Accuracy of FDG-PET-CT in the diagnostic work-up of vascular prosthetic graft infection.
OBJECTIVE
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.


METHODS
Prospective cohort study with retrospective analysis.


METHODS
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).


CONCLUSIONS
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.
Bruggink
J L M
JL
Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30 001, 9700 RB Groningen, The Netherlands.
Glaudemans
A W J M
AW
Saleem
B R
BR
Meerwaldt
R
R
Alkefaji
H
H
Prins
T R
TR
Slart
R H J A
RH
Zeebregts
C J
CJ
D000368:Aged; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18