D Ten Hove1,2, G Treglia3,4,5, R H J A Slart6,7, K Damman8, M Wouthuyzen-Bakker9, D F Postma10, O Gheysens11, R J H Borra6,12, G Mecozzi13, P P van Geel8, B Sinha9, A W J M Glaudemans6. 1. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ, Groningen, The Netherlands. d.ten.hove@umcg.nl. 2. Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. d.ten.hove@umcg.nl. 3. Clinic of Nuclear Medicine and PET/CT Centre, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona and Lugano, Switzerland. 4. Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. 5. Health Technology Assessment Unit, Academic Education, Research and Innovation Area, Ente Ospedaliero Cantonale, Via Lugano 4F, CH-6500, Bellinzona, Switzerland. 6. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ, Groningen, The Netherlands. 7. Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, Enschede, the Netherlands. 8. University of Groningen, Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 9. Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 10. Department of Internal Medicine and infectious diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 11. Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Brussels, Belgium. 12. Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 13. Department of Cardiothoracic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Abstract
BACKGROUND: Left ventricular assist devices (LVADs) are increasingly used for the treatment of advanced heart failure. LVADs improve quality of life and decrease mortality, but the driveline carries substantial risk for major infections. These device-related LVAD and driveline infections are difficult to diagnose with conventional imaging. We reviewed and analysed the current literature on the additive value of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) imaging for the diagnosis of LVAD-related infections." MATERIALS/ METHODS: We performed a systematic literature review using several databases from their inception until the 31st of December, 2019. Studies investigating the diagnostic performance of FDG-PET/CT in patients with suspected LVAD infection were retrieved. After a bias risk assessment using QUADAS-2, a study-aggregate meta-analysis was performed on a per examination-based analysis. RESULTS: A total of 10 studies were included in the systematic review, eight of which were also eligible for study-aggregate meta-analysis. For the meta-analysis, a total of 256 FDG-PET/CT scans, examining pump/pocket and/or driveline infection, were acquired in 230 patients. Pooled sensitivity of FDG-PET/CT was 0.95 (95% confidence interval (CI) 0.89-0.97) and pooled specificity was 0.91 (95% CI 0.54-0.99) for the diagnosis of device-related infection. For pump/pocket infection, sensitivity and specificity of FDG-PET/CT were 0.97 (95%CI 0.69-1.00) and 0.93 (95%CI 0.64-0.99), respectively. For driveline infection, sensitivity and specificity were 0.96 (95%CI 0.88-0.99) and 0.99 (95%CI 0.13-1.00) respectively. Significant heterogeneity existed across studies for specificity, mostly caused by differences in scan procedures. Predefined criteria for suspicion of LVAD and/or driveline infection were lacking in all included studies. CONCLUSIONS: FDG-PET/CT is a valuable tool for assessment of device-related infection in LVAD patients, with high sensitivity and high, albeit variable, specificity. Standardization of FDG-PET/CT procedures and criteria for suspected device-related LVAD infections are needed for consistent reporting of FDG-PET/CT scans.
BACKGROUND: Left ventricular assist devices (LVADs) are increasingly used for the treatment of advanced heart failure. LVADs improve quality of life and decrease mortality, but the driveline carries substantial risk for major infections. These device-related LVAD and driveline infections are difficult to diagnose with conventional imaging. We reviewed and analysed the current literature on the additive value of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) imaging for the diagnosis of LVAD-related infections." MATERIALS/ METHODS: We performed a systematic literature review using several databases from their inception until the 31st of December, 2019. Studies investigating the diagnostic performance of FDG-PET/CT in patients with suspected LVAD infection were retrieved. After a bias risk assessment using QUADAS-2, a study-aggregate meta-analysis was performed on a per examination-based analysis. RESULTS: A total of 10 studies were included in the systematic review, eight of which were also eligible for study-aggregate meta-analysis. For the meta-analysis, a total of 256 FDG-PET/CT scans, examining pump/pocket and/or driveline infection, were acquired in 230 patients. Pooled sensitivity of FDG-PET/CT was 0.95 (95% confidence interval (CI) 0.89-0.97) and pooled specificity was 0.91 (95% CI 0.54-0.99) for the diagnosis of device-related infection. For pump/pocket infection, sensitivity and specificity of FDG-PET/CT were 0.97 (95%CI 0.69-1.00) and 0.93 (95%CI 0.64-0.99), respectively. For driveline infection, sensitivity and specificity were 0.96 (95%CI 0.88-0.99) and 0.99 (95%CI 0.13-1.00) respectively. Significant heterogeneity existed across studies for specificity, mostly caused by differences in scan procedures. Predefined criteria for suspicion of LVAD and/or driveline infection were lacking in all included studies. CONCLUSIONS:FDG-PET/CT is a valuable tool for assessment of device-related infection in LVAD patients, with high sensitivity and high, albeit variable, specificity. Standardization of FDG-PET/CT procedures and criteria for suspected device-related LVAD infections are needed for consistent reporting of FDG-PET/CT scans.
Authors: Margaret M Hannan; Shahid Husain; Frauke Mattner; Lara Danziger-Isakov; Richard J Drew; G Ralph Corey; Stephan Schueler; William L Holman; Leo P Lawler; Steve M Gordon; Niall G Mahon; John M Herre; Kate Gould; Jose G Montoya; Robert F Padera; Robert L Kormos; John V Conte; Martha L Mooney Journal: J Heart Lung Transplant Date: 2011-04 Impact factor: 10.247
Authors: Paola Anna Erba; Patrizio Lancellotti; Isidre Vilacosta; Oliver Gaemperli; Francois Rouzet; Marcus Hacker; Alberto Signore; Riemer H J A Slart; Gilbert Habib Journal: Eur J Nucl Med Mol Imaging Date: 2018-05-24 Impact factor: 9.236
Authors: Girish S Shroff; Daniel Ocazionez; Bindu Akkanti; Daniel Vargas; Alheli Garza; Pushpender Gupta; Jayeshkumar A Patel; Manish K Patel; Igor D Gregoric Journal: Semin Ultrasound CT MR Date: 2017-08-02 Impact factor: 1.875
Authors: Angelo Maria Dell'Aquila; Stefano Mastrobuoni; Sebastian Alles; Christian Wenning; Welp Henryk; Stefan Rudolf Bertram Schneider; Heinz Deschka; Jürgen R Sindermann; Mirela Scherer Journal: Ann Thorac Surg Date: 2015-10-01 Impact factor: 4.330
Authors: Martina Sollini; Chiara Lauri; Roberto Boni; Elena Lazzeri; Paola Anna Erba; Alberto Signore Journal: Curr Pharm Des Date: 2018 Impact factor: 3.116
Authors: James K Kirklin; David C Naftel; Francis D Pagani; Robert L Kormos; Lynne W Stevenson; Elizabeth D Blume; Susan L Myers; Marissa A Miller; J Timothy Baldwin; James B Young Journal: J Heart Lung Transplant Date: 2015-10-08 Impact factor: 10.247
Authors: Sakir Akin; Rahat Muslem; Alina A Constantinescu; Olivier C Manintveld; Ozcan Birim; Jasper J Brugts; Alexander P W M Maat; Alida C Fröberg; Ad J J C Bogers; Kadir Caliskan Journal: ASAIO J Date: 2018 Mar/Apr Impact factor: 2.872
Authors: Anna Gomes; Peter Paul van Geel; Michiel Santing; Niek H J Prakken; Mathilde L Ruis; Sander van Assen; Riemer H J A Slart; Bhanu Sinha; Andor W J M Glaudemans Journal: J Nucl Cardiol Date: 2018-07-31 Impact factor: 5.952
Authors: Andreas P Kourouklis; Julius Kaemmel; Xi Wu; Evgenij Potapov; Nikola Cesarovic; Aldo Ferrari; Christoph Starck; Volkmar Falk; Edoardo Mazza Journal: Eur Biophys J Date: 2021-09-03 Impact factor: 1.733