Djamila Rojoa1, Nikos Kontopodis2, Stavros A Antoniou3, Christos V Ioannou2, George A Antoniou4. 1. Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK. 2. Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University Hospital of Heraklion, University of Crete, Heraklion, Greece. 3. Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK; Department of Colorectal Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK. 4. Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK; Division of Cardiovascular Sciences, School of Medical Sciences, University of Manchester, Manchester, UK. Electronic address: antoniou.ga@hotmail.com.
Abstract
BACKGROUND: For the diagnosis of vascular prosthetic graft infection (VPGI), an intra-operative peri-graft biopsy is often required. Controversy exists regarding the use of imaging techniques in the diagnostic process. This study aimed to evaluate the diagnostic accuracy of 18-fluorine fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in VPGI. METHODS: A systematic search of electronic databases was conducted, applying a combination of free text and controlled vocabulary searches adapted to thesaurus headings, search operators, and limits to identify studies assessing the use of 18F-FDG PET in the diagnosis of VPGI. A meta-analysis was conducted using a mixed effects logistic regression bivariate model. RESULTS: Twelve studies were identified reporting a total of 433 prostheses, of which 202 were proven to be infected. Analysis of PET scan was performed using five different methods: graded uptake, focal uptake, maximum standardised uptake value (SUVmax), tissue to background ratio (TBR), and dual time point (DTP). The pooled estimates for sensitivity and specificity for graded uptake were 0.89 (95% CI 0.73-0.96) and 0.61 (95% CI 0.48-0.74), respectively; they were 0.93 (95% CI 0.83-0.97) and 0.78 (95% CI 0.53-0.92) for focal uptake; 0.98 (95% CI 0.42-0.99) and 0.80 (95% CI 0.70-0.88) for SUVmax; 0.57 (95% CI 0.39-0.73) and 0.76 (95% CI 0.64-0.85) for TBR; and 1.00 (95% CI 0.48-1.00) and 0.88 (95% CI 0.68-0.97) for DTP. Sensitivity analysis including studies that investigated the diagnostic accuracy of PET combined with computed tomography (CT) showed higher sensitivity and specificity for focal uptake, graded uptake, and SUVmax than 18F-FDG PET alone. CONCLUSIONS: This meta-analysis suggests that 18F-FDG PET has a high sensitivity in diagnosing VPGI and its accuracy can be further increased by combining PET with CT.
BACKGROUND: For the diagnosis of vascular prosthetic graft infection (VPGI), an intra-operative peri-graft biopsy is often required. Controversy exists regarding the use of imaging techniques in the diagnostic process. This study aimed to evaluate the diagnostic accuracy of 18-fluorine fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in VPGI. METHODS: A systematic search of electronic databases was conducted, applying a combination of free text and controlled vocabulary searches adapted to thesaurus headings, search operators, and limits to identify studies assessing the use of 18F-FDG PET in the diagnosis of VPGI. A meta-analysis was conducted using a mixed effects logistic regression bivariate model. RESULTS: Twelve studies were identified reporting a total of 433 prostheses, of which 202 were proven to be infected. Analysis of PET scan was performed using five different methods: graded uptake, focal uptake, maximum standardised uptake value (SUVmax), tissue to background ratio (TBR), and dual time point (DTP). The pooled estimates for sensitivity and specificity for graded uptake were 0.89 (95% CI 0.73-0.96) and 0.61 (95% CI 0.48-0.74), respectively; they were 0.93 (95% CI 0.83-0.97) and 0.78 (95% CI 0.53-0.92) for focal uptake; 0.98 (95% CI 0.42-0.99) and 0.80 (95% CI 0.70-0.88) for SUVmax; 0.57 (95% CI 0.39-0.73) and 0.76 (95% CI 0.64-0.85) for TBR; and 1.00 (95% CI 0.48-1.00) and 0.88 (95% CI 0.68-0.97) for DTP. Sensitivity analysis including studies that investigated the diagnostic accuracy of PET combined with computed tomography (CT) showed higher sensitivity and specificity for focal uptake, graded uptake, and SUVmax than 18F-FDG PET alone. CONCLUSIONS: This meta-analysis suggests that 18F-FDG PET has a high sensitivity in diagnosing VPGI and its accuracy can be further increased by combining PET with CT.
Authors: Martina Sollini; Francesco Bartoli; Roberto Boni; Roberta Zanca; Andrea Colli; Maurizio Levantino; Francesco Menichetti; Mauro Ferrari; Raffaella Berchiolli; Elena Lazzeri; Paola A Erba Journal: Front Cardiovasc Med Date: 2021-12-01
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