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

Ann Vasc Surg

Université de Bordeaux, USC EA 3671, Infections Humaines à Mycoplasmes et à Chlamydiae, Bordeaux, France; INRA, USC EA3671, Infections Humaines à Mycoplasmes et à Chlamydiae, Bordeaux, France; CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, Bordeaux, France.

Published: August 2015

AI Article Synopsis

  • The diagnosis of prosthetic vascular graft infection (PVGI) poses a clinical challenge that requires effective diagnostic methods for better treatment management.
  • A 65-year-old patient suspected of having PVGI underwent (18)F-FDG PET-CT scanning, which revealed multiple areas of increased uptake indicative of infection, despite standard imaging not showing any issues.
  • Sonication of the prosthesis prior to standard cultures successfully identified the same bacteria found in a lymphocele aspiration, suggesting that (18)F-FDG PET-CT and sonication could be crucial for diagnosing PVGI, particularly for detecting biofilm-associated bacteria.

Article 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.

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Source
http://dx.doi.org/10.1016/j.avsg.2015.03.053DOI Listing

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