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01.06.2014 | Original Article

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

verfasst von: 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

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 3/2014

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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.

Sohail MR, Uslan DZ, Khan AH, Friedman PA, Hayes DL, Wilson WR, et al. Infective endocarditis complicating permanent pacemaker and implantable cardioverter-defibrillator infection. Mayo Clin Proc. 2008;83(1):46–53.PubMedCrossRef

Wilkoff BL, Love CJ, Byrd CL, Bongiorni MG, Carrillo RG, Crossley GH 3rd, Heart Rhythm Society, American Heart Association, et al. Transvenous lead extraction: Heart Rhythm Society expert consensus on facilities, training, indications, and patient management: This document was endorsed by the American Heart Association (AHA). Heart Rhythm. 2009;6(7):1085–104.PubMedCrossRef

Glaudemans AW, de Vries EF, Galli F, Dierckx RA, Slart RH, Signore A. The use of (18)F-FDG-PET/CT for diagnosis and treatment monitoring of inflammatory and infectious diseases. Clin Dev Immunol 2013. doi:10.1155/2013/623036.

Haroon A, Zumla A, Bomanji J. Role of fluorine 18 fluorodeoxyglucose positron emission tomography-computed tomography in focal and generalized infectious and inflammatory disorders. Clin Infect Dis. 2012;54(9):1333–41.PubMedCrossRef

Israel O, Keidar Z. PET/CT imaging in infectious conditions. Ann N Y Acad Sci. 2011;1228:150–66.PubMedCrossRef

Glaudemans AW, Signore A. FDG-PET/CT in infections: The imaging method of choice? Eur J Nucl Med Mol Imaging. 2010;37(10):1986–91.PubMedCentralPubMedCrossRef

Bensimhon L, Lavergne T, Hugonnet F, Mainardi JL, Latremouille C, Maunoury C, et al. Whole body [(18)F]fluorodeoxyglucose positron emission tomography imaging for the diagnosis of pacemaker or implantable cardioverter defibrillator infection: A preliminary prospective study. Clin Microbiol Infect. 2011;17(6):836–44.PubMedCrossRef

Ploux S, Riviere A, Amraoui S, Whinnett Z, Barandon L, Lafitte S, et al. Positron emission tomography in patients with suspected pacing system infections may play a critical role in difficult cases. Heart Rhythm. 2011;8(9):1478–81.PubMedCrossRef

Sarrazin JF, Philippon F, Tessier M, Guimond J, Molin F, Champagne J, et al. Usefulness of fluorine-18 positron emission tomography/computed tomography for identification of cardiovascular implantable electronic device infections. J Am Coll Cardiol. 2012;59(18):1616–25.PubMedCrossRef

10.

Harisankar CN, Mittal BR, Agrawal KL, Abrar ML, Bhattacharya A. Utility of high fat and low carbohydrate diet in suppressing myocardial FDG uptake. J Nucl Cardiol. 2011;18(5):926–36.PubMedCrossRef

11.

Dweck MR, Chow MW, Joshi NV, Williams MC, Jones C, Fletcher AM, et al. Coronary arterial 18F-sodium fluoride uptake: A novel marker of plaque biology. J Am Coll Cardiol. 2012;59(17):1539–48.PubMedCrossRef

12.

Rogers IS, Nasir K, Figueroa AL, Cury RC, Hoffmann U, Vermylen DA, et al. Feasibility of FDG imaging of the coronary arteries: Comparison between acute coronary syndrome and stable angina. JACC Cardiovasc Imaging. 2010;3(4):388–97.PubMedCrossRef

13.

Rudd JH, Warburton EA, Fryer TD, Jones HA, Clark JC, Antoun N, et al. Imaging atherosclerotic plaque inflammation with [18F]-fluorodeoxyglucose positron emission tomography. Circulation. 2002;105(23):2708–11.PubMedCrossRef

14.

Cheng VY, Slomka PJ, Le Meunier L, Tamarappoo BK, Nakazato R, Dey D, et al. Coronary arterial 18F-FDG uptake by fusion of PET and coronary CT angiography at sites of percutaneous stenting for acute myocardial infarction and stable coronary artery disease. J Nucl Med. 2012;53(4):575–83.PubMedCrossRef

15.

Basu S, Alavi A. Partial volume correction of standardized uptake values and the dual time point in FDG-PET imaging: Should these be routinely employed in assessing patients with cancer? Eur J Nucl Med Mol Imaging. 2007;34(10):1527–9.PubMedCrossRef

16.

Basu S, Kwee TC, Surti S, Akin EA, Yoo D, Alavi A. Fundamentals of PET and PET/CT imaging. Ann N Y Acad Sci. 2011;1228:1–18.PubMedCrossRef

17.

Brinker J. Imaging for infected cardiac implantable electronic devices: A new trick for your pet. J Am Coll Cardiol. 2012;59(18):1626–8.PubMedCrossRef

18.

Vos FJ, Bleeker-Rovers CP, van Dijk AP, Oyen WJ. Detection of pacemaker and lead infection with FDG-PET. Eur J Nucl Med Mol Imaging. 2006;33(10):1245.PubMedCrossRef

19.

Turpin S, Lambert R, Poirier N. An unusual looking pacemaker infection imaged with 18F-FDG PET/CT. Eur J Nucl Med Mol Imaging. 2010;37(7):1438.PubMedCrossRef

20.

Abikhzer G, Turpin S, Bigras JL. Infected pacemaker causing septic lung emboli detected on FDG PET/CT. J Nucl Cardiol. 2010;17(3):514–5.PubMedCrossRef

21.

Millar BC, Prendergast BD, Alavi A, Moore JE. Positron emission tomography (PET): A new tool in the diagnosis of endocarditis. Heart. 2009;95(4):332–3.PubMed

22.

Amraoui S, Texier-Maugein J, Bordachar P. PET scan in suspected but unproven pacemaker endocarditis. Arch Cardiovasc Dis. 2012;105(2):125–6.PubMedCrossRef

23.

Cautela J, Alessandrini S, Cammilleri S, Giorgi R, Richet H, Casalta JP, et al. Diagnostic yield of FDG positron-emission tomography/computed tomography in patients with CEID infection: A pilot study. Europace. 2013;15(2):252–7.PubMedCrossRef

24.

Caldarella C, Leccisotti L, Treglia G, Giordano A. Which is the optimal acquisition time for FDG PET/CT imaging in patients with infective endocarditis? J Nucl Cardiol. 2013;20(2):307–9.PubMedCrossRef

25.

Cheng G, Alavi A, Lim E, Werner TJ, Del Bello CV, Akers SR. Dynamic changes of FDG uptake and clearance in normal tissues. Mol Imaging Biol. 2013;15(3):345–52.PubMedCrossRef

26.

Blomberg BA, Akers SR, Saboury B, Mehta NN, Cheng G, Torigian DA, et al. Delayed time-point 18F-FDG PET CT imaging enhances assessment of atherosclerotic plaque inflammation. Nucl Med Commun. 2013;34(9):860–7.PubMed

27.

Demura Y, Tsuchida T, Ishizaki T, Mizuno S, Totani Y, Ameshima S, et al. 18F-FDG accumulation with PET for differentiation between benign and malignant lesions in the thorax. J Nucl Med. 2003;44(4):540–8.PubMed

28.

Jones HA, Cadwallader KA, White JF, Uddin M, Peters AM, Chilvers ER. Dissociation between respiratory burst activity and deoxyglucose uptake in human neutrophil granulocytes: Implications for interpretation of (18)F-FDG PET images. J Nucl Med. 2002;43(5):652–7.PubMed

29.

Deichen JT, Prante O, Gack M, Schmiedehausen K, Kuwert T. Uptake of [18F]fluorodeoxyglucose in human monocyte-macrophages in vitro. Eur J Nucl Med Mol Imaging. 2003;30(2):267–73.PubMedCrossRef

30.

Keidar Z, Engel A, Hoffman A, Israel O, Nitecki S. Prosthetic vascular graft infection: The role of 18F-FDG PET/CT. J Nucl Med. 2007;48(8):1230–6.PubMedCrossRef

Titel: Cardiovascular implantable electronic device infection: delayed vs standard FDG PET-CT imaging
verfasst von: 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
Publikationsdatum: 01.06.2014
Verlag: Springer US
Erschienen in: Journal of Nuclear Cardiology / Ausgabe 3/2014
Print ISSN: 1071-3581
Elektronische 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