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Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

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Characterization of Left Ventricular Assist Device-Specific Infection by Whole-Body Parametric PET Imaging.

Thorsten Derlin1,2, Jasmin S Hanke3, Rudolf A Werner4

  • 1Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany; derlin.thorsten@mh-hannover.de.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|July 17, 2025
PubMed
Summary

Parametric [18F]FDG PET imaging enhances diagnosis of left ventricular assist device (LVAD) infections by improving contrast and revealing systemic inflammatory interactions. This molecular imaging technique aids in assessing infection extent and correlates with blood immune markers.

Keywords:
LVADPET/CTPatlak modelingleft ventricular assist device infectionpositron emission tomography

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Area of Science:

  • Molecular Imaging
  • Nuclear Medicine
  • Cardiovascular Engineering

Background:

  • Left ventricular assist device (LVAD) infections pose significant clinical challenges.
  • Positron emission tomography (PET) plays a growing role in diagnosing LVAD-specific infections.
  • Parametric imaging offers advanced analysis beyond standard uptake values (SUVs).

Purpose of the Study:

  • To evaluate the added value of parametric whole-body [18F]FDG PET images for assessing LVAD infection.
  • To characterize local inflammatory responses and systemic organ network involvement.
  • To explore the prognostic significance of systems-based PET parameters.

Main Methods:

  • Prospective enrollment of 23 patients with suspected LVAD infection.
  • Multipass [18F]FDG PET/CT with direct Patlak reconstruction.
  • Generation and analysis of SUV-equivalent, maximum metabolic rate (MRFDG), and distribution volume images.

Main Results:

  • Increased [18F]FDG uptake identified at driveline exit sites and device components.
  • Parametric MRFDG images demonstrated improved contrast and accurate identification of driveline infection.
  • MRFDG correlated with peripheral inflammatory markers (e.g., monocyte count) and showed systemic interactions with hematopoietic organs.

Conclusions:

  • [18F]FDG PET/CT is effective for diagnosing and characterizing LVAD infections.
  • Parametric MRFDG imaging refines biologic understanding, improves infection detection, and correlates with immune biomarkers.
  • This technique reveals systemic interactions associated with LVAD infections.