1. PET/CT with 18F-FDG in suspected intracardiac device-related infections: analysis of performance and diagnostic usefulness
- Author
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Antonio Ramos-Martínez, Víctor Castro Urda, Isabel Sánchez Romero, Mercedes Mitjavila Casanovas, Marta Cobo Marcos, and Begoña Rodríguez-Alfonso
- Subjects
PET-CT ,medicine.medical_specialty ,business.industry ,Retrospective cohort study ,General Medicine ,030204 cardiovascular system & hematology ,medicine.disease ,Focal infection theory ,Intracardiac injection ,03 medical and health sciences ,0302 clinical medicine ,Infective endocarditis ,medicine ,Endocarditis ,Tomography ,Radiology ,Medical diagnosis ,business - 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.
- Published
- 2021
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