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Published in:

01-06-2014 | Original Article

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

Authors: Lucia Leccisotti, MD, Francesco Perna, MD, PhD, Mariaelena Lago, MD, Milena Leo, MD, Antonella Stefanelli, MD, Maria L. Calcagni, MD, Gemma Pelargonio, MD, Maria L. Narducci, MD, PhD, Gianluigi Bencardino, MD, Fulvio Bellocci, MD, Alessandro Giordano, MD

Published in: Journal of Nuclear Cardiology | Issue 3/2014

Abstract

Background

Positron emission tomography-computed tomography (PET-CT) with ¹⁸F-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.

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Title: Cardiovascular implantable electronic device infection: delayed vs standard FDG PET-CT imaging
Authors: Lucia Leccisotti, MD
Francesco Perna, MD, PhD
Mariaelena Lago, MD
Milena Leo, MD
Antonella Stefanelli, MD
Maria L. Calcagni, MD
Gemma Pelargonio, MD
Maria L. Narducci, MD, PhD
Gianluigi Bencardino, MD
Fulvio Bellocci, MD
Alessandro Giordano, MD
Publication date: 01-06-2014
Publisher: Springer US
Published in: Journal of Nuclear Cardiology / Issue 3/2014
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-014-9896-2

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

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Conclusions

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