title: The role of FDG-PET-CT in pediatric cardiac patients and patients with congenital heart defects.
abstract: OBJECTIVE
  Medical imaging by using FDG-PET/CT (PET-CT) can detect, confirm or eliminate with high sensitivity areas of suspected infections in case of persistent fever of unknown origin in combination with other bacteriological examinations. The aim of this study was to assess the potential role of PET-CT in detecting or excluding infections or other inflammatory processes in patients with congenital heart defects (CHD). In addition we wanted to evaluate the practical impact of PET-CT on the subsequent clinical management.
  
  
  METHODS
  In this retrospective study we analyzed the data of all CHD patients who underwent PET-CT over a 5year period in our institution. The results were then evaluated with regard to the potential impact on clinical decision making.
  
  
  RESULTS
  Between 2010 and 2015 PET-CT was performed in 30 patients. The mean age was 26years (SD 15years, range 1 to 66years). The diagnoses covered a large field of CHD. 11 patients (4/11 with assist device) were assessed before heart transplantation; suspected malignancies or infections were excluded and transplant listing was possible. In another 5/6 patients suspected assist device infection could be confirmed with PET/CT. Endocarditis was suspected in 13 patients, 2 of whom underwent previous MRI without confirmation and ECHO was inconclusive. Endocarditis was finally excluded in 5/13 patients but confirmed in 8/13 patients by PET-CT.
  
  
  CONCLUSIONS
  In this study we could show a high sensitivity of PET-CT for specific localization of infections and with high impact on subsequent therapy. Based on this results clinical management could be targeted and adapted. We could demonstrate that PET-CT has a high impact on the subsequent clinical therapy.
authors.affiliation: Department for Congenital Heart Defects, Heart and Diabetes Centre North Rhine Westphalia, Ruhr University Bochum, Germany. Electronic address: zmeyer@hdz-nrw.de.
authors.forename: Zora
authors.initials: Z
authors.lastname: Meyer
authors.affiliation: Department for Congenital Heart Defects, Heart and Diabetes Centre North Rhine Westphalia, Ruhr University Bochum, Germany; Department of Pediatric Cardiology and Intensive Care, Ludwig Maximilians University Munich, Campus Grosshadern, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Fischer
authors.affiliation: Department for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Centre North Rhine Westphalia, Ruhr University Bochum, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Koerfer
authors.affiliation: Department for Congenital Heart Defects, Heart and Diabetes Centre North Rhine Westphalia, Ruhr University Bochum, Germany.
authors.forename: K T
authors.initials: KT
authors.lastname: Laser
authors.affiliation: Department for Congenital Heart Defects, Heart and Diabetes Centre North Rhine Westphalia, Ruhr University Bochum, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Kececioglu
authors.affiliation: Department for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Centre North Rhine Westphalia, Ruhr University Bochum, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Burchert
authors.affiliation: Department of Pediatric Cardiology and Intensive Care, Ludwig Maximilians University Munich, Campus Grosshadern, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Ulrich
authors.affiliation: Department for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Centre North Rhine Westphalia, Ruhr University Bochum, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Preuss
authors.affiliation: Department for Congenital Heart Defects, Heart and Diabetes Centre North Rhine Westphalia, Ruhr University Bochum, Germany; Department of Pediatric Cardiology and Intensive Care, Ludwig Maximilians University Munich, Campus Grosshadern, Munich, Germany. Electronic address: Nikolaus.Haas@med.uni-muenchen.de.
authors.forename: N A
authors.initials: NA
authors.lastname: Haas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004697:Endocarditis, Bacterial / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Assist device; Congenital heart defects; Endocarditis; PET-CT; Pediatric cardiology