Rubini Giuseppe, Ferrari Cristina, Carretta Domenico, Santacroce Luigi, Ruta Rossella, Iuele Francesca, Lavelli Valentina, Merenda Nunzio, D'Agostino Carlo, Sardaro Angela, Niccoli Asabella Artor
Nuclear Medicine Unit, Interdisciplinary Department of Medicine - University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, 70124 Bari, Italy.
CardioThoracic Department - Policlinic of Bari, Piazza Giulio Cesare, 11, 70124, Bari, Italy.
J Clin Med. 2020 Jul 15;9(7):2246. doi: 10.3390/jcm9072246.
The presence of a cardiovascular implantable electronic device (CIED) can be burdened by complications such as late infections that are associated with significant morbidity and mortality and require immediate and effective treatment. The aim of this study was to evaluate the role of F-fluorodeoxyglucose positron-emission tomography/computed tomography (F-FDG PET/CT) in patients with suspected CIED infection. Fifteen patients who performed a F-FDG PET/CT for suspicion of CIED infection were retrospectively analyzed; 15 patients, with CIED, that underwent F-FDG PET/CT for oncological reasons, were also evaluated. Visual qualitative analysis and semi-quantitative analysis were performed. All patients underwent standard clinical management regardless F-FDG PET/CT results. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) resulted as 90.91%, 75%, 86.67%, 90.91% and 75% respectively. Maximum standardized uptake values (SUV) and semi-quantitative ratio (SQR) were collected and showed differences statistically significant between CIED infected patients and those who were not. Exploratory cut-off values were derived from receiver operating characteristic (ROC) curves for SUV (2.56) and SQR (4.15). This study suggests the clinical usefulness of F-FDG PET/CT in patients with CIED infection due to its high sensitivity, repeatability and non-invasiveness. It can help the clinicians in decision making, especially in patients with doubtful clinical presentation. Future large-scale and multicentric studies should be conducted to establish precise protocols about F-FDG PET/CT performance.
心血管植入式电子设备（CIED）可能会出现诸如晚期感染等并发症，这些并发症与显著的发病率和死亡率相关，需要立即进行有效治疗。本研究的目的是评估氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）在疑似CIED感染患者中的作用。对15例因疑似CIED感染而进行F-FDG PET/CT检查的患者进行了回顾性分析；还评估了15例因肿瘤原因接受F-FDG PET/CT检查的CIED患者。进行了视觉定性分析和半定量分析。无论F-FDG PET/CT结果如何，所有患者均接受标准临床管理。敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）分别为90.91%、75%、86.67%、90.91%和75%。收集了最大标准化摄取值（SUV）和半定量比值（SQR），结果显示CIED感染患者与未感染患者之间存在统计学显著差异。通过受试者操作特征（ROC）曲线得出SUV（2.56）和SQR（4.15）的探索性临界值。本研究表明，F-FDG PET/CT因其高敏感性、可重复性和非侵入性，在CIED感染患者中具有临床实用性。它可以帮助临床医生进行决策，尤其是在临床表现可疑的患者中。未来应开展大规模多中心研究，以建立关于F-FDG PET/CT性能的精确方案。
