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Advances in Radiotherapy
& Nuclear Medicine 18 F-FDG PET/CT in LVAD infection

infections, and non-LVAD infections. LVAD-specific Conflict of interest
infections include infections of the pump, the cannula,
the pocket, or the percutaneous driveline. LVAD-related The authors declare no conflicts of interest.
infection mainly refers to endocarditis, bloodstream Author contributions
infection, or mediastinitis. PET/CT whole-body imaging
is valuable for localizing and assessing the extent of Conceptualization: Bo Zheng, Yan Fan
infection. The first PET/CT scan displayed abnormal Investigation: Lijuan Di, Guangyu Zhao, Shanshi Li
10
FDG uptake around the abdominal outflow cannula, the Writing – original draft: Lijuan Di, Guangyu Zhao
post-operative sternum site, and along the driveline. Based Writing – review & editing: Lijuan Di, Bo Zheng, Yan Fan
on the above results, LVAD-specific infection should be
considered first according to the International Society of Ethics approval and consent to participate
Heart and Lung Transplantation criteria. However, it is not Study subject gave consent to participate in this study.
11
yet possible to accurately confirm whether all of the above
manifestations are infected or due to post-operative aseptic Consent for publication
inflammatory changes. The patient continued to undergo We obtained informed consent from study subject for
follow-up assessments of serum ESR and CRP levels, along publishing their data.
with PET/CT scans. Subsequent results indicated a gradual
decrease in radioactivity around the outflow cannula, which Availability of data
was consistent with the changes in the inflammatory maker
levels (Figure 3), suggesting potential improvement in the Data are available from the corresponding author upon
infected areas. In contrast, there was no significant change reasonable request.
in the degree of the FDG uptake around the sternum surgery References
area or along the driveline, indicating potential aseptic
inflammatory changes. The last PET/CT scan displayed 1. Goldstein DJ, Naka Y, Horstmanshof D, et al. Association
normal radioactive distribution around the outflow of clinical outcomes with left ventricular assist device
cannula, and the inflammatory marker levels also returned use by bridge to transplant or destination therapy intent:
to normal. The patient was instructed to discontinue oral The multicenter study of MagLev technology in patients
antibiotic treatment. At the time of writing this case report, undergoing mechanical circulatory support therapy with
the patient had been installed with LVAD for nearly 2½ HeartMate 3 (MOMENTUM 3) randomized clinical trial.
JAMA Cardiol. 2020;5(4):411-419.
years. The patient has stopped antibiotic treatment and
is free from fever. There are no signs of redness, swelling, doi: 10.1001/jamacardio.2019.5323
pain, or exudation in the abdominal surgical area. The ESR 2. Goldstein DJ, Meyns B, Xie R, et al. Third annual report
and CRP levels are within the normal range. The patient from the ISHLT mechanically assisted circulatory support
had received the LVAD implantation as destination therapy registry: A comparison of centrifugal and axial continuous-
and followed up regularly. flow left ventricular assist devices. J Heart Lung Transplant.
2019;38(4):352-363.
4. Conclusion doi: 10.1016/j.healun.2019.02.004
Continuous dynamic observation of changes in areas with 3. Patel CB, Blue L, Cagliostro B, et al. Left ventricular assist
high FDG uptake can aid in distinguishing an infected site systems and infection-related outcomes: A comprehensive
from sterile inflammatory lesions. F-FDG PET/CT may analysis of the MOMENTUM 3 trial. J Heart Lung
18
be instrumental in accurately diagnosing infection and Transplant. 2020;39(8):774-781.
evaluating the effectiveness of the antibiotic treatment after doi: 10.1016/j.healun.2020.03.002
LVAD implantation.
4. Martineau P, Gregoire J, Harel F, Pelletier-Galarneau M.
Acknowledgments Assessing cardiovascular infection and inflammation with
FDG-PET. Am J Nucl Med Mol Imaging. 2021;11(1):46-58.
None.
5. Dejust S, Guedec-Ghelfi R, Blanc-Autrant E, Lepers Y,
Funding Morland D. Infection of ventricular assist device detected
and monitored by 18F-FDG PET/CT. Clin Nucl Med.
This research was supported in part by the Beijing Natural 2017;42(9):695-696.
Science Foundation (No. Z20018) and the special fund for
clinical research by the Wu Jieping Medical Foundation doi: 10.1097/RLU.0000000000001736
(No. 320.6750.2020-6-25). 6. Ten Hove D, Wahadat AR, Slart RHJ, et al. Added value of semi-

Volume 2 Issue 2 (2024) 4 doi: 10.36922/arnm.3690