Accuracy of 18F-FDG PET/CT in patients with the suspicion of cardiac implantable electronic device infections
| Autor: | Carmen Olmos, María Jesús Pérez-Castejón, Adrián Jerónimo, Carlos Pérez-García, A. Ortega-Candil, José Luis Carreras, Isidre Vilacosta, Carlos Ferrera, Daniel García-Arribas, Cristina Fernández-Pérez, C. Rodríguez-Rey |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry 030204 cardiovascular system & hematology Radionuclide uptake medicine.disease Intracardiac injection 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Infective endocarditis medicine Radiology Nuclear Medicine and imaging Fdg pet ct In patient Radiology Negative studies Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Nuclear Cardiology. 29:594-608 |
| ISSN: | 1532-6551 1071-3581 |
| DOI: | 10.1007/s12350-020-02285-z |
| Popis: | Utility of 18F-FDG PET/CT in diagnosing infective endocarditis (IE) associated with cardiac implantable electronic devices (CIEDs) is not well established. Current ESC guidelines recommend the use of FDG-PET imaging in patients with CIEDs and positive blood cultures, but the number of studies evaluating the diagnostic performance of FDG-PET imaging in these patients remain limited. Our objective was to assess the diagnostic yield of 18F-FDG PET/CT in patients with suspected CIED infections, differentiating between pocket infection (PI) and lead infection (CIED-IE). From 2013 to 2018, all patients (n = 63) admitted to a hospital with suspected CIED infection were prospectively recruited, undergoing a diagnostic work-up including a PET/CT. Explanted devices and material from the pocket were cultured. 14 cases corresponded to isolated PI and 13 were categorized as CIED-IE. Considering radionuclide uptake in the intracardiac portion of the lead, sensitivity and specificity of PET/CT for CIED-IE were 38.5% and 98.0%, respectively. Positive (19.2) and negative (0.6) likelihood ratio values, suggest that a positive PET/CT is much more probable to correspond to a patient with CIED-IE, whereas it is not possible to exclude this diagnosis when negative. For PI, sensitivity and specificity were 72.2% and 95.6%, respectively. The yield of 18F-FDG PET/CT for suspected CIED infections differs depending on the site of infection. Due to very high specificity but poor sensitivity, negative studies must be interpreted with caution if the suspicion of CIED-IE is high. |
| Databáze: | OpenAIRE |
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