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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Sep 26, 2016; 8(9): 534-546
Published online Sep 26, 2016. doi: 10.4330/wjc.v8.i9.534
Role of radionuclide imaging for diagnosis of device and prosthetic valve infections
Jean-François Sarrazin, François Philippon, Mikaël Trottier, Michel Tessier
Jean-François Sarrazin, François Philippon, Department of Cardiology, Institut Universitaire de Cardiologie et Pneumologie de Québec, Laval University, Québec, QC G1V 4G5, Canada
Mikaël Trottier, Michel Tessier, Department of Nuclear Medicine, Institut Universitaire de Cardiologie et Pneumologie de Québec, Laval University, Québec, QC G1V 4G5, Canada
Author contributions: Sarrazin JF, Philippon F, Trottier M and Tessier M drafted the article or made critical revisions to the manuscript and gave their final approval of the version of the article to be published.
Conflict-of-interest statement: No conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jean-François Sarrazin, MD, FRCPC, FACC, FHRS, Department of Cardiology, Institut Universitaire de Cardiologie et Pneumologie de Québec, Laval University, 2725 chemin Sainte-Foy, Quebec, QC G1V 4G5, Canada. jean-francois.sarrazin@criucpq.ulaval.ca
Telephone: +1-418-6564598 Fax: +1-418-6564581
Received: April 24, 2016
Peer-review started: April 25, 2016
First decision: June 6, 2016
Revised: July 7, 2016
Accepted: July 20, 2016
Article in press: July 22, 2016
Published online: September 26, 2016
Processing time: 149 Days and 7.5 Hours
Abstract

Cardiovascular implantable electronic device (CIED) infection and prosthetic valve endocarditis (PVE) remain a diagnostic challenge. Cardiac imaging plays an important role in the diagnosis and management of patients with CIED infection or PVE. Over the past few years, cardiac radionuclide imaging has gained a key role in the diagnosis of these patients, and in assessing the need for surgery, mainly in the most difficult cases. Both 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and radiolabelled white blood cell single-photon emission computed tomography/computed tomography (WBC SPECT/CT) have been studied in these situations. In their 2015 guidelines for the management of infective endocarditis, the European Society of Cardiology incorporated cardiac nuclear imaging as part of their diagnostic algorithm for PVE, but not CIED infection since the data were judged insufficient at the moment. This article reviews the actual knowledge and recent studies on the use of 18F-FDG PET/CT and WBC SPECT/CT in the context of CIED infection and PVE, and describes the technical aspects of cardiac radionuclide imaging. It also discusses their accepted and potential indications for the diagnosis and management of CIED infection and PVE, the limitations of these tests, and potential areas of future research.

Keywords: Device; Endocarditis; Fluorodeoxyglucose; Imaging; Infection; Leukocytes; Positron emission tomography/computed tomography; Prosthetic valve; Radionuclide; Scintigraphy

Core tip: Cardiovascular implantable electronic device infection and prosthetic valve endocarditis remain a diagnostic challenge. This review article describes the evolving role of cardiac radionuclide imaging in the diagnosis and management of cardiac infections. It focuses on recent published studies, indications and limitations of both 18F-fluorodeoxyglucose positron emission tomography/computed tomography and radiolabelled white blood cell single-photon emission computed tomography/computed tomography.