Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Nuclear Medicine Review
MENU
Shortcuts Submit an article Author Guidelines Editorial Board Reviewers 2023

open access

Vol 23, No 2 (2020)
Research paper
Submitted: 2020-05-03
Accepted: 2020-05-22
Published online: 2020-07-31
View PDF Download PDF file
Get Citation

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

Beata E. Chrapko1, Marek Chrapko2, Anna Nocuń1, Tomasz Zubilewicz2, Bogusław Stefaniak1, Jakub Mitura1, Andrzej Wolski3, Piotr Terelecki2
DOI: 10.5603/NMR.a2020.0015
·
Pubmed: 33007092
·
Nucl. Med. Rev 2020;23(2):63-70.
Affiliations
  1. Chair and Department of Nuclear Medicine, Medical University of Lublin
  2. Chair and Department of Vascular Surgery and Angiology, Medical University of Lublin
  3. Chair and Department of Interventional Radiology and Neuroradiology, Medical University of Lublin

open access

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

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.

Full Text:

View PDF Download PDF file
Get Citation

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)

Article type

Research paper

Pages

63-70

Published online

2020-07-31

Page views

1467

Article views/downloads

1507

DOI

10.5603/NMR.a2020.0015

Pubmed

33007092

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

References (26)
  1. Legout L, D'Elia PV, Sarraz-Bournet B, et al. Vascular graft infections. Curr Opin Infect Dis. 2012; 25(2): 154–158.
    CrossRefPubMed
  2. Setacci C, Müller-Hülsbeck S, Jamar FX. Common diagnostic flowcharts in vascular and endovascular surgery. Q J Nucl Med Mol Imaging. 2014; 58(1): 46–54.
    PubMed
  3. Baddour LM, Bettmann MA, Bolger AF, et al. AHA. Nonvalvular cardiovascular device-related infections. Circulation. 2003; 108(16): 2015–2031.
    CrossRefPubMed
  4. Keidar Z, Nitecki S. FDG-PET in prosthetic graft infections. Semin Nucl Med. 2013; 43(5): 396–402.
    CrossRefPubMed
  5. Antonios VS, Noel AA, Steckelberg JM, et al. Prosthetic vascular graft infection: a risk factor analysis using a case-control study. J Infect. 2006; 53(1): 49–55.
    CrossRefPubMed
  6. Hasse B, Husmann L, Zinkernagel A, et al. Vascular graft infections. Swiss Med Wkly. 2013; 143: w13754.
    CrossRefPubMed
  7. Swain TW, Calligaro KD, Dougherty MD. Management of infected aortic prosthetic grafts. Vasc Endovascular Surg. 2004; 38(1): 75–82.
    CrossRefPubMed
  8. Lyons OTA, Baguneid M, Barwick TD, et al. Diagnosis of Aortic Graft Infection: A Case Definition by the Management of Aortic Graft Infection Collaboration (MAGIC). Eur J Vasc Endovasc Surg. 2016; 52(6): 758–763.
    CrossRefPubMed
  9. Bowles H, Ambrosioni J, Mestres G, et al. Diagnostic yield of 18F-FDG PET/CT in suspected diagnosis of vascular graft infection: A prospective cohort study. J Nucl Cardiol. 2018; 27(1): 294–302.
    CrossRef
  10. Sah BR, Husmann L, Mayer D, et al. VASGRA Cohort. Diagnostic performance of 18F-FDG-PET/CT in vascular graft infections. Eur J Vasc Endovasc Surg. 2015; 49(4): 455–464.
    CrossRefPubMed
  11. Lyons OTA, Patel AS, Saha P, et al. A 14-year experience with aortic endograft infection: management and results. Eur J Vasc Endovasc Surg. 2013; 46(3): 306–313.
    CrossRefPubMed
  12. Li HL, Chan YC, Cheng SW. Current Evidence on Management of Aortic Stent-graft Infection: A Systematic Review and Meta-Analysis. Ann Vasc Surg. 2018; 51: 306–313.
    CrossRefPubMed
  13. FitzGerald SF, Kelly C, Humphreys H. Diagnosis and treatment of prosthetic aortic graft infections: confusion and inconsistency in the absence of evidence or consensus. J Antimicrob Chemother. 2005; 56(6): 996–999.
    CrossRefPubMed
  14. McWilliams ET, Yavari A, Raman V. Aortic root abscess: multimodality imaging with computed tomography and gallium-67 citrate single-photon emission computed tomography/computed tomography hybrid imaging. J Cardiovasc Comput Tomogr. 2011; 5(2): 122–124.
    CrossRefPubMed
  15. Legout L, D'Elia PV, Sarraz-Bournet B, et al. Diagnosis and management of prosthetic vascular graft infections. Med Mal Infect. 2012; 42(3): 102–109.
    CrossRefPubMed
  16. O'Hara PJ, Borkowski GP, Hertzer NR, et al. Natural history of periprosthetic air on computerized axial tomographic examination of the abdomen following abdominal aortic aneurysm repair. J Vasc Surg. 1984; 1(3): 429–433.
    CrossRefPubMed
  17. Qvarfordt PG, Reilly LM, Mark AS, et al. Computerized tomographic assessment of graft incorporation after aortic reconstruction. Am J Surg. 1985; 150(2): 227–231.
    CrossRefPubMed
  18. Jamar F, Buscombe J, Chiti A, et al. EANM/SNMMI guideline for 18F-FDG use in inflammation and infection. J Nucl Med. 2013; 54(4): 647–658.
    CrossRefPubMed
  19. Liberatore M, Iurilli AP, Ponzo F, et al. Clinical usefulness of technetium-99m-HMPAO-labeled leukocyte scan in prosthetic vascular graft infection. J Nucl Med. 1998; 39(5): 875–879.
    PubMed
  20. Husmann L, Huellner MW, Ledergerber B, et al. and the Vasgra Cohort. Comparing diagnostic accuracy of F-FDG-PET/CT, contrast enhanced CT and combined imaging in patients with suspected vascular graft infections. Eur J Nucl Med Mol Imaging. 2019; 46(6): 1359–1368.
    CrossRefPubMed
  21. Wassélius J, Malmstedt J, Kalin Bo, et al. High 18F-FDG Uptake in synthetic aortic vascular grafts on PET/CT in symptomatic and asymptomatic patients. J Nucl Med. 2008; 49(10): 1601–1605.
    CrossRefPubMed
  22. Kara PÖ, Gedik GK, Kara T, et al. FDG Uptake Pattern on PET/CT Imaging in Non-Infectious Graft of a Patient with Operated Abdominal Aortic Aneurysm. Mol Imaging Radionucl Ther. 2012; 21(3): 110–113.
    CrossRefPubMed
  23. Granados U, Fuster D, Pericas JM, et al. Hospital Clinic Endocarditis Study Group. Diagnostic Accuracy of 18F-FDG PET/CT in Infective Endocarditis and Implantable Cardiac Electronic Device Infection: A Cross-Sectional Study. J Nucl Med. 2016; 57(11): 1726–1732.
    CrossRefPubMed
  24. Berger P, Vaartjes I, Scholtens A, et al. Differential FDG-PET Uptake Patterns in Uninfected and Infected Central Prosthetic Vascular Grafts. Eur J Vasc Endovasc Surg. 2015; 50(3): 376–383.
    CrossRefPubMed
  25. Keidar Z, Engel A, Hoffman A, et al. Prosthetic vascular graft infection: the role of 18F-FDG PET/CT. J Nucl Med. 2007; 48(8): 1230–1236.
    CrossRefPubMed
  26. Kim SJ, Lee SW, Jeong S, et al. A systematic review and meta-analysis of 18F-fluorodeoxyglucose positron emission tomography or positron emission tomography/computed tomography for detection of infected prosthetic vascular grafts. J Vasc Surg Venous Lymphat Disord. 2019; 70(1): 307–313.
    CrossRef

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

phone: +48 58 320 94 94, fax: +48 58 320 94 60, e-mail: viamedica@viamedica.pl