Lars Husmann1, Martin W Huellner2, Bruno Ledergerber3, Nadia Eberhard3, Marisa B Kaelin3, Alexia Anagnostopoulos3, Ken Kudura2, Irene A Burger2, Carlos-A Mestres4, Zoran Rancic5, Barbara Hasse3. 1. Department of Nuclear Medicine, University Hospital of Zurich/University of Zurich, Zurich, Switzerland. Electronic address: lars.husmann@usz.ch. 2. Department of Nuclear Medicine, University Hospital of Zurich/University of Zurich, Zurich, Switzerland. 3. Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich/University of Zurich, Zurich, Switzerland. 4. Clinic for Cardiac Surgery, University Hospital of Zurich, University of Zurich, Zurich, Switzerland. 5. Clinic for Vascular Surgery, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Abstract
OBJECTIVE: Infected aortic aneurysms are highly lethal, and management is very demanding, requiring an early diagnosis. The aim of this study was to evaluate the diagnostic accuracy of positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (PET/CT) and contrast enhanced CT (CE-CT) in patients with suspected infected aortic aneurysms. METHODS: PET/CT was performed in patients with clinically suspected infected aortic aneurysms, and additional CE-CT was performed if feasible. Diagnostic accuracy was assessed by two independent readers using a four point grading score for both imaging modalities. Maximum standardised uptake values (SUVmax) were calculated for quantitative measurements of metabolic activity in PET/CT. The reference standard was a combination of clinical presentation, laboratory findings, and imaging. RESULTS: Ten patients were included prospectively in the study, 24 retrospectively; 16 patients (47%) prior to the start of antimicrobial treatment and all 34 patients prior to any vascular intervention. Thirteen of the 34 patients had an infected aortic aneurysm (38%). Proven infected aortic aneurysms were all metabolically active on PET/CT with a median SUVmax of 6.6 (interquartile range 4.7-21.8). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT for the diagnosis of infected aortic aneurysm was 100%, 71%, 68%, 100%, and 82%, for reader 1 and 85%, 71%, 65%, 88%, and 77%, for reader 2. Respective values for CE-CT, performed in 20 patients (59%), were 63%, 75%, 63%, 75%, and 70%, for reader 1 and 88%, 50%, 54%, 86%, and 65%, for reader 2. CONCLUSION: The diagnostic accuracy of PET/CT in the detection of infected aortic aneurysms (n = 13) is high, and higher than CE-CT. While PET/CT demonstrates an excellent sensitivity, its specificity is hampered because of false positive findings.
OBJECTIVE:Infected aortic aneurysms are highly lethal, and management is very demanding, requiring an early diagnosis. The aim of this study was to evaluate the diagnostic accuracy of positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (PET/CT) and contrast enhanced CT (CE-CT) in patients with suspected infected aortic aneurysms. METHODS: PET/CT was performed in patients with clinically suspected infected aortic aneurysms, and additional CE-CT was performed if feasible. Diagnostic accuracy was assessed by two independent readers using a four point grading score for both imaging modalities. Maximum standardised uptake values (SUVmax) were calculated for quantitative measurements of metabolic activity in PET/CT. The reference standard was a combination of clinical presentation, laboratory findings, and imaging. RESULTS: Ten patients were included prospectively in the study, 24 retrospectively; 16 patients (47%) prior to the start of antimicrobial treatment and all 34 patients prior to any vascular intervention. Thirteen of the 34 patients had an infected aortic aneurysm (38%). Proven infected aortic aneurysms were all metabolically active on PET/CT with a median SUVmax of 6.6 (interquartile range 4.7-21.8). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT for the diagnosis of infected aortic aneurysm was 100%, 71%, 68%, 100%, and 82%, for reader 1 and 85%, 71%, 65%, 88%, and 77%, for reader 2. Respective values for CE-CT, performed in 20 patients (59%), were 63%, 75%, 63%, 75%, and 70%, for reader 1 and 88%, 50%, 54%, 86%, and 65%, for reader 2. CONCLUSION: The diagnostic accuracy of PET/CT in the detection of infected aortic aneurysms (n = 13) is high, and higher than CE-CT. While PET/CT demonstrates an excellent sensitivity, its specificity is hampered because of false positive findings.
Authors: Lars Husmann; Martin W Huellner; Nadia Eberhard; Bruno Ledergerber; Marisa B Kaelin; Alexia Anagnostopoulos; Ken Kudura; Irene A Burger; Carlos-A Mestres; Zoran Rancic; Barbara Hasse Journal: Sci Rep Date: 2021-03-03 Impact factor: 4.379
Authors: Srikanth Mairpady Shambat; Alejandro Gómez-Mejia; Tiziano A Schweizer; Markus Huemer; Chun-Chi Chang; Claudio Acevedo; Judith Bergada-Pijuan; Clément Vulin; Daniel A Hofmaenner; Thomas C Scheier; Sanne Hertegonne; Elena Parietti; Nataliya Miroshnikova; Pedro D Wendel Garcia; Matthias P Hilty; Philipp Karl Buehler; Reto A Schuepbach; Silvio D Brugger; Annelies S Zinkernagel Journal: PLoS Pathog Date: 2022-01-10 Impact factor: 6.823
Authors: Lars Husmann; Martin W Huellner; Hannes Gruenig; Bruno Ledergerber; Michael Messerli; Carlos-A Mestres; Zoran Rancic; Barbara Hasse Journal: PLoS One Date: 2022-08-09 Impact factor: 3.752
Authors: Lars Husmann; Nadia Eberhard; Martin W Huellner; Bruno Ledergerber; Anna Mueller; Hannes Gruenig; Michael Messerli; Carlos-A Mestres; Zoran Rancic; Alexander Zimmermann; Barbara Hasse Journal: Sci Rep Date: 2021-07-02 Impact factor: 4.379