The value of fluorine-18 deoxyglucose positron emission tomography scans in patients with ventricular assist device specific infections†

TY - JOUR

T1 - The value of fluorine-18 deoxyglucose positron emission tomography scans in patients with ventricular assist device specific infections†

AU - Bernhardt, Alexander M

AU - Pamirsad, Mustafa A

AU - Brand, Chantal

AU - Reichart, Daniel

AU - Tienken, Milena

AU - Barten, Markus J

AU - Schaefer, Andreas

AU - Grahn, Hanno

AU - Rybczynski, Meike

AU - Deuse, Tobias

AU - Reichenspurner, Hermann

AU - Wagner, Florian M

N1 - © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - BACKGROUND: Infections are major complications in patients with ventricular assist devices (VAD). Positron emission tomography with deoxyglucose marked by fluorine-18 ( 18 F-FDG PET/CT) is a diagnostic tool to scan for tissue with high metabolism as present in infections. The specificity of 18 F-FDG PET/CT to discriminate between infection and an aseptic reaction of the implanted device is not defined and its evaluation is the aim of this retrospective analysis.METHODS: Until September 2015 a total of 100 patients underwent VAD implantations in our institution. Twenty-one patients (mean age 53.7 ± 14.3 years) had 29 PET-CT examinations for a suspected infection. All radiology reports were compared to clinical and intraoperative parameters. Infections were reported according to the guidelines of the International Society of Heart and Lung Transplantation. Follow-up was 222 days (range 107-484 days) after PET-CT scans and was complete in all patients.RESULTS: In 7 patients PET-CT scan ruled out any VAD associated infection. Sixteen patients had a VAD specific infection. Two patients had false negative PET-CT scan results. The sensitivity of VAD-specific infections was 87.5%, the specificity 100%, the positive predictive value was 100% and the negative predictive value 86.7%. Seven patients had more than one PET-CT scans at different time points.CONCLUSIONS: PET-CT scan findings showed a high specificity and positive predictive value for VAD-specific infections. Therefore, it may have the potential to guide the clinician in handling patients with infectious complications after VAD implantation.

AB - BACKGROUND: Infections are major complications in patients with ventricular assist devices (VAD). Positron emission tomography with deoxyglucose marked by fluorine-18 ( 18 F-FDG PET/CT) is a diagnostic tool to scan for tissue with high metabolism as present in infections. The specificity of 18 F-FDG PET/CT to discriminate between infection and an aseptic reaction of the implanted device is not defined and its evaluation is the aim of this retrospective analysis.METHODS: Until September 2015 a total of 100 patients underwent VAD implantations in our institution. Twenty-one patients (mean age 53.7 ± 14.3 years) had 29 PET-CT examinations for a suspected infection. All radiology reports were compared to clinical and intraoperative parameters. Infections were reported according to the guidelines of the International Society of Heart and Lung Transplantation. Follow-up was 222 days (range 107-484 days) after PET-CT scans and was complete in all patients.RESULTS: In 7 patients PET-CT scan ruled out any VAD associated infection. Sixteen patients had a VAD specific infection. Two patients had false negative PET-CT scan results. The sensitivity of VAD-specific infections was 87.5%, the specificity 100%, the positive predictive value was 100% and the negative predictive value 86.7%. Seven patients had more than one PET-CT scans at different time points.CONCLUSIONS: PET-CT scan findings showed a high specificity and positive predictive value for VAD-specific infections. Therefore, it may have the potential to guide the clinician in handling patients with infectious complications after VAD implantation.

KW - Adult

KW - Aged

KW - Female

KW - Fluorodeoxyglucose F18/therapeutic use

KW - Heart-Assist Devices/adverse effects

KW - Humans

KW - Male

KW - Middle Aged

KW - Positron Emission Tomography Computed Tomography

KW - Predictive Value of Tests

KW - Prosthesis-Related Infections/diagnostic imaging

KW - Retrospective Studies

U2 - 10.1093/ejcts/ezx016

DO - 10.1093/ejcts/ezx016

M3 - SCORING: Journal article

C2 - 28329162

VL - 51

SP - 1072

EP - 1077

JO - EUR J CARDIO-THORAC

JF - EUR J CARDIO-THORAC

SN - 1010-7940

IS - 6

ER -