White Blood Cell Imaging Detects Infection in Pacemakers or Implantable Cardiac Defibrillators

Background: Radiolabeled white blood cell (WBC) imaging has not been shown to be very effective for detecting endocarditis. There are, however, case reports of WBC imaging successfully detecting infected leads from pacemakers (PM) or implantable cardiac defibrillators (ICD). Treatment for an infected lead usually requires removal. Extraction of PM or ICD wires from the heart carries some risk because tissue grows around the wire; extraction can result in disruption of the endomyocardium. Objective: To determine the diagnostic accuracy of single-photon emission computed tomography/computed tomography (SPECT/CT) using Tc-99m-labeled autologous WBCs in patients referred for suspected lead infection. Methods/Participants: The authors evaluated the records of 63 patients who underwent planar and SPECT WBC imaging for suspicion of infection in PMs or ICDs. Results: Lead extraction and microbiology in 23 patients and clinical follow-up 12 months later in an additional 9 patients confirmed a more...