Molecular Imaging of Cardiovascular Device Infection

A presentation of the rationale for using <sup>18</sup>F-FDG PET/CT for its unique merits over anatomic imaging to potentially diagnose early cardiac device infection.

Course ID: Q00625 Category:
Modalities: , , , , ,

2.0

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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Cardiac-Interventional Radiography: 0.25
Procedures: 0.25
Diagnostic and Conduction System Studies: 0.25

Computed Tomography: 0.50
Procedures: 0.50
Neck and Chest: 0.50

Nuclear Medicine Technology: 1.75
Procedures: 1.75
Other Imaging Procedures: 1.75

Registered Radiologist Assistant: 1.75
Procedures: 1.75
Thoracic Section: 1.75

Outline

  1. Introduction
  2. Anatomic Imaging Tools
  3. Functional Imaging Tools
  4. Bacteria-Targeting Tracers
    1. Bacterial Metabolic Substances
    2. Antibiotics
    3. Antimicrobial Peptides
    4. Bacterial Antibodies
    5. Bacteriophages and Bacterial DNA/RNA Hybrid Nucleotide Oligomers
  5. Considerations of 18F-FDG and Bacteria-Targeting Tracers for Infection Imaging
  6. Technical Challenges for Bacteria-Targeting PET Tracers
    1. Bile Duct Stricture
  7. Conclusion

Objectives

Upon completion of this course, students will:

  1. be familiar with anatomically based modalities for detecting cardiovascular device infection
  2. be familiar with functionally based modalities for detecting cardiovascular device infection
  3. be familiar with the issues surrounding metal ring-related acoustic shadowing artifact on transesophageal echocardiography
  4. identify the imaging modalities that demonstrate late morphologic changes and have findings that are often nonspecific and associated with device related artifacts
  5. be familiar with how 18F-FDG PET/CT can affect the management of patients with clinically suspected endocarditis
  6. be familiar with the imaging modalities that have been accepted in the U.S. for detection of cardiac device infection
  7. be familiar with the lack of clinical translation of 99mTc-ciproflozacin as a radiotracer for detection of infection
  8. be familiar with 18F-labeled maltodextrin tracers being studied for infection detection
  9. identify the pharmacokinetic features that make 18F-maltotriose a promising radiotracer for infection imaging
  10. be familiar with the characteristics of 111In WBC SPECT/CT for cardiac device infection imaging
  11. be familiar with first line imaging modalities for infective endocarditis
  12. be familiar with nucleoside radiotracers for infection detection
  13. be familiar with the limitation of 99mTc-ciproflozacin as a radiotracer for detection of infection
  14. be familiar with antimicrobial peptides used for bacterial infection imaging
  15. be familiar with the radionuclides used to label antimicrobial peptides for infection imaging
  16. recognize the limitations of radiolabeled antibodies for bacterial infection imaging
  17. identify organizations recommending 18F-FDG PET/CT for diagnosis of cardiac device-related and prosthetic valve endocarditis
  18. be familiar with methods to address nonspecific accumulation of 18F FDG PET/CT
  19. be familiar with the limited use of 18F-FDG PET/CT for cardiac device infection in the U.S.
  20. understand what a negative18F-FDG PET/CT represents in patients with suspected cardiac device infection
  21. understand the effects of antibiotics on bacterial radiotracer imaging
  22. be familiar with the method of excretion for 18F-maltose
  23. be familiar with the MDT radiotracer that holds the most promise for imaging infection in a clinical setting
  24. identify the target of 18F-FDG PET/CT imaging
  25. be familiar with the radiotracers for infection imaging studied in humans
  26. identify the bacterial radiotracers that target DNA gyrase
  27. be familiar with the main findings surrounding studies conducted with antimicrobial peptides
  28. be familiar with the biofilm formation associated with cardiac device infection
  29. recognize the reasons for lower sensitivity found in the use of most bacterial radiotracers
  30. be familiar with the use 18F-FDG PET/CT in detecting cardiac device infection