Differential FDG-PET Uptake Patterns in Uninfected and Infected Central Prosthetic Vascular Grafts

Abstract

The patterns of FDG uptake for uninfected vascular grafts largely overlap with those of infected vascular grafts. This questions the value of these individual FDG-PET-CT parameters in identifying infected grafts.

Textural features of 18F-fluorodeoxyglucose positron emission tomography scanning in diagnosing aortic prosthetic graft infection

“…A diffuse homogeneous uptake was observed in 67 grafts (63%) and heterogeneous uptake was observed in 31 grafts (29% F-FDG PET uptake in non-infected grafts is a result of a local sterile inflammatory process around the prosthesis due to a foreign body-related reaction, and also related to the type of implanted material. Moreover, Berger et al found the mentioned standard parameters largely to overlap in infected and uninfected central vascular grafts [34], which confirms our findings that conventional parameters are not sufficient in distinguishing these groups.…”

FDG Uptake by Prosthetic Arterial Grafts in Large Vessel Vasculitis Is Not Specific for Active Disease

“…Meanwhile, the patient with an infected graft had a peri-prosthetic SUV max of 17.1, and he eventually succumbed to sepsis. However, the accuracy of individual 18 FDG-PET/CT parameters including SUV max for separating infected and non-infected grafts has been questioned [19]. It is possible that ongoing antibiotic therapy may impair discrimination of graft infection from nonspecific uptake at PET/CT, and further prospective analysis is required.…”

“…Synthetic graft material is 18 F-FDG avid in up to 92% of non-infected patients following surgery for non-inflammatory aneurysm repair or bypass of obstructive arterial atherosclerosis [17,19,20].…”

Aortic prosthetic graft infection detected by 18F-fluorodeoxyglucose positron emission tomography/computed tomography

“…This region was the same as the echo-free space observed on thoracic echocardiography. 18 F-FDG PET/CT was very useful for the diagnosis of aortic prosthetic graft infection.However, 18 F-FDG PET/CT images do not completely discriminate between infected grafts and noninfected grafts, because these images sometimes overlap [8]. However, when 18 F-FDG PET/CT is combined with the results of the physical examination or laboratory…”