Cardiovascular implantable electronic device infection: delayed vs standard FDG PET-CT imaging

Maria Lucia Calcagni, Gemma Pelargonio, Alessandro Giordano, Lucia Leccisotti, Francesco Perna, Mariaelena Lago, Milena Leo, Antonella Stefanelli, Maria Lucia Narducci

Risultato della ricerca: Contributo in rivistaArticolo in rivista

48 Citazioni (Scopus)

Abstract

Positron emission tomography-computed tomography (PET-CT) with (18)F-fluorodeoxyglucose (FDG) has emerged as a rapidly evolving diagnostic tool for infectious diseases. However, the optimal imaging time in this clinical setting is not clear yet. The aim of this study is to investigate whether delayed (3 hours) FDG PET-CT could increase the diagnostic accuracy of this technique compared to standard (1 hour) imaging in the detection of septic foci involving the pocket and/or pacing leads in patients with suspected cardiovascular implantable electronic device (CIED) infection scheduled for device removal. METHODS AND RESULTS: Twenty-seven patients underwent standard and delayed imaging. PET-CT results were compared to bacteriological cultures after CIED removal. Fifteen controls free of infection underwent PET-CT imaging as part of investigation of malignancy. The diagnostic accuracy of delayed imaging was significantly higher than 1-hour scan for lead infection (70% vs 51%, P = .024). No significant difference was found between standard and delayed diagnostic accuracy for pocket or device infection. Semi-quantitative analysis showed that mean pocket and lead target-to-background ratio were significantly higher on delayed compared to standard imaging (3.7 ± 1.9 vs 1.6 ± 1.1, P = .0002; 3.0 ± 1.3 vs 0.7 ± 1.0, P = .01). CONCLUSIONS: Delayed FDG PET-CT imaging should be considered at least in patients with negative 1-hour scan and founded suspicion of pacing lead infection.
Lingua originaleEnglish
pagine (da-a)622-632
Numero di pagine11
RivistaJournal of Nuclear Cardiology
DOI
Stato di pubblicazionePubblicato - 2014

Keywords

  • ELECTRONIC DEVICE
  • FDG PET-CT

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