Abstract
Objective: to investigate the semi-quantitative assessment of 18F-fluorodeoxyglucose (18F-FDG) position emission/
computed tomography (PET/CT) in patients with infection of cardiac implantable electronic devices (CIED)
and without it.
Material and methods. The analysis included results of 18F-FDG PET/CT examinations performed in 34 patients
with CIED – with surgically confirmed infection (n = 9) and with malignancies used as control group (n = 25).
PET/CT results were assessed visually and semi-quantitatively with calculation of parameters of 18F-FDG uptake
intensity – SUVmax and SUVratio – in whole device, pocket, extra- and intracardiac segments of electrodes.
SUVratio was calculated as SUVmax in the CIED to SUVmean in the reference zone – aorta, liver and lung.
All PET/CT results were confirmed according to clinical, laboratory, morphological and intraoperative data.
Results. Visual analysis of PET/CT results revealed abnormal 18F-FDG uptake in all patients with CIED infection
(n=9) in different regions of interest: in pocket (n=6), along extra- (n=8) and intracardiac (n=6) portions of leads.
In control group (n=25) 18F-FDG uptake was normal in all 75 regions of interest (n=25 in each).
In semiquantitative analysis all parameters, SUVmax and three types of SUVratios, in the CIED pocket and extracardiac
portion of leads were higher in patients with confirmed infection, compared to patients without it (p<0.05).
But the was no statistical difference in the uptake along intracardiac portion of leads in the compared groups
(p>0.05).
ROC-curve analysis for optimal thresholds of SUVmax and three types of SUVratios for the diagnosis of CIED infections
(for whole device, as well as its different regions) by PET/CT was performed.
Conclusion. According to the obtained data visual analysis in combination with semi-quantitative assessment
of 18F-FDG PET/CT images showed a good diagnostic performance in the detection of CIED infection.
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About the authors
- Leo A. Bockeria, Academician of RAS and RAMS, Director, orcid.org/0000-0002-6180-2619
-
Irakliy P. Aslanidis, Dr. Med. Sc., Professor, Head of the Department, orcid.org/0000-0001-6386-2378
-
Diana M. Pursanova, Cand. Med. Sc., Researcher, orcid.org/0000-0002-1846-0115
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Ol’ga V. Mukhortova, Dr. Med. Sc., Senior Researcher, orcid.org/0000-0002-7716-5896
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Irina V. Shurupova, Dr. Med. Sc., Senior Researcher, orcid.org/0000-0002-2154-474X
-
Tat’yana A. Katunina, Researcher, orcid.org/0000-0002-5430-366Х
-
Sergey Yu. Serguladze, Dr. Med. Sc., Head of the Department;
-
Tat’yana A. Trifonova, Cand. Med. Sc., Head of Department
