PMC6110267_01
Planar whole body anterior image shows a focal area of intense radiotracer activity overlying the right abdomen (A). This activity corresponds to skin contamination on the single photon emission tomography images, which is consistent with a superficial driveline infection (B and C).
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F1
Figure 1A showed a focal area of intense radiotracer activity overlying the right abdomen corresponding to skin contamination on the SPECT-CT images consistent with a superficial driveline infection (Figure 1B and C).
The planar whole body anterior image shows tracer activity along the driveline (A). Fused single photon emission tomography-computed tomography transaxial and coronal images confirm tracer concentration in the site of the driveline and the left ventricular assist device (B and C).
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F2
The images were consistent with extension of the prior infection of the LVAD as demonstrated by linear uptake in the right abdominal wall (Figure 2).
Planar whole body anterior image shows more extensive driveline infection than seen on prior study (A). Fused single photon emission tomography-computed tomography transaxial (B) and coronal (C) images confirm tracer concentration uptake along the driveline and along the entire course of the driveline to the point of entry of the left ventricular assist device.
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F3
He underwent an additional gallium study that was consistent with more extensive infection compared with prior studies 6 months earlier (Figure 3).
PMC6110267_02
A planar whole body anterior image demonstrates a curvilinear uptake anteriorly in the right upper quadrant. This uptake represents an infected driveline, whereas the uptake in anterior midline was likely related to prior median sternotomy (A). Fused single photon emission tomography-computed tomography transaxial and coronal images confirm tracer concentration along the driveline (B and C).
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F4
A planar whole body anterior image demonstrates tracer activity along the driveline (Figure 4A). Fused SPECT-CT transaxial and coronal images confirm tracer concentration in the site of the driveline and the LVAD (Figure 4B and C, respectively).
PMC6110267_03
Planar whole body anterior image demonstrates uptake in the right upper quadrant representing an infected driveline (A). Fused single photon emission tomography-computed tomography transaxial (B) and coronal (C) images confirm tracer concentration in the site of the driveline in the right upper quadrant. Uptake in the midsternal region may be secondary to prior median sternotomy. There is also uptake demonstrated in the lower left chest, which may be consistent with extension of driveline infection to include the left ventricular assist device.
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F5
In addition, there was uptake noted in the midsternal region that was thought to be secondary to prior sternotomy (Figure 5A). In addition, there is uptake noted in the left chest that may represent infection in the LVAD (Figure 5B and C).
Partial improvement in the previously seen infectious foci along the driveline; however, residual focus of infection has progressed toward the left ventricular assist device in the left lower chest on whole body planar image (A). Corresponding fused single photon emission tomography-computed tomography transaxial (B) and coronal (C) images demonstrate increased activity specifically along the deep driveline.
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F6
Repeat Ga-67 SPECT-CT imaging demonstrated improvement in the previously seen infectious foci; however, residual infection remained in both the driveline and the LVAD (Figure 6).
PMC6110267_04