Publish in this journal
Journal Information
Visits
Not available
Original article
DOI: 10.1016/j.rec.2020.01.026
Available online 27 May 2020
PET/CT with 18F-FDG in suspected intracardiac device-related infections: analysis of performance and diagnostic usefulness
PET/TC con 18F-FDG en la sospecha de infección asociada a dispositivos intracardiacos: rendimiento y utilidad diagnóstica
Visits
...
Begoña Rodríguez-Alfonsoa,
Corresponding author
brodrigueza@salud.madrid.org

Corresponding author Servicio de Medicina Nuclear, Planta –1, Hospital Universitario Puerta de Hierro, Manuel de Falla 1, 28222 Majadahonda, Madrid, Spain.
, Mercedes Mitjavila Casanovasa, Víctor Castro Urdab, Marta Cobo Marcosb, Isabel Sánchez Romeroc, Antonio Ramos-Martínezd
a Servicio de Medicina Nuclear, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
b Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
c Servicio de Microbiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
d Servicio de Medicina Interna (Infectología), Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
This item has received
...
Visits
(Daily data update)
Received 12 June 2019. Accepted 24 January 2020
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (3)
Show moreShow less
Tables (7)
Table 1. Types of infection associated with intracardiac devices according to the definitions proposed by Sandoe et al.12
Table 2. Patient characteristics
Table 3. Initial and definitive diagnostic classification of patients and test results
Table 4. Distribution of blood culture results according to the definitive diagnosis
Table 5. Diagnostic performance of ultrasound and PET/CT in the detection of infective endocarditis and of PET/CT in generator pocket infection
Table 6. Performance of imaging tests for the diagnosis of ie according to initial clinical suspicion
Table 7. Distribution of patients according to the time of diagnosis
Show moreShow less
Abstract
Introduction and objectives

Cardiac device-related infections (CDRI) may be life-threatening and require early and accurate diagnosis. The aims of this study were to analyze the performance of positron emission tomography-computed tomography (PET/CT) in suspected CDRI, to assess changes to the initial diagnosis, and to identify a clinical subgroup deriving the greatest benefit from this imaging modality.

Methods

Retrospective study including patients evaluated by PET/CT for suspected CDRI from 2011 to 2018. We assessed PET/CT performance and the agreement between the initial, post-PET and definitive diagnoses. We also assessed changes in the diagnosis, depending on initial clinical suspicion, to identify patients deriving the greatest benefit from PET/CT.

Results

We included 44 patients. The prevalence of endocarditis was 57%. The sensitivity and specificity of PET/CT for the diagnosis of infective endocarditis were 0.84 and 0.95, respectively. Post-PET diagnosis improved the initial diagnosis by 45%. PET/CT correctly reclassified 57% of patients with initial suspicion of generator pocket infection by detecting lead infection.

Conclusions

PET/CT showed high diagnostic performance in suspected of CDRI and significantly improved the conventional diagnostic approach, especially in patients with initial suspicion of focal infection.

Keywords:
PET/CT
Endocarditis
Pacemaker
Defibrillator
Cardiac device-related infection
Abbreviations:
CDRI
CIED
FUO
IE
PET/CT
Resumen
Introducción y objetivos

Las infecciones relacionadas con dispositivos intracardiacos (i-DIC) son potencialmente graves y requieren un diagnóstico precoz y certero. Los objetivos del estudio son analizar el rendimiento de la tomografía por emisión de positrones con tomografía computarizada (PET/TC) ante sospecha de i-DIC y los cambios que induce sobre el diagnóstico inicial e identificar el escenario con mayor beneficio de uso.

Métodos

Estudio retrospectivo de pacientes valorados mediante PET/TC por sospecha de i-DIC desde 2011 a 2018. Se calcularon valores de rendimiento diagnóstico de la PET/TC y la concordancia entre diagnóstico inicial y post-PET y el diagnóstico definitivo. Se analizaron los cambios diagnósticos considerando la sospecha clínica inicial para identificar a los pacientes con mayor beneficio.

Resultados

Se incluyó a 44 pacientes. La prevalencia de endocarditis fue del 57%. La sensibilidad y la especificidad de la 18F-FDG-PET/TC para el diagnóstico de endocarditis fueron 0,84 y 0,95. El diagnóstico tras la PET mejoró el inicial un 45%. De los pacientes con sospecha de infección local, la PET/TC reclasificó adecuadamente al 57% por detección de infección profunda.

Conclusiones

La PET/TC muestra elevado rendimiento diagnóstico ante la sospecha de i-DIC y mejora significativamente el diagnóstico convencional, sobre todo en el grupo de pacientes con sospecha de infección limitada al bolsillo.

Palabras clave:
PET/TC
Endocarditis
Marcapasos
Desfibrilador
Infección de dispositivo intracardiaco

Article

These are the options to access the full texts of the publication Revista Española de Cardiología (English Edition)
Member
Members of SEC
Use the Society's website login and password here
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Revista Española de Cardiología (English Edition)

Comprar
Comprar acceso al artículo

Comprando el artículo el PDF del mismo podrá ser descargado

Precio 19,34 €

Comprar ahora
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.