Diagnostics of 'non-acute' vascular prosthesis infection using 18F-FDG PET/CT: our experience with 96 prostheses
| Autor: | P. Sebesta, J. Votrubova, P. Stadler, Miroslav Špaček, O. Belohlavek |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Prosthesis-Related Infections medicine.medical_treatment Anastomosis Prosthesis Lesion Pseudoaneurysm Fluorodeoxyglucose F18 medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Aged Aged 80 and over PET-CT business.industry Reproducibility of Results General Medicine Middle Aged medicine.disease Blood Vessel Prosthesis Positron-Emission Tomography Female Tomography Radiology medicine.symptom Radiopharmaceuticals Complication business Tomography X-Ray Computed |
| Zdroj: | European journal of nuclear medicine and molecular imaging. 36(5) |
| ISSN: | 1619-7089 |
| Popis: | Vascular prosthesis infection (VPI) is a life-threatening complication that occurs in 0.5–5% of prostheses. Low-grade infections in non-acute patients are a diagnostic challenge requiring a new method with good diagnostic accuracy. The aim of this work was to define the accuracy of 18F-FDG PET/CT in these settings and to identify essential parameters of the evaluation. PET/CT was performed prospectively in 76 consecutive patients with a total of 96 vascular prosthetic grafts in which infection was suspected. PET/CT scans were analysed in terms of the presence and intensity of focal and diffuse FDG uptake, the presence of an anastomotic pseudoaneurysm, the presence of an irregular boundary of infiltration, a combination of these, and the uptake ratio between the graft and blood background. The gold standard was based on operative/histopathological finding or a clinical follow up of >6 months. Among the various assessed parameters only focal FDG uptake and an irregular graft boundary were significant predictors of VPI. Focal intense FDG uptake together with an irregular boundary of the lesion on CT scan predicted VPI with 97% probability, while smooth lesion boundaries and no focal FDG uptake predicted a probability of VPI of less than 5%. Even in lesions with nondiagnostic inhomogeneous focal FDG uptake (18/96) an irregular boundary effectively helped in decision-making with a probability of 28% (smooth) or 77% (irregular) for VPI. PET/CT gave reliable results with an accuracy >95% in 75% of prostheses. PET/CT can identify those prostheses (25% of prosthesis) for which its diagnostic accuracy is diminished to 70–75%. In our series PET/CT was an excellent diagnostic modality for suspected VPI. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink