Comparison of the Diagnostic Performance of Transesophageal Echocardiography and Positron Emission Tomography in Patients with Cardiovascular Implantable Electronic Device Infections.


Serifler N. T., TAN KÜRKLÜ T. S., Koyuncu İ. M., Demirtola A. I., TURHAN S.

Kardiologia polska, cilt.82, sa.10, ss.958-966, 2024 (SCI-Expanded) identifier identifier

  • 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.