Characteristics and prognosis of patients with prosthetic vascular graft infection (PVGI) followed by positron emission tomography (PET) scan: a prospective cohort of 67 patients

Background Fluorine-18-fluorodeoxyglucose positron-emission tomography with computed tomography has revolutionized medical diagnosis by adding functional activity to anatomic imaging. We report our experience with this technique in patients with mycotic aortic pathology and aortic vascular graft infection. Methods We conducted a retrospective review of a prospective database of patients who underwent 18F-fluorodeoxyglucose positron-emission tomography with computed tomography for suspected infective aortic disease. From 2012 to 2016, 13 patients underwent 18F-fluorodeoxyglucose positron-emission tomography. Of these, 9 (69%) had a vascular graft infection (5 infrarenal aorta, 1 para-visceral, 2 descending, and 1 arch; 2 had previous open surgery and 7 had endovascular interventions) and 4 (31%) had a mycotic aneurysm (2 aortic arch, 1 infrarenal aorta, and 1 distal aorta and common iliac; 3 had endografts). The indications for imaging, location of pathology, 18F uptake, and clinical outcomes were analyzed. Results Eight (62%) patients had a single scan and 5 (38%) had serial scans performed. Among the 5 patients who had serial imaging, 3 showed decreased 18F uptake and 2 had increased uptake. Only one patient underwent subsequent endograft removal; the others were treated with lifelong antibiotics. There were 5 (38%) deaths on follow-up. Conclusion 18F-fluorodeoxyglucose positron-emission tomography with computed tomography could be a valuable adjunct in the diagnosis and surveillance of patients with aortic infection. Serial scans may be useful for monitoring disease activity and response to antibiotic therapy.

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Hybrid imaging of vascular graft infection by positron emission tomography with computed tomography using fluorine-18-labeled fluorodeoxyglucose: The Serbian National PET Center experience

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh190301041s ◽

2019 ◽

Vol 147 (7-8) ◽

pp. 405-409

Author(s):

Jelena Saponjski ◽

Dragana Sobic-Saranovic ◽

Nebojsa Petrovic ◽

Strahinja Odalovic ◽

Vera Artiko ◽

...

Keyword(s):

Fdg Pet ◽

Vascular Graft ◽

Diagnostic Method ◽

Graft Infection ◽

Emission Tomography ◽

Vascular Graft Infection ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Introduction. Positron emission tomography (PET) with computed tomography (CT) using fluorine- 18-labeled fluorodeoxyglucose (18F-FDG PET/CT) is a hybrid diagnostic method based on the cell?s glucose uptake detection, which correlates with the degree of disease activity. While other diagnostic procedures fail to evaluate functional tissue, 18F-FDG PET/CT can be helpful in discovering active disease in patients with vascular graft infection. Methods. This cohort retrospective study included 22 patients (17 male, five female; aged 61.7 ? 16.1) with suspected vascular graft infection. Blood analyses and CT were performed in all patients. Degree of glucose uptake was evaluated visually and semiquantitatively using maximal standardized uptake value (SUVmax). Findings were considered positive if focal fluoro-deoxyglucose (FDG) accumulation was greater in vascular graft projection than other parts of the blood vessel and liver. Results. The sighs of active disease were found in 19 patients (86%) (16 male, three female) at the level of implanted vascular grafts: six aortobifemoral (27%), four aortoiliac (18.2%), four of abdominal aorta (18.2%), two of thoracic aorta (9.1%), two femoral (9.1%), one femoropopliteal (4.5%) (SUVmax 7.9 + 2.4). Two patients were considered true and one false negative- due to antibiotic usage, which reduces FDG uptake. PET/CT helped in treatment alteration of 12 patients, seven (31.8%) started new medicament therapy, five (22.7%) had a surgical graft replacement. Overall sensitivity of this method is 95%, specificity 100%, positive predictive value 100%, negative predictive value 66.6%, accuracy 95.4%. Conclusion. 18F-FDG PET/CT is a useful diagnostic method in detection of active vascular graft infection with high diagnostic accuracy, which is important in avoiding unnecessary surgery and appropriate therapy planning.

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In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽

10.1024/0301-1526/a000867 ◽

2020 ◽

Vol 49 (4) ◽

pp. 281-284

Author(s):

Atıf Yolgosteren ◽

Gencehan Kumtepe ◽

Melda Payaslioglu ◽

Cuneyt Ozakin

Keyword(s):

Vascular Graft ◽

Graft Infection ◽

Vascular Graft Infection ◽

Group 4 ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Prosthetic Vascular Graft Infection ◽

Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

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Detection of aortic graft infection by fluorodeoxyglucose positron emission tomography: Comparison with computed tomographic findings

Yearbook of Vascular Surgery ◽

10.1016/s0749-4041(08)70427-5 ◽

2007 ◽

Vol 2007 ◽

pp. 106-108

Author(s):

G.L. Moneta

Keyword(s):

Positron Emission Tomography ◽

Graft Infection ◽

Emission Tomography ◽

Fluorodeoxyglucose Positron Emission Tomography ◽

Aortic Graft ◽

Computed Tomographic ◽

Positron Emission ◽

Aortic Graft Infection ◽

Fluorodeoxyglucose Positron Emission

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Faculty Opinions recommendation of Prosthetic vascular graft infection: the role of 18F-FDG PET/CT.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1089552.544806 ◽

2007 ◽

Author(s):

Barry Shulkin

Keyword(s):

Fdg Pet ◽

Vascular Graft ◽

Graft Infection ◽

Vascular Graft Infection ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Prosthetic Vascular Graft Infection

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[18F]fluoro-2-deoxy-d-glucose ([18F]FDG) positron emission tomography imaging of thymic carcinoid tumor presenting with recurrent Cushing’s syndrome

Acta Endocrinologica ◽

10.1530/eje.1.01839 ◽

2005 ◽

Vol 152 (4) ◽

pp. 521-525 ◽

Cited By ~ 39

Author(s):

Athina Markou ◽

Patrick Manning ◽

Banu Kaya ◽

Sam N Datta ◽

Jamshed B Bomanji ◽

...

Keyword(s):

Positron Emission Tomography ◽

High Resolution ◽

Carcinoid Tumor ◽

Fdg Pet ◽

Pet Scan ◽

Emission Tomography ◽

Thymic Carcinoid ◽

Acth Secretion ◽

Positron Emission ◽

Thymic Carcinoid Tumor

We report a case of a young woman with Cushing’s syndrome (CS), in whom although endocrine investigations and negative pituitary imaging were suggestive of ectopic ACTH secretion, the results of inferior petrosal sinus (IPS) sampling after coricotropin-releasing hormone (CRH) stimulation were suggestive of pituitary ACTH hypersecretion. 111In-labelled octreotide and high-resolution computer tomography (CT) revealed a lesion possibly responsible for the ACTH source in the thymus. Thymectomy confirmed concomitant ectopic CRH and probable ACTH production by a thymic neuroendocrine carcinoma. After an 8-year remission period the patient developed a clinical and biochemical relapse. A high-resolution computed tomography (CT) scan of the thorax showed a 2-cm nodule in the thymic bed, which was positive on a [18F]fluoro-2-deoxy-d-glucose ([18F]FDG) positron emission tomography (PET) scan. However, a repeated thymectomy did not result in remission. A repeat [18F]FDG PET study showed persistent disease in the thymic bed and also uptake in the adrenals. The patient underwent bilateral adrenalectomy, which resulted in clinical remission. A further [18F]FDG PET scan 8 months later showed no progression of the thymic tumor and confirmed complete excision of the adrenals. This is a rare case of concomitant CRH and ACTH secretion from a thymic carcinoid tumor; the case illustrates the usefulness of functional imaging with [18F]FDG PET in the diagnosis, management and follow-up of neuroendocrine tumors.

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