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Diagnostic Accuracy of FDG PET/CT in Suspected LVAD Infections: A Case Series, Systematic Review, and Meta-Analysis – JIMG May 2020

OBJECTIVES: The purpose of this study was to describe our experience with fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography computed tomography (PET/CT) in diagnosing left ventricular assist device (LVAD) infections and perform a meta-analysis of published studies to determine overall diagnostic accuracy.

BACKGROUND: Device-related infections are a common complication of LVADs and are linked to worse outcomes. Diagnosis of LVAD infections remains challenging. FDG PET/CT has demonstrated good diagnostic accuracy in several other infectious conditions.

METHODS: This was a single-center, retrospective case series of FDG PET/CT scans in suspected LVAD infection between September 2015 and February 2018. A systematic review of PubMed from database inception through March 2018 was also conducted to identify additional studies.

RESULTS: Nineteen FDG PET/CT scans were identified for the retrospective case series. The systematic review identified an additional 3 publications, for a total of 4 studies involving 119 scans assessing diagnostic performance. Axial (n = 36) and centrifugal (n = 83) flow LVADs were represented. Pooled sensitivity was 92% (95% confidence interval [CI]: 82% to 97%) and specificity was 83% (95% CI: 24% to 99%) for FDG PET/CT in diagnosing LVAD infections. Summary receiver-operating characteristic curve analysis demonstrated an AUC of 0.94 (95% CI: 0.91 to 0.95).

CONCLUSIONS: FDG PET/CT for suspected LVAD infections demonstrates good diagnostic accuracy, with overall high sensitivity but variable specificity.


Y.S. Chandrashekhar, MD, DM, FACC

CME Editor
Ragavendra R. Baliga, MD

Marty C. Tam, MD
Venkatesh L. Murthy, MD, PhD

CME/MOC/ECME Information

Target Audience

JACC Journal CME/MOC is intended for physicians who treat patients with cardiovascular disease.

Important Dates

Date of Release: May 4, 2020
Term of Approval/Date of CME/MOC/ECME Expiration: May 3, 2021

Availability: On-Demand
Available May 04, 2020 to May 03, 2021
Cost: FREE
Credit Offered: 1 ABIM-MOC Point
1 CME Credit
1 ECME Credit
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