
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  3. Saira Farid MD
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Correspondence to Maryam Mahmood MBChB.

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Mahmood, M., Kendi, A.T., Farid, S. et al. Role of 18F-FDG PET/CT in the diagnosis of cardiovascular implantable electronic device infections: A meta-analysis. J. Nucl. Cardiol. 26, 958–970 (2019). https://doi.org/10.1007/s12350-017-1063-0

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  • DOI: https://doi.org/10.1007/s12350-017-1063-0

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