A1 Journal article – refereed

18F-FDG positron emission tomography/computed tomography of cardiac implantable electronic device infections

List of Authors: Soile Pauliina Salomäki, Antti Saraste, Jukka Kemppainen, Saija Hurme, Juhani Knuuti, Pirjo Nuutila, Marko Seppänen, Anne Roivainen, Juhani Airaksinen, Tiina Salo, Jarmo Oksi, Laura Pirilä, Ulla Hohenthal

Publisher: Springer

Publication year: 2020

Journal: Journal of Nuclear Cardiology

Journal name in source: Journal of Nuclear Cardiology

Number of pages: 12

ISSN: 1071-3581

DOI: http://dx.doi.org/10.1007/s12350-020-02256-4


Background. The diagnosis of cardiac implantable electronic device (CIED) infection is challenging because of its variable presentations. We studied the value of 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in the detection of CIED infection.

Methods and results. Thirty patients with suspected CIED infection underwent 18F-FDG-PET/CT. The control group was ten patients with asymptomatic CIED who underwent cancer related 18F-FDG-PET/CT. 18F-FDG-PET/CT was evaluated visually, semiquantitatively as maximum standardized uptake value (SUVmax) and target-to-background ratio (TBR). Final diagnosis of CIED infection was based on clinical and bacteriological data. 18F-FDG-PET/CT was visually positive in all 9 patients with recent ( ≤ 8 weeks) implantation of CIED, but only 4 had confirmed CIED infection. 18F-FDG-PET/CT was true positive in 9 out of 21 cases with remote implantation of CIED and false positive in 3 (14.3%) cases. 18F-FDG-PET/CT was also false positive in 3 (30%) cases of control group. The SUVmax of the pocket area was significantly higher in patients with CIED infection than in the control group (4.8 ± 2.4 vs 2.0 ± .8, P < .001). By using the cut-off value of TBR ≥ 1.8, sensitivity of 18F-FDG-PET/CT for the diagnosis of CIED infection in patients with remote implantation was 90% and specificity 73%, PPV 75%, and NPV 89%

Conclusions. 18F-FDG-PET/CT is a sensitive but nonspecific method in the diagnosis of CIED infection.

Downloadable publication

This is an electronic reprint of the original article.
This reprint may differ from the original in pagination and typographic detail. Please cite the original version.

Last updated on 2021-24-06 at 09:14