How to recognize stent graft infection after endovascular aortic repair: the utility of 18F-FDG PET/CT in an infrequent
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ORIGINAL ARTICLE
How to recognize stent graft infection after endovascular aortic repair: the utility of 18F‑FDG PET/CT in an infrequent but serious clinical setting David Zogala1 · David Rucka2 · Vaclav Ptacnik1 · Vladimir Cerny3 · Jiri Trnka1 · Petr Varejka2 · Samuel Heller4 · Lukas Lambert3 Received: 18 February 2019 / Accepted: 19 May 2019 / Published online: 29 May 2019 © The Japanese Society of Nuclear Medicine 2019
Abstract Objective To evaluate the diagnostic performance of 18F-FDG PET/CT in the detection of stent graft infection (SGI). Methods In a retrospective study, two nuclear medicine physicians have independently analyzed 17 18F-FDG PET/CT examinations performed for clinical suspicion of SGI. The images were evaluated for the uptake pattern and intensity, and by the maximum standard uptake value (SUVmax), the target-to-background ratio with blood pool (TBRBP) and liver uptake (TBRhep) as a reference. The SGI was defined as the presence of focal hyperactivity with an intensity exceeding hepatic uptake. CT images were independently assessed for signs of SGI. Clinical review of all further patients’ data served as the standard of reference. Results Nine cases were established as SGI by the clinical review. PET/CT correctly diagnosed SGI in eight and yielded a sensitivity of 89% and specificity of 100%. The mean S UVmax, TBRBP, and T BRhep values were 9.8 ± 4.0, 6.9 ± 2.6, and 4.6 ± 1.7 in the group of patients with true SGI, and 4.0 ± 1.1, 2.5 ± 0.4 (p
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