title: 18F-FDG PET-CT in suspected prosthetic vascular graft infection.
abstract: BACKGROUND
  Diagnosis of prosthetic vascular graft infections is a clinical challenge, and surgical therapy is associated with comorbidity. Therefore, accurate diagnostic methods are required for their optimal management.
  
  
  METHODS
  A 61-year-old-patient presented with erysipelas of the right lower limb 7 months after receiving a hybrid femoropopliteal bypass composed of a saphenous vein distally and external supported polytetrafluoroethylene proximally. He had been first treated for suspicious of septic arterial thrombosis or false aneurysm with antibiotics. A computed tomography (CT) angiogram was performed to detect any potential infection of the bypass and to explore erysipelas. It revealed a subcutaneous infiltration and an infiltration of the right groin but no anastomotic pseudoaneurysm or thrombosis of the bypass. The 2-[18F]-fluoro-2-desoxy-d-glucose positron emission tomography (18F-FDG PET) evidenced a significant uptake of cutaneous and subcutaneous tissue but no uptake on the vascular prosthetic graft. Therefore, the bypass was considered as noninfected and antibiotics were continued for 3 months. A physical examination on antibiotic cessation revealed a nonerythematous thigh with a C-reactive protein level significantly decreased to 36 mg/L and a normal white blood cell count. A PET scan confirmed this clinical improvement as attested by a dramatically decreased uptake of cutaneous and subcutaneous tissues and still no uptake of the graft.
  
  
  CONCLUSIONS
  In conclusion, this case highlights the role that 18F-FDG PET-CT may play in excluding suspected prosthetic graft infection, thanks to its high sensitivity and in avoiding needless revision surgery with subsequent comorbidities.
authors.affiliation: Department of Nuclear Medicine, CHU Bordeaux, Pessac, France. Electronic address: jean-baptiste.pinaquy@chu-bordeaux.fr.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Pinaquy
authors.affiliation: Department of Nuclear Medicine, CHU Bordeaux, Pessac, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Cazanave
authors.affiliation: Department of Nuclear Medicine, CHU Bordeaux, Pessac, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Stecken
authors.affiliation: Department of Nuclear Medicine, CHU Bordeaux, Pessac, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Bordenave
authors.affiliation: Department of Nuclear Medicine, CHU Bordeaux, Pessac, France.
authors.forename: Ghoufrane
authors.initials: G
authors.lastname: Tlili
authors.affiliation: Department of Nuclear Medicine, CHU Bordeaux, Pessac, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Berard
mesh_terms: D001672:Biocompatible Materials; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D005465:Fluorocarbon Polymers; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D016459:Prosthesis-Related Infections / Q000175:diagnosis*; D019275:Radiopharmaceuticals; D012501:Saphenous Vein / Q000637:transplantation; D014057:Tomography, X-Ray Computed
chemical_list: D001672:Biocompatible Materials; D005465:Fluorocarbon Polymers; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; C010946:polytetrafluoroethane