| Usefulness of fluorine-18 positron emission tomography/computed tomography for identification of cardiovascular implantable electronic device infections. | |
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MedLine Citation:
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PMID: 22538331 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study evaluated the usefulness of fluorodesoxyglucose marked by fluorine-18 ((18)F-FDG) positron emission tomography (PET) and computed tomography (CT) in patients with suspected cardiovascular implantable electronic device (CIED) infection. BACKGROUND: CIED infection is sometimes challenging to diagnose. Because extraction is associated with significant morbidity/mortality, new imaging modalities to confirm the infection and its dissemination would be of clinical value. METHODS: Three groups were compared. In Group A, 42 patients with suspected CIED infection underwent (18)F-FDG PET/CT. Positive PET/CT was defined as abnormal uptake along cardiac devices. Group B included 12 patients without infection who underwent PET/CT 4 to 8 weeks post-implant. Group C included 12 patients implanted for >6 months without infection who underwent PET/CT for another indication. Semi-quantitative ratio (SQR) was obtained from the ratio between maximal uptake and lung parenchyma uptake. RESULTS: In Group A, 32 of 42 patients with suspected CIED infection had positive PET/CT. Twenty-four patients with positive PET/CT underwent extraction with excellent correlation. In 7 patients with positive PET/CT, 6 were treated as superficial infection with clinical resolution. One patient with positive PET/CT but negative leukocyte scan was considered false positive due to Dacron pouch. Ten patients with negative-PET/CT were treated with antibiotics and none has relapsed at 12.9 ± 1.9 months. In Group B, patients had mild uptake seen at the level of the connector. There was no abnormal uptake in Group C patients. Median SQR was significantly higher in Group A (A = 2.02 vs. B = 1.08 vs. C = 0.57; p < 0.001). CONCLUSIONS: PET/CT is useful in differentiating between CIED infection and recent post-implant changes. It may guide appropriate therapy. |
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Authors:
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Jean-François Sarrazin; François Philippon; Michel Tessier; Jean Guimond; Franck Molin; Jean Champagne; Isabelle Nault; Louis Blier; Maxime Nadeau; Lyne Charbonneau; Mikaël Trottier; Gilles O'Hara |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 59 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-04-27 Completed Date: 2012-07-10 Revised Date: 2013-01-07 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1616-25 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Medicine, Division of Cardiology, Institut universitaire de cardiologie et pneumologie de Québec, 2725 chemin Sainte-Foy, Québec City, Quebec, Canada. jean-francois.sarrazin@criucpq.ulaval.ca |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Arrhythmias, Cardiac / therapy Cardiovascular Infections / diagnosis*, epidemiology, etiology Defibrillators, Implantable / microbiology* Diagnosis, Differential Female Fluorodeoxyglucose F18 / diagnostic use* Follow-Up Studies Humans Male Middle Aged Morbidity / trends Myocarditis / diagnosis*, epidemiology, etiology Positron-Emission Tomography and Computed Tomography / utilization* Prospective Studies Prosthesis-Related Infections / diagnosis* Quebec / epidemiology Radiopharmaceuticals / diagnostic use Reproducibility of Results |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18 |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2012 Nov 20;60(21):2259-60; author reply 2260
[PMID:
23153852
]
J Am Coll Cardiol. 2012 May 1;59(18):1626-8 [PMID: 22538332 ] J Am Coll Cardiol. 2012 Oct 9;60(15):1436-7; author reply 1437 [PMID: 23036634 ] J Am Coll Cardiol. 2012 Oct 9;60(15):1435-6; author reply 1437 [PMID: 23036633 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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