Diagnostic Accuracy of FDG PET/CT in Suspected LVAD Infections

Tam, Marty; Patel, Vaiibhav; Weinberg, Richard L.; Hulten, Edward; Aaronson, Keith D.; Pagani, Francis D.; Corbett, James R.; Murthy, Venkatesh L.

doi:10.1016/j.jcmg.2019.04.024

Cited by 54 publications

(27 citation statements)

References 28 publications

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“…Among nuclear radiologic modalities, 18F-FDG PET/CT appeared to be superior to leucocyte scintigraphy-based technologies in the context of general sensitivity and specificity, due to its high spatial resolution [ 75 , 76 ]. Two recent systematic reviews and meta-analyses assessed the performance of 18F-FDG PET/CT in diagnosing VAD-related infections, and both reported high accuracy of this dual-modality imaging system, supported by pooled sensitivities of 92% and 95%, and specificities of 83% and 91%, respectively [ 77 , 78 ]. Caution, however, should still be taken when using 18F-FDG PET/CT to detect biofilm-related driveline infections.…”

Section: Diagnosis Of Vad-specific Infectionsmentioning

confidence: 99%

Ventricular Assist Device-Specific Infections

Peleg

McGiffin

2021

JCM

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Ventricular assist device (VAD)-specific infections, in particular, driveline infections, are a concerning complication of VAD implantation that often results in significant morbidity and even mortality. The presence of a percutaneous driveline at the skin exit-site and in the subcutaneous tunnel allows biofilm formation and migration by many bacterial and fungal pathogens. Biofilm formation is an important microbial strategy, providing a shield against antimicrobial treatment and human immune responses; biofilm migration facilitates the extension of infection to deeper tissues such as the pump pocket and the bloodstream. Despite the introduction of multiple preventative strategies, driveline infections still occur with a high prevalence of ~10–20% per year and their treatment outcomes are frequently unsatisfactory. Clinical diagnosis, prevention and management of driveline infections are being targeted to specific microbial pathogens grown as biofilms at the driveline exit-site or in the driveline tunnel. The purpose of this review is to improve the understanding of VAD-specific infections, from basic “bench” knowledge to clinical “bedside” experience, with a specific focus on the role of biofilms in driveline infections.

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Section: Diagnosis Of Vad-specific Infectionsmentioning

confidence: 99%

Ventricular Assist Device-Specific Infections

Peleg

McGiffin

2021

JCM

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“…They also confirmed the utility of FDG PET/CT in the location and quantification of the extent of infection. Moreover, a recent case series and meta-analysis of four studies showed a pooled sensitivity of 92% and specificity of 83% for the diagnosis of LVAD infection, but the specificity varied considerably between studies (25% to 100%) [ 30 ]. Akin et al [ 31 ] showed that FDG PET/CT imaging provided accurate information on the location and extent of LVAD-related infections 3 weeks after implantation.…”

Section: Left Ventricular Assist Device Infectionmentioning

confidence: 99%

F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the infection of heart

Kong

2021

Yeungnam Univ J Med

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Infections involving the heart are becoming increasingly common, and a timely diagnosis of utmost importance, despite its challenges. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a recently introduced diagnostic tool in cardiology. This review focuses on the current evidence for the use of FDG PET/CT in the diagnosis of infective endocarditis, cardiac implantable device infection, left ventricular assist device infection, and secondary complications. The author discuss considerations when using FDG PET/CT in routine clinical practice, patient preparation for reducing physiologic myocardial uptake, acquisition of images, and interpretation of PET/CT findings. This review also functions to highlight the need for a standardized acquisition protocol.

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“…ROC analiza pokazala je AUC od 0,94 (95 % CI 0,91 -0,95). 45 Još jedan scenarij dokaza infekcije u kojem oslikavanje nuklearnim tehnikama ima važnu ulogu jest endokarditis povezan s implantacijom srčanih uređaja (CDRIE). Holcman i sur.…”

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“…The ROC curve analysis demonstrated an AUC of 0.94 (95% CI 0.91-0.95). 45 Another infectious scenario in which nuclear imaging techniques play an important diagnostic role is cardiac device-related infected endocarditis (CDRIE). Holcman et al assessed the diagnostic accuracy of the hybrid technique of SPECT CT with technetium99mhexamethylpropyleneamine oxime-labelled leucocytes (99mTc-HMPAO-SPECT/CT).…”

mentioning

confidence: 99%