Nuclear Medicine Imaging of Cardiovascular Implantable Electronic Device Infection and Endocarditis

Cardiovascular infections are associated with high morbidity and mortality. Early diagnosis is crucial for adequate patient management, as early treatment improves the prognosis, hardly diagnosed on the basis of a single symptom, sign or diagnostic test. Rather, the diagnosis requires a multidisciplinary discussion in addition to the integration of clinical signs, microbiology data and imaging data. The application of multimodality imaging, including molecular imaging techniques, has improved the sensitivity to detect infections involving heart valves and vessels and implanted cardiovascular devices while also allowing for early detection of septic emboli and metastatic infections before these become clinically apparent. In this chapter, we describe data supporting the use of a multimodality and multidisciplinary approach to cardiovascular infections. In particular, the role of WBC SPECT/CT and [18F]FDG PET/CT in most prevalent and clinically relevant cardiovascular infections is discussed.