The Role of F18 FDG PET-CT in Pediatric Cardiology and Congenital Heart Disease

Objective: PET-CT Is Increasingly Used In The Evaluation Of Patients With Various Malignancies

other indications are unidentified sources of infection or inflammation. We report the use of PET-CT in patients with congenital heart defects (CHD).

Methods: Retrospective analysis of all CHD patients with PET-CT between 2010 and 2015.

Results: Between 2010 and 2015, F 18 FDG PET-CT was performed in 32 patients. The mean age was 27 years (SD 12 years, range: 1–66 years). The diagnoses covered a large field of CHD: PA with VSD and MAPCAS (n = 1), TGA after ASO (n = 2), TGA after Mustard (n = 3) and assist device (n = 2), ccTGA (n = 2) with assist device (n = 1), CoA (n = 3), mechanical aortic valve (n = 1), Fallot group (n = 5) and conduit (n = 4), Ebstein's anomaly (n = 2) and Perimount prosthesis in tricuspid position (n = 1), Truncus and Contegra (n = 1), myocardial non compaction (n = 1), Shone complex (n = 1), heart transplant (n = 2), AVSD and assist device (n = 1). PET-CT was performed to screen for infections and malignancies before heart-transplantation (n = 13), for detecting endocarditis or foci of septic embolization (n = 12) and for detecting assist device infection (n = 6). The patients assessed before heart transplantation showed no malignancies or infections and transplant listing was possible. In ⅚ patients assist device infection could be confirmed. The antibiotic therapy was continued in five patients and stopped in one. Endocarditis was suspected in 3/12 patients by TTE, 2 patients underwent MRT without confirmation of endocarditis. Endocarditis was confirmed in 7/12 patients by PET-CT. The patient with PA and MAPCASs had aortic valve endocarditis with embolization to the spleen, lung and liver, one patient with CoA had aortic valve endocarditis with embolization in the spleen, one patient with cc TGA had a pulmonary valve endocarditis, three patients with TOF had conduit endocarditis and one patient with conduit had septic embolization to the lung. The antibiotic therapy was continued in 7/12 and stopped in 5/12.

Conclusion: In the field of congenital heart defects, PET-CT is a very reliable technique in detecting acute endocarditis, septic embolization foci and for ruling out or confirming assist-device related infections. In this study, we could show a high sensitivity of PET-CT for specific localization of infection with high impact on subsequent therapy