scholarly journals The Additive Value of Semi-Quantitative Analysis of 18F-FDG PET/CT For The Diagnosis of Device Related Infections In Patients With A Left Ventricular Assist Device.

2021 ◽  
Author(s):  
Derk ten Hove ◽  
Ali R. Wahadat ◽  
Riemer H.J.A. Slart ◽  
Marjan Wouthuyzen-Bakker ◽  
Gianclaudio Mecozzi ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Sensitivity And Specificity ◽  
Fdg Pet ◽  
Visual Analysis ◽  
Left Ventricular ◽  
Ventricular Assist ◽  
Pet Ct ◽  
Device Infection ◽  
Fdg Pet Ct ◽  
Central Device

Abstract Background: Left ventricular assist devices (LVADs) improve quality of life and long-term survival in advanced heart failure, but device related infections (DRI) remain cumbersome. We evaluated the diagnostic capability of FDG-PET/CT and the additive value of semi-quantitative analysis for the diagnosis of DRI. Methods: LVAD recipients undergoing FDG-PET/CT between December 2012 and August 2020 for suspected DRI were retrospectively included. FDG-PET/CT was performed and evaluated according to EANM guidelines and assessors were blinded to the clinical context of included patients. Final clinical diagnosis of driveline infection and/or central device infection, based on multidisciplinary consensus and findings during surgery whenever performed, was used as the reference for the diagnosis. Results: 44 patients were evaluated for 62 episodes of suspected DRI. Clinical evaluation established driveline infection in 33 (54%) episodes, central device infection in 8 (14%) and combined infection in 2 (4%). Visual analysis of FDG-PET/CT achieved a sensitivity and specificity of 0.83 and 0.73, respectively, for driveline infections, while semi-quantitative analysis found comparable results (p=0.77). For central device component infections, visual analysis of FDG-PET/CT achieved a sensitivity and specificity of 1.0 and 0.26, respectively, while semi-quantitative analysis using SUVratio (background liver) achieved a sensitivity and specificity of 1.0 and 0.8, respectively. Both SUVmax and SUVratio outperformed visual analysis (p<0.001). Conclusions: FDG-PET/CT is a valuable tool for the assessment of DRI in LVAD recipients. Semiquantitative analysis significantly increases specificity of FDG-PET/CT for the analysis of central device components and should be considered in equivocal cases after visual analysis.

scholarly journals The value of 18F-FDG PET/CT for the diagnosis of device related infections in patients with a left ventricular assist device - a dual centre study

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
D Ten Hove ◽  
A Wahadat ◽  
RHJA Slart ◽  
K Damman ◽  
G Mecozzi ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Sensitivity And Specificity ◽  
Fdg Pet ◽  
Visual Analysis ◽  
Left Ventricular ◽  
Ventricular Assist ◽  
Pet Ct ◽  
Device Infection ◽  
Fdg Pet Ct ◽  
Central Device

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Partnership UMCG Siemens for building the future of Health (PUSH) Background Left ventricular assist devices (LVADs) are increasingly used for the treatment of end-stage heart failure. LVADs improve quality of life and long-term survival, but device specific infections remain cumbersome. These infections can lead to life threatening complications and are difficult to diagnose with conventional radiological imaging. In this study, FDG-PET/CT accuracy for the diagnosis of LVAD specific infections was evaluated with specific focus on potential confounders and the additive value of semi-quantitative analysis. Materials/methods All LVAD recipients with an available FDG-PET/CT from September 2013 until August 2020 in two LVAD centres in the Netherlands, with a suspicion of driveline and/or central device infection were included. FDG-PET/CT was performed according to European Association of Nuclear Medicine (EANM) guidelines. Potential confounders were documented and assessors were blinded to the clinical context of included patients. Assessment of FDG-PET/CT was performed visually and semi-quantitatively with 6 regions of interest alongside the driveline and central device components. The final clinical diagnosis of either driveline infection or central device infection, based on findings during surgical intervention or multidisciplinary consensus, was used as the reference for diagnosis. Results In total 38 patients (average age 55 years, 84% males) were evaluated for a total of 55 episodes of suspected device-specific infection. Clinical evaluation established driveline infection in 28 cases, central device infection in 7 and combined infection in 4. Visual analysis obtained  a sensitivity and specificity of 0.83 and 0.75 respectively, in differentiation between infected and non-infected drivelines. Visual analysis of FDG-PET/CT of central device components showed excellent sensitivity: 1.0, but suffered from poor specificity: 0.23.  Semi-quantitative analysis using a SUVmax was comparable to visual analysis for establishing driveline infections, with a sensitivity and specificity of 0.80 and 0.84 respectively, while for central device infections, semi-quantitative analysis using a SUVratio outperformed visual analysis, with a sensitivity and specificity reaching 0.88 and 0.90 respectively. Conclusions FDG-PET/CT is a valuable tool for the assessment of device-specific infections in LVAD recipients. Semi-quantitative analysis can significantly increase diagnostic accuracy of FDG-PET/CT for the analysis of the central device components and should be considered in cases where the diagnosis cannot be rejected based on visual analysis.

scholarly journals 18F-FDG PET/CT in Left-Ventricular Assist Device Infection: Initial Results Supporting the Usefulness of Image-Guided Therapy

2019 ◽  
Vol 61 (7) ◽  
pp. 971-976 ◽  
Author(s):  
Jan M. Sommerlath Sohns ◽  
Hannah Kröhn ◽  
Alexandra Schöde ◽  
Thorsten Derlin ◽  
Axel Haverich ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Image Guided ◽  
Pet Ct ◽  
Device Infection ◽  
Left Ventricular Assist ◽  
Fdg Pet Ct ◽  
Initial Results ◽  
Guided Therapy

FDG PET/CT in cancer therapy monitoring

2011 ◽  
Vol 50 (02) ◽  
pp. 83-92 ◽  
Author(s):  
S. Renisch ◽  
R. Opfer ◽  
T. Derlin ◽  
R. Buchert ◽  
I. C. Carlsen ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Cancer Therapy ◽  
Fdg Pet ◽  
Visual Analysis ◽  
Therapy Monitoring ◽  
Software Tool ◽  
Computer Assisted ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Assisted Analysis

SummaryObjectives: We developed and tested a software tool for computer-assisted analysis of FDG-PET/CT in cancer therapy monitoring. The tool provides automatic semi-quantitative analysis of a baseline scan together with up to two follow-up scans (standardized uptake values, glycolytic volume). The tool also supports visual analysis by local spatial registration which allows display of tumor lesions with the same orientation in all scans. The tool’s stability and accuracy was tested at typical everyday image quality. Patients, methods: Ten unselected cancer patients in whom three FDG PET/CT scans had been performed were included. A total of 18 lesions were analyzed. Results: Automatic lesion tracking worked properly in all lesions but one. In this lesion local coregistration had to be adjusted manually tuwhich, however, is easily performed with the tool. Semi-automatic lesion segmentation and fully automatic semi-quantitative analysis worked properly in all cases. Computer-assisted analysis was significantly less time consuming than manual analysis. Conclusions: The novel software tool appears useful for analysis of FDGPET/ CT in cancer therapy monitoring in clinical routine patient care.

scholarly journals Clinical Value of Fluorine-18 2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography/Computed Tomography in Bladder Cancer

2010 ◽  
Vol 28 (25) ◽  
pp. 3973-3978 ◽  
Author(s):  
Andrea B. Apolo ◽  
Jamie Riches ◽  
Heiko Schöder ◽  
Oguz Akin ◽  
Alisa Trout ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Bladder Cancer ◽  
Sensitivity And Specificity ◽  
Fdg Pet ◽  
Malignant Disease ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Purpose Fluorine-18 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) has been approved for imaging in many malignancies but not for bladder cancer. This study investigated the value of FDG-PET/CT imaging in the management of patients with advanced bladder cancer. Patients and Methods Between May 2006 and February 2008, 57 patients with bladder cancer at our center underwent FDG-PET/CT after CT (n = 52) or magnetic resonance imaging (MRI; n = 5). The accuracy of FDG-PET/CT was assessed using both organ-based and patient-based analyses. FDG-PET/CT findings were validated by either biopsy or serial CT/MRI. Clinician questionnaires performed before and after FDG-PET/CT assessed whether those scan results affected management. Results One hundred thirty-five individual lesions were evaluable in 47 patients for the organ-based analysis. Overall sensitivity and specificity were 87% (95% CI, 76% to 94%) and 88% (95% CI, 78% to 95%), respectively. In the patient-based analysis, malignant disease was correctly diagnosed in 25 of 31 patients, resulting in a sensitivity of 81% (95% CI, 63% to 93%). FDG-PET/CT was negative in 15 of 16 patients without malignant lesions for a specificity of 94% (95% CI, 71% to 100%). Pre- and post-PET surveys revealed that FDG-PET/CT detected more malignant disease than conventional CT/MRI in 40% of patients. Post-PET surveys showed that clinicians changed their planned management in 68% of patients based on the FDG-PET/CT results. Conclusion FDG-PET/CT has excellent sensitivity and specificity in the detection of metastatic bladder cancer and provides additional diagnostic information that enhances clinical management more than CT/MRI alone. FDG-PET/CT scans may provide better accuracy in clinical information for directing therapy.

Sign in / Sign up

Export Citation Format

Share Document