Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine-Westphalia, University Hospital of the Ruhr-University Bochum, Bad Oeynhausen, Germany.
J Nucl Cardiol. 2019 Aug;26(4):1212-1221. doi: 10.1007/s12350-017-1161-z. Epub 2018 Jan 16.
Despite the use of F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT), diagnosis of a driveline infection in ventricular assist device (LVAD) recipients remains challenging. Our aim was to evaluate the potential of a baseline F-FDG PET/CT (prior to an infection) for the diagnosis of an LVAD-related infection.
We retrospectively selected all LVAD recipients who had undergone two consecutive whole-body F-FDG PET/CT examinations between January 2010 and December 2016. PET/CT was analyzed qualitatively (uptake pattern) and semi-quantitatively (SUV and ∆SUV). SUV was measured and compared in five distinctive volumes of interest along the LVAD driveline. An SUV threshold was calculated. Final diagnosis was made by clinical examination, microbiological parameters, and molecular imaging.
Thirty patients were enrolled (mean age 54 ± 12 years; 26 male). Mean difference in SUV for all five positions between the first and the second PET/CT along the driveline was significantly higher in patients with an LVAD-related infection (mean ∆SUV = 4.38 ± 1.44) compared to those without a driveline infection (mean ∆SUV = 0.03 ± 0.43), P < 0.05. Applying ROC analysis, an SUV threshold of 3.88 resulted in a sensitivity and specificity of 100%, respectively. There were three distinctive uptake patterns in patients with a driveline infection.
PET/CT diagnosis in the context of an LVAD-related infection can be improved by comparison to a baseline examination using a distinctive SUV threshold.
尽管使用了 F-氟代脱氧葡萄糖（F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT），但心室辅助装置（LVAD）受者的移植物感染的诊断仍然具有挑战性。我们的目的是评估基线 F-FDG PET/CT（在感染之前）对 LVAD 相关感染的诊断潜力。
我们回顾性选择了 2010 年 1 月至 2016 年 12 月期间连续两次接受全身 F-FDG PET/CT 检查的所有 LVAD 受者。对 PET/CT 进行定性（摄取模式）和半定量（SUV 和 ∆SUV）分析。在 LVAD 驱动线的五个不同感兴趣区域测量 SUV 并进行比较。计算 SUV 阈值。最终诊断通过临床检查，微生物学参数和分子成像确定。
共纳入 30 例患者（平均年龄 54 ± 12 岁；26 例男性）。与无移植物感染的患者相比，沿驱动线的第一次和第二次 PET/CT 之间的所有五个位置的 SUV 差异在 LVAD 相关感染患者中明显更高（平均 ∆SUV = 4.38 ± 1.44），而无驱动线感染患者的 SUV 差异（平均 ∆SUV = 0.03 ± 0.43），P <0.05。应用 ROC 分析，SUV 阈值为 3.88 时，灵敏度和特异性分别为 100％。感染患者的摄取模式有三种独特的表现。
通过与基线检查相比，使用独特的 SUV 阈值可以提高 LVAD 相关感染的 PET/CT 诊断。
