Accuracy of FDG-PET–CT in the Diagnostic Work-up of Vascular Prosthetic Graft Infection

Bruggink, J.L.M.; Glaudemans, A.W.J.M.; Saleem, B.R.; Meerwaldt, R.; Alkefaji, H.; Prins, T.R.; Slart, R.H.J.A.; Zeebregts, C.J.

doi:10.1016/j.ejvs.2010.05.016

« Previous Next »European Journal of Vascular & Endovascular Surgery
Volume 40, Issue 3 , Pages 348-354, September 2010

Accuracy of FDG-PET–CT in the Diagnostic Work-up of Vascular Prosthetic Graft Infection

J.L.M. Bruggink
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30 001, 9700 RB Groningen, The Netherlands
A.W.J.M. Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30 001, 9700 RB Groningen, The Netherlands
B.R. Saleem
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30 001, 9700 RB Groningen, The Netherlands
R. Meerwaldt
- Department of Surgery, Medisch Spectrum Twente, P.O. Box 50 000, 7500 KA, Enschede, The Netherlands
H. Alkefaji
- Department of Radiology, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30 001, 9700 RB Groningen, The Netherlands
T.R. Prins
- Department of Radiology, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30 001, 9700 RB Groningen, The Netherlands
R.H.J.A. Slart
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30 001, 9700 RB Groningen, The Netherlands
C.J. Zeebregts
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30 001, 9700 RB Groningen, The Netherlands
- Corresponding author. Tel.: +31 503613382; fax: +31 503611745.

Received 8 March 2010; accepted 25 May 2010. published online 24 June 2010.

Abstract

Objectives

To investigate the diagnostic accuracy of fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) compared with computed tomography (CT) scanning and added value of fused FDG-PET–CT in diagnosing vascular prosthetic graft infection.

Design

Prospective cohort study with retrospective analysis.

Materials

Twenty five patients with clinically suspected vascular prosthetic infection underwent CT and FDG-PET scanning.

Methods

Two nuclear medicine physicians assessed the FDG-PET scans; all CT scans were assessed by two radiologists. Fused FDG-PET/CT were judged by the radiologist and the nuclear medicine physician. The concordance between CT and FDG-PET and the inter-observer agreement between the different readers were investigated.

Results

Fifteen patients had a proven infection by culture. Single FDG-PET had the best results (sensitivity 93%, specificity 70%, positive predictive value 82% and negative predictive value 88%). For CT, these values were 56%, 57%, 60% and 58%, respectively. Fused CT and FDG-PET imaging also showed high sensitivity and specificity rates and high positive and negative values. Inter-observer agreement for FDG-PET analysis was excellent (kappa = 1.00) and moderate for CT and fused FDG-PET–CT analysis (0.63 and 0.66, respectively).

Conclusion

FDG-PET scanning showed a better diagnostic accuracy than CT for the detection of vascular prosthetic infection. This study suggests that FDG-PET provides a useful tool in the work-up for diagnosis of vascular prosthetic graft infection.

Keywords: Prosthetic graft infection, Diagnosis, Positron emission tomography, Computerised tomography scanning, Accuracy