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Journal of Nuclear Cardiology
Published in: Journal of Nuclear Cardiology 6/2021

Open Access 01-12-2021 | Computed Tomography | ORIGINAL ARTICLE

18F-FDG positron emission tomography/computed tomography of cardiac implantable electronic device infections

Authors: Soile Pauliina Salomäki, MD, Antti Saraste, MD, PhD, Jukka Kemppainen, MD, PhD, Saija Hurme, MSc, Juhani Knuuti, MD, PhD, Pirjo Nuutila, MD, PhD, Marko Seppänen, MD, PhD, Anne Roivainen, PhD, Juhani Airaksinen, MD, PhD, Tiina Salo, MD, Jarmo Oksi, MD, PhD, Laura Pirilä, MD, PhD, Ulla Hohenthal, MD, PhD

Published in: Journal of Nuclear Cardiology | Issue 6/2021

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Abstract

Background

The diagnosis of cardiac implantable electronic device (CIED) infection is challenging because of its variable presentations. We studied the value of 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in the detection of CIED infection.

Methods and results

Thirty patients with suspected CIED infection underwent 18F-FDG-PET/CT. The control group was ten patients with asymptomatic CIED who underwent cancer-related 18F-FDG-PET/CT. 18F-FDG-PET/CT was evaluated visually, semiquantitatively as maximum standardized uptake value (SUVmax) and target-to-background ratio (TBR). Final diagnosis of CIED infection was based on clinical and bacteriological data. 18F-FDG-PET/CT was visually positive in all 9 patients with recent (≤ 8 weeks) implantation of CIED, but only 4 had confirmed CIED infection. 18F-FDG-PET/CT was true positive in 9 out of 21 cases with remote implantation of CIED and false positive in 3 (14.3%) cases. 18F-FDG-PET/CT was also false positive in 3 (30%) cases of control group. The SUVmax of the pocket area was significantly higher in patients with CIED infection than in the control group (4.8 ± 2.4 vs 2.0 ± .8, P < .001). By using the cut-off value of TBR ≥ 1.8, sensitivity of 18F-FDG-PET/CT for the diagnosis of CIED infection in patients with remote implantation was 90% and specificity 73%, PPV 75%, and NPV 89%.

Conclusions

18F-FDG-PET/CT is a sensitive but nonspecific method in the diagnosis of CIED infection.
Appendix
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Metadata
Title
18F-FDG positron emission tomography/computed tomography of cardiac implantable electronic device infections
Authors
Soile Pauliina Salomäki, MD
Antti Saraste, MD, PhD
Jukka Kemppainen, MD, PhD
Saija Hurme, MSc
Juhani Knuuti, MD, PhD
Pirjo Nuutila, MD, PhD
Marko Seppänen, MD, PhD
Anne Roivainen, PhD
Juhani Airaksinen, MD, PhD
Tiina Salo, MD
Jarmo Oksi, MD, PhD
Laura Pirilä, MD, PhD
Ulla Hohenthal, MD, PhD
Publication date
01-12-2021
Publisher
Springer International Publishing
Published in
Journal of Nuclear Cardiology / Issue 6/2021
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-020-02256-4

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