Ahmed, FZ, James, J, Cunnington, C et al. (13 more authors) (2015) Early diagnosis of cardiac implantable electronic device generator pocket infection using F-18-FDG-PET/CT. European Heart Journal-Cardiovascular Imaging, 16 (5). 521 - 530. ISSN 2047-2404
Abstract
Aims: To examine the utility of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the early diagnosis of cardiac implantable electronic device (CIED) generator pocket infection. Methods and results: A total of 86 patients with CIEDs were evaluated with 18F-FDG PET/CT imaging: 46 with suspected generator pocket infection and 40 without any history of infection. 18F-FDG activity in the region of the generator pocket was expressed as a semi-quantitative ratio (SQR)—defined as the maximum count rate around the CIED divided by the mean count rate between normal right and left lung parenchyma. All patients underwent standard clinical management, independent of the PET/CT result. Patients with suspected generator pocket infection that required CIED extraction (n = 32) had significantly higher 18F-FDG activity compared with those that did not (n = 14), and compared with controls (n = 40) [SQR: 4.80 (3.18–7.05) vs. 1.40 (0.88–1.73) vs. 1.10 (0.98–1.40), respectively; P < 0.001]. On receiver operator characteristic analysis, SQR had a high diagnostic accuracy (area under curve = 0.98) for the early identification of patients with confirmed infection (i.e. those ultimately needing extraction)—with an optimal SQR cut-off value of >2.0 (sensitivity = 97%; specificity = 98%). Conclusion: This study highlights the potential benefits of evaluating patients with suspected CIED generator pocket infection using 18F-FDG PET/CT. In this study, 18F-FDG PET/CT had a high diagnostic accuracy in the early diagnosis of CIED generator pocket infection, even where initial clinical signs were underwhelming.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © The Authors, 2015. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the originalwork is properly cited. For commercial re-use, please contact journals.permissions @oup.com |
Keywords: | Pacemakers; Infection; Generator pocket infection; Imaging and diagnostics; Nuclear cardiology; F-18-FDG PET/CT |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Molecular Gastroenterology (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 08 Oct 2015 14:17 |
Last Modified: | 01 Mar 2019 11:44 |
Published Version: | http://dx.doi.org/10.1093/ehjci/jeu295 |
Status: | Published |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/ehjci/jeu295 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:87906 |