The Potential of FDG PET/CT for Early Diagnosis of Cardiac Device and Prosthetic Valve Infection Before Morphologic Damages Ensue

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• 作者：Wengen Chen (1) (2)
  Jongho Kim (1)
  Olga P. Molchanova-Cook (1)
  Vasken Dilsizian (1)
  
• 关键词：18?F ; fluorodeoxyglucose ; FDG ; Positron emission tomography ; PET/CT ; FDG PET/CT ; Cardiac imaging ; Infection ; Endocarditis ; Cardiac device ; Prosthetic valve ; Pacemaker ; Defibrillator ; Mechanical device ; Morphologic damage
• 刊名：Current Cardiology Reports
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：16
• 期：3
• 全文大小：499 KB
• 作者单位：Wengen Chen (1) (2)
  Jongho Kim (1)
  Olga P. Molchanova-Cook (1)
  Vasken Dilsizian (1)
  
  1. University of Maryland School of Medicine, Baltimore, MD, USA
  2. Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S. Greene Street, Room N2W78, Baltimore, MD, 21201-1595, USA
  
• ISSN：1534-3170

文摘

Diagnosis of cardiac mechanical device or prosthesis valve infection, and more importantly accurate localization of the infection site, such as defibrillator pocket, pacemaker lead, annular or peri-annular valve ring abscesses remain clinically challenging. Inconclusive diagnosis can lead to delayed antibiotic therapy, device extraction or surgical intervention, which may have dire consequences to the patient. Among patients with suspected cardiac mechanical device or prosthetic valve infection, recent publications advocate the use of 18?F-fluoro-2-deoxyglucose positron emission tomography computed tomography (FDG PET/CT), particularly when anatomy based imaging studies, such as echocardiography or CT, are uncertain or negative. A potential advantage of FDG PET/CT is in its detection of inflammatory cells early in the infection process, before morphologic damages ensue. However, there are many unanswered questions in the literature. There is a need for standardization amongst the various imaging studies, such as dietary preparation, duration and timing of image acquisition, image processing with and without CT attenuation correction, and more importantly image interpretation criteria. The answer for these issues awaits well designed, prospective studies.