Hans Bowles1, Juan Ambrosioni2,3, Gaspar Mestres4, Marta Hernández-Meneses2, Nuria Sánchez1, Jaime Llopis5, Xavier Yugueros4, Manel Almela6, Asunción Moreno2,3, Vicenç Riambau4, David Fuster7,8, Jose M Miró2,3. 1. Nuclear Medicine Department, Hospital Clínic i Provincial de Barcelona, Villarroel, 170, 08036, Barcelona, Spain. 2. Infectious Diseases Service, Hospital Clinic, Barcelona, Spain. 3. Institut d'Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. 4. Cardiovascular Surgery Department, Hospital Clinic, Barcelona, Spain. 5. Statistics Department, Faculty of Biology, University of Barcelona, Barcelona, Spain. 6. Clinical Microbiology Department, Hospital Clínic, Barcelona, Spain. 7. Nuclear Medicine Department, Hospital Clínic i Provincial de Barcelona, Villarroel, 170, 08036, Barcelona, Spain. dfuster@clinic.cat. 8. Institut d'Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. dfuster@clinic.cat.
Abstract
BACKGROUND: Prosthetic vascular graft infection (PVGI) is a severe complication associated with high morbidity and mortality. Clinical diagnosis is complex, requiring image testing such as CT angiography or leukocyte scintigraphy, which has considerable limitations. The aim of this study was to know the diagnostic yield of PET/CT with 18F-Fluorodeoxyglucose (18F-FDG) in patients with suspected PVGI. METHODS: We performed a prospective cohort study including 49 patients with suspected PVGI, median age of 62 ± 14 years. Three uptake patterns were defined following published recommendations: (i) focal, (ii) patched (PVGI criteria), and (iii) diffuse (no PVGI criterion). RESULTS: Sensitivity, specificity, and positive and negative predictive values for 18F-FDG-PET/CT were 88%, 79%, 67%, and 93%, respectively. 18F-FDG-PET/CT identified 14/16 cases of PVGI showing a focal (n = 10) or patched pattern (n = 4), being true negative in 26/33 cases with either a diffuse pattern (n = 16) or without uptake (n = 10). Five of the seven false-positive cases (71%) showed a patched pattern and all coincided with the application of adhesives for PVG placement. CONCLUSIONS: 18F-FDG-PET/CT is a useful technique for the diagnosis of PVGI. A patched pattern on PET/CT in patients in whom adhesives were applied for prosthetic vascular graft placement does not indicate infection.
BACKGROUND: Prosthetic vascular graft infection (PVGI) is a severe complication associated with high morbidity and mortality. Clinical diagnosis is complex, requiring image testing such as CT angiography or leukocyte scintigraphy, which has considerable limitations. The aim of this study was to know the diagnostic yield of PET/CT with 18F-Fluorodeoxyglucose (18F-FDG) in patients with suspected PVGI. METHODS: We performed a prospective cohort study including 49 patients with suspected PVGI, median age of 62 ± 14 years. Three uptake patterns were defined following published recommendations: (i) focal, (ii) patched (PVGI criteria), and (iii) diffuse (no PVGI criterion). RESULTS: Sensitivity, specificity, and positive and negative predictive values for 18F-FDG-PET/CT were 88%, 79%, 67%, and 93%, respectively. 18F-FDG-PET/CT identified 14/16 cases of PVGI showing a focal (n = 10) or patched pattern (n = 4), being true negative in 26/33 cases with either a diffuse pattern (n = 16) or without uptake (n = 10). Five of the seven false-positive cases (71%) showed a patched pattern and all coincided with the application of adhesives for PVG placement. CONCLUSIONS:18F-FDG-PET/CT is a useful technique for the diagnosis of PVGI. A patched pattern on PET/CT in patients in whom adhesives were applied for prosthetic vascular graft placement does not indicate infection.
Entities:
Keywords:
Fluorodeoxyglucose (FDG); PET/CT imaging; diagnostic and prognostic application
Authors: Larry M Baddour; Michael A Bettmann; Ann F Bolger; Andrew E Epstein; Patricia Ferrieri; Michael A Gerber; Michael H Gewitz; Alice K Jacobs; Matthew E Levison; Jane W Newburger; Thomas J Pallasch; Walter R Wilson; Robert S Baltimore; Donald A Falace; Stanford T Shulman; Lloyd Y Tani; Kathryn A Taubert Journal: Circulation Date: 2003-10-21 Impact factor: 29.690
Authors: J L M Bruggink; A W J M Glaudemans; B R Saleem; R Meerwaldt; H Alkefaji; T R Prins; R H J A Slart; C J Zeebregts Journal: Eur J Vasc Endovasc Surg Date: 2010-06-23 Impact factor: 7.069
Authors: B-R Sah; L Husmann; D Mayer; A Scherrer; Z Rancic; G Puippe; R Weber; B Hasse Journal: Eur J Vasc Endovasc Surg Date: 2015-01-31 Impact factor: 7.069
Authors: Sabina P W Guenther; Clemens C Cyran; Axel Rominger; Tobias Saam; Philipp M Kazmierzcak; Erik Bagaev; Maximilian Pichlmaier; Christian Hagl; Nawid Khaladj Journal: Interact Cardiovasc Thorac Surg Date: 2015-07-13
Authors: Francois Jamar; John Buscombe; Arturo Chiti; Paul E Christian; Dominique Delbeke; Kevin J Donohoe; Ora Israel; Josep Martin-Comin; Alberto Signore Journal: J Nucl Med Date: 2013-01-28 Impact factor: 10.057
Authors: O T A Lyons; M Baguneid; T D Barwick; R E Bell; N Foster; S Homer-Vanniasinkam; S Hopkins; A Hussain; K Katsanos; B Modarai; J A T Sandoe; S Thomas; N M Price Journal: Eur J Vasc Endovasc Surg Date: 2016-10-19 Impact factor: 7.069
Authors: Johan Wassélius; Jonas Malmstedt; Bo Kalin; Stig Larsson; Anders Sundin; Ulf Hedin; Hans Jacobsson Journal: J Nucl Med Date: 2008-09-15 Impact factor: 10.057
Authors: Ulises Granados; David Fuster; Juan M Pericas; Jaime L Llopis; Salvador Ninot; Eduard Quintana; Manel Almela; Carlos Paré; José M Tolosana; Carlos Falces; Asuncion Moreno; Francesca Pons; Francisco Lomeña; Jose M Miro Journal: J Nucl Med Date: 2016-06-03 Impact factor: 10.057
Authors: P A Erba; G Leo; M Sollini; C Tascini; R Boni; R N Berchiolli; F Menichetti; M Ferrari; E Lazzeri; G Mariani Journal: Eur J Nucl Med Mol Imaging Date: 2013-10-19 Impact factor: 9.236
Authors: Chiara Lauri; Alberto Signore; Andor W J M Glaudemans; Giorgio Treglia; Olivier Gheysens; Riemer H J A Slart; Roberto Iezzi; Niek H J Prakken; Eike Sebastian Debus; Susanne Honig; Anne Lejay; Nabil Chakfé Journal: Eur J Nucl Med Mol Imaging Date: 2022-04-04 Impact factor: 10.057