Targeting Cardiovascular Implant Infection: Multimodality and Molecular Imaging

Circ Cardiovasc Imaging. 2017 Dec;10(12):e005376. doi: 10.1161/CIRCIMAGING.117.005376.

Abstract

Owing to their success in clinical practice, the prevalence of cardiovascular implants is continuously increasing. Implant infection is a relevant complication but remains a diagnostic challenge because echocardiography as a first-line test may be limited. Accordingly, a multimodality approach is increasingly used for diagnostic workup and supported by recent guidelines. As reviewed here, computed tomography and nuclear imaging provide incremental diagnostic value and may be combined in a single hybrid imaging session using positron emission tomography/computed tomography or single photon emission computed tomography/computed tomography. Molecular or cellular imaging helps to overcome the limitations of morphological imaging in implants. Larger-scale clinical studies, earlier application in the time course of diagnosis, monitoring of therapy success, technical advances, and novel radiopharmaceuticals will all contribute to sustained growth of advanced infection-targeted imaging in cardiovascular medicine.

Keywords: echocardiography; endocarditis; infection; molecular imaging.

Publication types

  • Review

MeSH terms

  • Defibrillators, Implantable / adverse effects*
  • Echocardiography
  • Endocarditis / diagnostic imaging*
  • Endocarditis / etiology
  • Heart Valve Prosthesis / adverse effects*
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Magnetic Resonance Imaging
  • Molecular Imaging / methods*
  • Pacemaker, Artificial / adverse effects*
  • Positron Emission Tomography Computed Tomography*
  • Predictive Value of Tests
  • Prognosis
  • Prosthesis-Related Infections / diagnostic imaging*
  • Prosthesis-Related Infections / etiology
  • Reproducibility of Results
  • Single Photon Emission Computed Tomography Computed Tomography*