Abstract
Objective: to investigate the features of visual and semiquantitative assessment of 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomodraphy/computed tomography (PET/CT) results in patients with suspected vascular graft (VG) infection and without VG infection.
Material and methods. The analysis included results of 42 PET/CT examinations performed in patients with VG: for suspected infection (n = 30) and for oncologic reasons without infection (n = 12). PET/CT results were assessed by areas of interest using two methods: 1) visual – with assessment of the type and intensity of 18F-FDG uptake; 2) semi-quantitative – with calculation of standartized uptane volume (SUV) – SUVmax and SUVratio using three referent zones (aorta, liver, lung). All PET/CT results were verified by clinical (including 6 months follow-up after PET/CT), laboratory and intraoperative (n = 21) data: VG infection was confirmed in 19 and ruled out in 23 patients in 22 and 29 areas of VG, respectively
Results. Visual analysis of PET/CT results showed that in the most of the VG areas with true abnormal 18F-FDG uptake (n = 22) its distribution was focal – in 19/22 (86%) and of high intensity – in 18/22 (82%). Semiquantitative analysis confirmed significantly higher values of SUVmax and three SUVratios in areas with VG infection, compared with areas without infection (p < 0.001). According to ROC analysis, the optimal lung SUVratio threshold was of 13.25 (AUC = 0.888) with sensitivity 86% and specificity 83%.
Combined interpretation of PET/CT results – visual and semiquantitative using lung SUVratio – allowed to increase the specificity from 64 to 91% and the accuracy from 87 to 97%, maintaining 100% sensitivity.
Conclusion. Obtained results confirmed 18F-fluorodeoxyglucose PET/CT to be highly informative in the diagnosis of VG infection. For VG infection the focal 18F-FDG uptake of high intensity is typical. Combined interpretation of PET/CT results increases its specificity and accuracy. Lung SUVratio over13.25 (AUC = 0.888) is the most informative indicator for the diagnosis of the VG infection.
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About the authors
- Irakliy P. Aslanidis, Dr. Med. Sc., Professor, Head of the Department of Nuclear Medicine, ORCID
- Diana M. Pursanova, Cand. Med. Sc., Senior Researcher, ORCID
- Ol’ga V. Mukhortova, Dr. Med. Sc., Senior Researcher,ORCID
- Irina V. Shurupova, Dr. Med. Sc., Senior Researcher, ORCID
- Tat’yana A. Katunina, Senior Researcher,ORCID
- Irina V. Ekaeva, Cand. Chem. Sc., Head of the Laboratory,ORCID
