USEFULNESS OF SPECT-CT WITH RADIOISOTOPE LABELED LEUCOCYTES FOR DIAGNOSIS OF LEAD-DEPENDENT INFECTIVE ENDOCARDITIS
B. Malecka, A. Zabek, W. Szot, K. Boczar, M. Debski, J. Lelakowski, M. Kostkiewicz
1. Department of Electrocardiology, John Paul II Hospital in Krakow, Krakow, Poland; 2. Institute of Cardiology, Jagiellonian University Medical College in Krakow, Krakow, Poland
Introduction: Our aim was to evaluate the diagnostic accuracy of SPECT-CT with radioisotope labeled leucocytes (SCY) in patients with suspected LDIE.
Methods: Study population consisted of 11 patients (2F+9M), mean age 69.8±11.9 years, with different types of CIED and intracavitary vegetation/thrombus detected by TTE/TEE.
Results: The results are presented in Figure. SCY in 11 patients population showed a sensitivity of 60% and specificity of 83.3%. Positive predictive value (PPV) and negative predictive value (NPV) of the procedure were found to be 75% and 71.4%, respectively. After the exclusion of 2 patients due to preceding antibiotic use and evaluation of SCY in 9 patients it showed a sensitivity of 100%, specificity of 83.3%, PPV of 75% and NPV of 100% in the diagnosis of LDIE. No adverse side effects were observed during the procedures.
Conclusions:
SCY is an additional tool with high specificity (83.3%) and high NPV which helps to establish LDIE diagnosis in patients with vegetation/thrombus attached to the endocavitary leads. In patients with firm diagnosis of LDIE according to Duke Criteria the antibiotic therapy caused SCY false negative results.
Figure 1.
