Comparison of Anatomic and Functional Imaging Modalities for Imaging Cardiovascular Device Infection
| Modality | Pros | Cons |
| TEE/TTE | Provides first-line imaging for infective endocarditis | Shadows artifacts/misses lesions |
| Detects vegetation and perivalvular complications | Cannot differentiate infectious from noninfected vegetation | |
| Assesses valvular function | Cannot evaluate right-side heart and chest wall CIED pocket and leads | |
| Predicts embolic risk | ||
| Cardiac CT | Provides first-line imaging for infective endocarditis | Has metallic artifacts, nonspecific findings |
| Detects large vegetation | Is less sensitive for small vegetation | |
| Is better than TEE for perivalvular complication evaluation | Is not for extrathoracic evaluation | |
| Detects chest wall CIED infection | ||
| 18F-FDG PET/CT | Has high imaging sensitivity | Provides false-positive findings for inflammation |
| Provides earlier diagnosis | Is less sensitive for small vegetation | |
| Assesses extracardiac infection | ||
| Provides a signal of host immune response | ||
| WBC scan | Has high specificity | Has moderate sensitivity |
| Assesses extracardiac infection | Is labor-intensive |
TEE/TTE: Transesophageal/transthoracic echocardiography; CIED: Cardiac implantable electronic device.