Abstract
Background
Cardiovascular implantable electronic devices (CIED) infections are life-threatening complications. The diagnosis can be difficult to establish. Our purpose is to evaluate the diagnostic value of 18F-FDG PET.
Methods
Forty patients who received work-up for suspected CIED infection were retrospectively included (group 1) and compared with 40 controls (group 2); CIED patients were referred for oncologic PET. PET-CT data were blindly assessed. Interpretation was based on visual analysis of both attenuation-corrected and non-corrected images and a semi-quantitative analysis was performed. The gold standard was bacteriological data of explanted devices or clinical follow-up for at least 1 year.
Results
Infection was present in 18 out of 40 patients of group 1. Sensitivity, specificity, positive predictive value, and negative predictive value of PET-CT were 83%, 95%, 94%, and 88%, respectively. Accuracy was 90%. PET-CT revealed the presence of additional pathological hypermetabolic foci in 28% of cases. PET-CT was negative at implanted devices in all patients of group 2.
Conclusion
18F-FDG PET-CT is helpful in the work-up of suspected CIED infections. It is a potential tool to make the accurate diagnosis of CIED infection and to assess the extent of infection. The promising results in this indication need to be validated in a prospective multicenter study.
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Tlili, G., Amroui, S., Mesguich, C. et al. High performances of 18F-fluorodeoxyglucose PET-CT in cardiac implantable device infections: A study of 40 patients. J. Nucl. Cardiol. 22, 787–798 (2015). https://doi.org/10.1007/s12350-015-0067-x
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DOI: https://doi.org/10.1007/s12350-015-0067-x