Comparison of the Diagnostic Performance of Transesophageal Echocardiography and Positron Emission Tomography in Patients with Cardiovascular Implantable Electronic Device Infections.
Kardiologia polska, cilt.82, sa.10, ss.958-966, 2024 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 82 Sayı: 10
- Basım Tarihi: 2024
- Doi Numarası: 10.33963/v.phj.101702
- Dergi Adı: Kardiologia polska
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL
- Sayfa Sayıları: ss.958-966
- Anahtar Kelimeler: Cardiovascular implantable electronic devices, positron emission tomography, transesophageal echocardiography
- Ankara Üniversitesi Adresli: Evet
Özet
Background: The modified Duke criteria and transesophageal echocardiography (TEE) are often insufficient to diagnose infective endocarditis in patients with cardiovascular implantable electronic devices (CIEDs). F-18-fluoro-2-deoxy-glucose positron emission tomography (18F-FDG PET/CT) is a promising method for detecting lead endocarditis. Aims: The study aimed to compare diagnostic performance of 18F-FDG PET/CT and TEE in detecting lead endocarditis (LE). Methods: We included 40 patients admitted to the hospital for CIED infection. Patients were classified as “LE-positive” and “LE-negative” according to TEE and 18F-FDG PET/CT findings. After three months of follow-up, the patients'lead cultures, tissue and blood cultures, and clinical responses after antibiotic treatment were reviewed using the Duke criteria. The final exact diagnosis was compared with 18F-FDG PET/CT and TEE findings. Results: No involvement was observed on 18F-FDG PET/CT in 12 patients (30%). The remaining 25% of patients had device pocket involvement, and two patients had systemic involvement. In the follow-up of 23 patients diagnosed with LE by TEE, 14 were consistent with LE. Seventeen of 18 patients with suspicion of LE were diagnosed with definite LE by 18F-FDG PET/CT. Six of the 22 patients with negative 18F-FDG PET/CT scans were false negative and diagnosed as definite infective endocarditis. 18F-FDG PET/CT had sensitivity of 73.9% and specificity of 94.1%. It was observed that there was a statistically significant difference between TEE and PET (P = 0.006). Conclusion: 18F-FDG PET/CT is superior to TEE in diagnosing IE in patients with CIED.