open access

Vol 23, No 2 (2020)
Original articles
Published online: 2020-07-31
Submitted: 2020-05-03
Accepted: 2020-05-22
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Patterns of vascular graft infection in 18F-FDG PET/CT

Beata E. Chrapko, Marek Chrapko, Anna Nocuń, Tomasz Zubilewicz, Bogusław Stefaniak, Jakub Mitura, Andrzej Wolski, Piotr Terelecki
DOI: 10.5603/NMR.a2020.0015
·
Nucl. Med. Rev 2020;23(2):63-70.

open access

Vol 23, No 2 (2020)
Original articles
Published online: 2020-07-31
Submitted: 2020-05-03
Accepted: 2020-05-22

Abstract

BACKGROUND: 18F-FDG PET/CT has become an important tool in diagnosis of prosthetic vascular graft infections (PVGI). The aim of the study was to identify the patterns of vascular graft infection in 18F-FDG PET/CT.

MATERIAL AND METHODS: The study was performed in 24 patients with vascular graft infection, in 17 patients implanted in an open surgery mode and in 7 patients by endovascular aortic repair (EVAR). Vascular prostheses were evaluated by two visual scales and semi-quantitative analysis with maximum standardized uptake values (SUV max).

RESULTS: In the 3-point scale: 23 patients were in grade 1 and one patient was in grade 2. In the 5-point scale: 19 patients were in grade 5 with the highest activity in the focal area, 4 patients were in grade 4 and one patient in grade 3. The visual evaluation of 18F-FDG PET/CT study revealed that peri-graft high metabolic activity was associated with occurrence of morphological abnormalities (n = 21) like gas bubbles and peri-graft fluid retention or without abnormal CT findings (n = 3). The presence of the gas bubbles was linked to higher uptake of 18F-FDG (p < 0.01, SUVmax 11.81 ± 4.35 vs 7.36 ± 2.80, 15 vs 9 pts). In EVAR procedure, the highest metabolic activity was greater than in classical prosthesis (SUVmax 21.5 vs 13).

CONCLUSIONS: 18F-FDG PET/CT is a very useful tool for assessment of vascular graft infections. CT findings like gas bubbles, or peri-graft fluid retention were associated with significantly higher glucose metabolism; however, in some cases without anatomic alterations, increased metabolic activity was the only sign of infection.

Abstract

BACKGROUND: 18F-FDG PET/CT has become an important tool in diagnosis of prosthetic vascular graft infections (PVGI). The aim of the study was to identify the patterns of vascular graft infection in 18F-FDG PET/CT.

MATERIAL AND METHODS: The study was performed in 24 patients with vascular graft infection, in 17 patients implanted in an open surgery mode and in 7 patients by endovascular aortic repair (EVAR). Vascular prostheses were evaluated by two visual scales and semi-quantitative analysis with maximum standardized uptake values (SUV max).

RESULTS: In the 3-point scale: 23 patients were in grade 1 and one patient was in grade 2. In the 5-point scale: 19 patients were in grade 5 with the highest activity in the focal area, 4 patients were in grade 4 and one patient in grade 3. The visual evaluation of 18F-FDG PET/CT study revealed that peri-graft high metabolic activity was associated with occurrence of morphological abnormalities (n = 21) like gas bubbles and peri-graft fluid retention or without abnormal CT findings (n = 3). The presence of the gas bubbles was linked to higher uptake of 18F-FDG (p < 0.01, SUVmax 11.81 ± 4.35 vs 7.36 ± 2.80, 15 vs 9 pts). In EVAR procedure, the highest metabolic activity was greater than in classical prosthesis (SUVmax 21.5 vs 13).

CONCLUSIONS: 18F-FDG PET/CT is a very useful tool for assessment of vascular graft infections. CT findings like gas bubbles, or peri-graft fluid retention were associated with significantly higher glucose metabolism; however, in some cases without anatomic alterations, increased metabolic activity was the only sign of infection.

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Keywords

fluorodeoxyglucose; PET/CT scan; vascular graft infections

About this article
Title

Patterns of vascular graft infection in 18F-FDG PET/CT

Journal

Nuclear Medicine Review

Issue

Vol 23, No 2 (2020)

Pages

63-70

Published online

2020-07-31

DOI

10.5603/NMR.a2020.0015

Bibliographic record

Nucl. Med. Rev 2020;23(2):63-70.

Keywords

fluorodeoxyglucose
PET/CT scan
vascular graft infections

Authors

Beata E. Chrapko
Marek Chrapko
Anna Nocuń
Tomasz Zubilewicz
Bogusław Stefaniak
Jakub Mitura
Andrzej Wolski
Piotr Terelecki

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