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Diagnostic Accuracy of FDG PET/CT in Suspected LVAD Infections: A Case Series,Systematic Review,and Meta-Analysis |
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| Institution: | 1. Division of Cardiovascular Medicine, Department of Medicine, University of Michigan, Ann Arbor, Michigan;2. Department of Medicine, Fort Belvoir Community Hospital, Fort Belvoir, Virginia;3. Department of Medicine, Uniformed Services University, Bethesda, Maryland;4. Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan |
| Abstract: | ObjectivesThe purpose of this study was to describe our experience with fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography computed tomography (PET/CT) in diagnosing left ventricular assist device (LVAD) infections and perform a meta-analysis of published studies to determine overall diagnostic accuracy.BackgroundDevice-related infections are a common complication of LVADs and are linked to worse outcomes. Diagnosis of LVAD infections remains challenging. FDG PET/CT has demonstrated good diagnostic accuracy in several other infectious conditions.MethodsThis was a single-center, retrospective case series of FDG PET/CT scans in suspected LVAD infection between September 2015 and February 2018. A systematic review of PubMed from database inception through March 2018 was also conducted to identify additional studies.ResultsNineteen FDG PET/CT scans were identified for the retrospective case series. The systematic review identified an additional 3 publications, for a total of 4 studies involving 119 scans assessing diagnostic performance. Axial (n = 36) and centrifugal (n = 83) flow LVADs were represented. Pooled sensitivity was 92% (95% confidence interval CI]: 82% to 97%) and specificity was 83% (95% CI: 24% to 99%) for FDG PET/CT in diagnosing LVAD infections. Summary receiver-operating characteristic curve analysis demonstrated an AUC of 0.94 (95% CI: 0.91 to 0.95).ConclusionsFDG PET/CT for suspected LVAD infections demonstrates good diagnostic accuracy, with overall high sensitivity but variable specificity. |
| Keywords: | diagnostic testing heart failure infection left ventricular assist device meta-analysis positron emission tomography AUC"} {"#name":"keyword" "$":{"id":"kwrd0045"} "$$":[{"#name":"text" "_":"area under the curve CI"} {"#name":"keyword" "$":{"id":"kwrd0055"} "$$":[{"#name":"text" "_":"confidence interval CT"} {"#name":"keyword" "$":{"id":"kwrd0065"} "$$":[{"#name":"text" "_":"computed tomography FDG"} {"#name":"keyword" "$":{"id":"kwrd0075"} "$$":[{"#name":"text" "_":"fluorine-18 fluorodeoxyglucose LVAD"} {"#name":"keyword" "$":{"id":"kwrd0085"} "$$":[{"#name":"text" "_":"left ventricular assist device PET"} {"#name":"keyword" "$":{"id":"kwrd0095"} "$$":[{"#name":"text" "_":"positron emission tomography SROC"} {"#name":"keyword" "$":{"id":"kwrd0105"} "$$":[{"#name":"text" "_":"summary receiver-operating characteristic TEE"} {"#name":"keyword" "$":{"id":"kwrd0115"} "$$":[{"#name":"text" "_":"transesophageal echocardiography |
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