title: Prosthetic vascular graft infection imaging.
abstract: OBJECTIVE
  We are reporting our experience with imaging of vascular graft infections using computed tomography angiography (CTA), white blood cell (WBC) scintigraphy and software-based fusion imaging.
  
  
  METHODS
  Institutional review board approval was obtained. We performed a retrospective review of patients who had clinical signs and symptoms of vascular graft infection in whom both WBC single photon emission computed tomography (SPECT) and CTA was performed between 2005 and 2010. We performed fusion imaging with available data using software coregistration technique and analyzed outcome of the patients.
  
  
  RESULTS
  We had 20 patients; 11 had grafts of the aorta, five had peripheral vascular grafts, three had aortic and peripheral vascular grafts, and one had a thoracic aortic graft. WBC imaging was positive in 10 patients, negative in six patients and indeterminate in 4 patients. CTA was positive in six patients, negative in four patients and indeterminate in 10 patients. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value (NPV) for WBC, CTA and WBC SPECT/CTA fusion were 75/100/80/100/50%, 88/50/80/88/50% and 94/50/85/88/67% respectively.
  
  
  CONCLUSIONS
  The use of CTA, WBC scintigraphy, and image co-registration influenced the diagnostic confidence of graft infection and the outcome of the patients. Software-based fusion imaging of both modalities resulted in improved sensitivity, accuracy, and NPV.
authors: Department of Radiology, Health System Foundation, University of Virginia, Charlottesville, VA 22908, USA.
authors: Minhaj S
authors: MS
authors: Khaja
authors: Onur
authors: O
authors: Sildiroglu
authors: Klaus
authors: K
authors: Hagspiel
authors: Patrice K
authors: PK
authors: Rehm
authors: Kenneth J
authors: KJ
authors: Cherry
authors: Ulku C
authors: UC
authors: Turba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012984:Software; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*