Search

The usage of left-ventricular-assist device (LVAD) is increasing in patients presenting with advanced heart failure. However, device-related infections are a challenge to recognize and to treat, with an important morbidity and mortality rate. The role of nuclear medicine imaging remains not well established for LVAD infections. The present study compared the accuracy of positron emission tomography/computed tomography with 18F-fludeoxyglucose (18F-FDG PET/CT) and radiolabeled leucocyte scintigraphy for the diagnosis of infections in patients supported with a continuous-flow LVAD. From a prospectively maintained database, we retrospectively analyzed the diagnostic performance of radiolabeled leucocyte scintigraphy and 18F-FDG PET/CT in 24 patients who had a LVAD with a suspected device-related infection. Both examinations were routinely performed in all patients. Infection was assessed by the International Society for Heart and Lung Transplantation criteria. Twenty-four patients were included: 15 had a specific VAD infection (5 cardiac-LVAD and 10 driveline), 6 had a VAD-related infection, while 3 patients had a non-VAD-related infection. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.2%, 66.7%, 95.2%, 66.7%, and 91.6%, respectively, for 18F-FDG-PET; and 71.4%, 100%, 100%, 33.3%, and 75%, respectively, for leucocyte scintigraphy. 18F-FDG PET/CT showed significantly higher sensitivity (P = 0.01) than leucocyte scintigraphy. 18F-FDG PET/CT and radiolabeled leucocyte scintigraphy single-photon emission computed tomography carry high performance in the diagnostic of LVAD infections. 18F-FDG PET/CT shows significantly higher sensitivity and could be proposed as first-line nuclear medicine procedure.

The usage of left-ventricular-assist device (LVAD) is increasing in patients presenting with advanced heart failure. However, device-related infections are a challenge to recognize and to treat, with an important morbidity and mortality rate. The role of nuclear medicine imaging remains not well established for LVAD infections. The present study compared the accuracy of positron emission tomography/computed tomography withFrom a prospectively maintained database, we retrospectively analyzed the diagnostic performance of radiolabeled leucocyte scintigraphy andTwenty-four patients were included: 15 had a specific VAD infection (5 cardiac-LVAD and 10 driveline), 6 had a VAD-related infection, while 3 patients had a non-VAD-related infection. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.2%, 66.7%, 95.2%, 66.7%, and 91.6%, respectively, for

Treating cancer directly at the tumor site while preserving healthy neighbouring tissues seems to be an ideal alternative for neoplasia treatment. Liver tumors show a high mortality rate and the existing therapies proposed have not achieved entirely satisfactory results. In nuclear medecine, selective or vectored internal radiotherapies treat cancer while preserving the healthy tissues. Among them, selective internal radiotherapy, also called radioembolization, with Yttrium-90-labelled microspheres is an innovative selective hepatic tumor protocol, selective of hepatic tumors. It is about introducing spheres with a diameter of a few tens of microns radiolabelled with a radionuclide directly into the liver to destroy the tumor in situ. The first results are encouraging and randomized clinical trials whose conclusions are expected for the next few years have been launched in order to collect robust data and optimize the place of this therapy in the hepatic neoplasias management., Traiter le cancer directement au siège de la tumeur en préservant les tissus sains paraît être une alternative idéale au traitement des néoplasies. Les tumeurs du foie présentent une mortalité élevée et les thérapies actuelles proposées n’ont pas donné des résultats entièrement satisfaisants. En médecine nucléaire, les radiothérapies internes vectorisées ou sélectives visent à traiter le cancer directement au siège de la tumeur en préservant les tissus sains. Parmi elles, la radiothérapie interne sélective ou radioembolisation, avec les microsphères marquées à l’Yttrium-90 est un protocole novateur, sélectif des tumeurs hépatiques. Il s’agit d’introduire des sphères d’un diamètre de quelques dizaines de microns, radiomarquées avec un radionucléide, directement dans le foie afin de détruire la tumeur in situ. Les premiers résultats sont prometteurs et des essais cliniques randomisés dont les conclusions sont attendues pour les prochaines années, ont été lancé afin de recueillir des données robustes et optimiser la place de cette thérapie dans la prise en charge des néoplasies hépatiques.