ORIGINAL ARTICLE Infections in patients using ventricular-assist devices: Comparison of the diagnostic performance of 18 F-FDG PET/CT scan and leucocyte-labeled scintigraphy Carole de Vaugelade, MD, a Charles Mesguich, MD, a Karine Nubret, MD, b Fabrice Camou, MD, d Carine Greib, MD, e Gael Dournes, MD, g Fre ´de ´ric Debordeaux, PharmD, a Elif Hindie, MD, PhD, a,c Laurent Barandon, MD, PhD, c,f and Ghoufrane Tlili, MD a a Nuclear Medicine Department, CHU de Bordeaux, Pessac, France b Cardiology Department, CHU de Bordeaux, Pessac, France c Univ. Bordeaux, CHU de Bordeaux, Pessac, France d Intensive Care Department, CHU de Bordeaux, Pessac, France e Internal Medicine Department, CHU de Bordeaux, Pessac, France f Thoracic Surgery Department, CHU de Bordeaux, Pessac, France g Radiology Department, CHU de Bordeaux, Pessac, France Received Dec 9, 2017; accepted Mar 26, 2018 doi:10.1007/s12350-018-1323-7 Background. The usage of left-ventricular-assist device (LVAD) is increasing in patients presenting with advanced heart failure. However, device-related infections are a challenge to recognize and to treat, with an important morbidity and mortality rate. The role of nuclear medicine imaging remains not well established for LVAD infections. The present study compared the accuracy of positron emission tomography/computed tomography with 18 F-fludeoxyglucose ( 18 F-FDG PET/CT) and radiolabeled leucocyte scintigraphy for the diagnosis of infections in patients supported with a continuous-flow LVAD. Methods. From a prospectively maintained database, we retrospectively analyzed the diagnostic performance of radiolabeled leucocyte scintigraphy and 18 F-FDG PET/CT in 24 patients who had a LVAD with a suspected device-related infection. Both examinations were routinely performed in all patients. Infection was assessed by the International Society for Heart and Lung Transplantation criteria. Results. Twenty-four patients were included: 15 had a specific VAD infection (5 cardiac- LVAD and 10 driveline), 6 had a VAD-related infection, while 3 patients had a non-VAD-related infection. Sensitivity, specificity, positive predictive value, negative predictive value, and accu- racy were 95.2%, 66.7%, 95.2%, 66.7%, and 91.6%, respectively, for 18 F-FDG-PET; and 71.4%, 100%, 100%, 33.3%, and 75%, respectively, for leucocyte scintigraphy. 18 F-FDG PET/CT showed significantly higher sensitivity (P=0.01) than leucocyte scintigraphy. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-018-1323-7) contains supplementary material, which is available to authorized users. The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarises the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com. JNC thanks Erick Alexanderson MD, Carlos Guitar MD, and Diego Vences MD, UNAM, Mexico, for providing the Spanish abstract; Haipeng Tang MS, Zhixin Jiang MD, and Weihua Zhou PhD, for providing the Chinese abstract; and Jean-Luc Urbain, MD, PhD, CPE, Past President CANM, Chief Nuclear Medicine, Lebanon VAMC, PA, for providing the French abstract. Reprint requests: Carole de Vaugelade, Nuclear Medicine Department, University Hospital of Bordeaux, Avenue de Magellan, 33604 Pessac, France; carole.dvdb@gmail.com 1071-3581/$34.00 Copyright © 2018 American Society of Nuclear Cardiology. 42