TY - JOUR
T1 - Best Practices for Imaging Cardiac Device–Related Infections and Endocarditis
T2 - A JACC: Cardiovascular Imaging Expert Panel Statement
AU - Dilsizian, Vasken
AU - Budde, Ricardo P.J.
AU - Chen, Wengen
AU - Mankad, Sunil V.
AU - Lindner, Jonathan R.
AU - Nieman, Koen
N1 - Publisher Copyright:
© 2022 American College of Cardiology Foundation
PY - 2022/5
Y1 - 2022/5
N2 - The diagnosis of cardiac device infection and, more importantly, accurate localization of the infection site, such as defibrillator pocket, pacemaker lead, along the peripheral driveline or central portion of the left ventricular assist device, prosthetic valve ring abscesses, and perivalvular extensions, remain clinically challenging. Although transthoracic and transesophageal echocardiography are the first-line imaging tests in suspected endocarditis and for assessing hemodynamic complications, recent studies suggest that cardiac computed tomography (CT) or CT angiography and functional imaging with 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) with CT (FDG PET/CT) may have an incremental role in technically limited or inconclusive cases on echocardiography. One of the key benefits of FDG PET/CT is in its detection of inflammatory cells early in the infection process, before morphological damages ensue. However, there are many unanswered questions in the literature. In this document, we provide consensus on best practices among the various imaging studies, which includes the detection of cardiac device infection, differentiation of infection from inflammation, image-guided patient management, and detailed recommendations on patient preparation, image acquisition, processing, interpretation, and standardized reporting.
AB - The diagnosis of cardiac device infection and, more importantly, accurate localization of the infection site, such as defibrillator pocket, pacemaker lead, along the peripheral driveline or central portion of the left ventricular assist device, prosthetic valve ring abscesses, and perivalvular extensions, remain clinically challenging. Although transthoracic and transesophageal echocardiography are the first-line imaging tests in suspected endocarditis and for assessing hemodynamic complications, recent studies suggest that cardiac computed tomography (CT) or CT angiography and functional imaging with 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) with CT (FDG PET/CT) may have an incremental role in technically limited or inconclusive cases on echocardiography. One of the key benefits of FDG PET/CT is in its detection of inflammatory cells early in the infection process, before morphological damages ensue. However, there are many unanswered questions in the literature. In this document, we provide consensus on best practices among the various imaging studies, which includes the detection of cardiac device infection, differentiation of infection from inflammation, image-guided patient management, and detailed recommendations on patient preparation, image acquisition, processing, interpretation, and standardized reporting.
KW - cardiac device infection
KW - cardiac implantable electronic devices
KW - computed tomography
KW - echocardiography
KW - endocarditis
KW - fluoro-2-deoxyglucose
KW - positron emission tomography
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U2 - 10.1016/j.jcmg.2021.09.029
DO - 10.1016/j.jcmg.2021.09.029
M3 - Review article
C2 - 34922877
AN - SCOPUS:85123078638
SN - 1936-878X
VL - 15
SP - 891
EP - 911
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
IS - 5
ER -