Should white blood cell scan be replaced by (18)F-FDG PET-CT in the diagnosis of prosthetic vascular graft infection?

Ann Vasc Surg. 2015 Aug;29(6):1321.e1-4. doi: 10.1016/j.avsg.2015.03.053. Epub 2015 Jun 14.

Abstract

Diagnosis of prosthetic vascular graft infection (PVGI) is a clinical challenge requiring accurate diagnostic methods for their optimal management. A 65-year-old patient with suspected PVGI was explored by fluorodeoxyglucose positron emission tomography combined with computed tomography ((18)F-FDG PET-CT) for pretreatment staging. Standard imaging was unrevealing but PET images showed multiple foci with increased uptake suggesting prosthetic infection. While routine results from the diagnostic laboratory were negative, prosthesis sonication before standard culture revealed the same bacterium as a culture of preoperative lymphocele aspiration. (18)F-FDG PET-CT and preliminary sonication of the prosthetic graft could be very helpful in the diagnosis of PVGI especially for highlighting biofilm bacteria.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bacteria / growth & development
  • Bacteria / isolation & purification
  • Biofilms
  • Blood Vessel Prosthesis / adverse effects*
  • Blood Vessel Prosthesis Implantation / adverse effects*
  • Blood Vessel Prosthesis Implantation / instrumentation
  • Device Removal
  • Fluorodeoxyglucose F18*
  • Humans
  • Leukocyte Count
  • Male
  • Multimodal Imaging
  • Positron-Emission Tomography*
  • Predictive Value of Tests
  • Prosthesis-Related Infections / diagnostic imaging*
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / surgery
  • Radiopharmaceuticals*
  • Reoperation
  • Saphenous Vein / transplantation
  • Sonication
  • Tomography, X-Ray Computed*
  • Treatment Outcome

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18