Author + information
- Received July 7, 2011
- Revision received November 9, 2011
- Accepted November 22, 2011
- Published online May 1, 2012.
- Jean-François Sarrazin, MD⁎,⁎ (, )
- François Philippon, MD⁎,
- Michel Tessier, MD†,
- Jean Guimond, MD†,
- Franck Molin, MD⁎,
- Jean Champagne, MD⁎,
- Isabelle Nault, MD⁎,
- Louis Blier, MD⁎,
- Maxime Nadeau⁎,
- Lyne Charbonneau, RN⁎,
- Mikaël Trottier, MD† and
- Gilles O'Hara, MD⁎
- ↵⁎Reprint requests and correspondence:
Dr. Jean-François Sarrazin, Department of Medicine, Division of Cardiology, Institut universitaire de cardiologie et de pneumologie de Québec, 2725, chemin Sainte-Foy, Quebec City, Quebec G1V 4G5, Canada
Objectives This study evaluated the usefulness of fluorodesoxyglucose marked by fluorine-18 (18F-FDG) positron emission tomography (PET) and computed tomography (CT) in patients with suspected cardiovascular implantable electronic device (CIED) infection.
Background CIED infection is sometimes challenging to diagnose. Because extraction is associated with significant morbidity/mortality, new imaging modalities to confirm the infection and its dissemination would be of clinical value.
Methods Three groups were compared. In Group A, 42 patients with suspected CIED infection underwent 18F-FDG PET/CT. Positive PET/CT was defined as abnormal uptake along cardiac devices. Group B included 12 patients without infection who underwent PET/CT 4 to 8 weeks post-implant. Group C included 12 patients implanted for >6 months without infection who underwent PET/CT for another indication. Semi-quantitative ratio (SQR) was obtained from the ratio between maximal uptake and lung parenchyma uptake.
Results In Group A, 32 of 42 patients with suspected CIED infection had positive PET/CT. Twenty-four patients with positive PET/CT underwent extraction with excellent correlation. In 7 patients with positive PET/CT, 6 were treated as superficial infection with clinical resolution. One patient with positive PET/CT but negative leukocyte scan was considered false positive due to Dacron pouch. Ten patients with negative-PET/CT were treated with antibiotics and none has relapsed at 12.9 ± 1.9 months. In Group B, patients had mild uptake seen at the level of the connector. There was no abnormal uptake in Group C patients. Median SQR was significantly higher in Group A (A = 2.02 vs. B = 1.08 vs. C = 0.57; p < 0.001).
Conclusions PET/CT is useful in differentiating between CIED infection and recent post-implant changes. It may guide appropriate therapy.
All authors have reported that they have no relationships relevant to the contents to this paper to disclose.
- Received July 7, 2011.
- Revision received November 9, 2011.
- Accepted November 22, 2011.
- American College of Cardiology Foundation