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18F-FDG PET/CT for therapy control in vascular graft infections: a first feasibility study


Husmann, Lars; Sah, Bert-Ram; Scherrer, Alexandra; Burger, Irene A; Stolzmann, Paul; Weber, Rainer; Rancic, Zoran; Mayer, Dieter; Hasse, Barbara (2015). 18F-FDG PET/CT for therapy control in vascular graft infections: a first feasibility study. Journal of Nuclear Medicine, 56(7):1024-1029.

Abstract

UNLABELLED: The aim of this study was to evaluate the clinical value of PET/CT with (18)F-FDG for therapy control in patients with prosthetic vascular graft infections (PVGIs).
METHODS: In this single-center, observational, prospective cohort study, 25 patients with a median age of 66 y (range, 48-81 y) who had a proven PVGI were included. Follow-up (18)F-FDG PET/CT was performed at a median of 170 d (range, 89-249 d) after baseline examination. Two independent and masked interpreters measured maximum standardized uptake values to quantify metabolic activity and analyzed whole-body datasets for a secondary diagnosis (i.e., infectious foci not near the graft). The metabolic activity of the graft was correlated with clinical information and 2 laboratory markers (C-reactive protein and white blood cell count).
RESULTS: (18)F-FDG PET/CT had an impact on management in all patients. In 19 of 25 patients (76%), antibiotic treatment was continued because of the results of follow-up (18)F-FDG PET/CT. Antibiotic treatment was stopped or changed in 8% and 16% of patients, respectively. In 8 patients (32%), additional incidental findings were detected on follow-up (18)F-FDG PET/CT and had a further impact on patient management. Only in a subgroup of patients with PVGI and no other sites of infection was a significant correlation found between the difference in C-reactive protein at the time of baseline and follow-up (18)F-FDG PET/CT and the difference in maximum standardized uptake value (n = 11; R(2) = 0.67; P = 0.002).
CONCLUSION: (18)F-FDG PET/CT represents a useful tool in therapy monitoring of PVGI and has an impact on patient management.

Abstract

UNLABELLED: The aim of this study was to evaluate the clinical value of PET/CT with (18)F-FDG for therapy control in patients with prosthetic vascular graft infections (PVGIs).
METHODS: In this single-center, observational, prospective cohort study, 25 patients with a median age of 66 y (range, 48-81 y) who had a proven PVGI were included. Follow-up (18)F-FDG PET/CT was performed at a median of 170 d (range, 89-249 d) after baseline examination. Two independent and masked interpreters measured maximum standardized uptake values to quantify metabolic activity and analyzed whole-body datasets for a secondary diagnosis (i.e., infectious foci not near the graft). The metabolic activity of the graft was correlated with clinical information and 2 laboratory markers (C-reactive protein and white blood cell count).
RESULTS: (18)F-FDG PET/CT had an impact on management in all patients. In 19 of 25 patients (76%), antibiotic treatment was continued because of the results of follow-up (18)F-FDG PET/CT. Antibiotic treatment was stopped or changed in 8% and 16% of patients, respectively. In 8 patients (32%), additional incidental findings were detected on follow-up (18)F-FDG PET/CT and had a further impact on patient management. Only in a subgroup of patients with PVGI and no other sites of infection was a significant correlation found between the difference in C-reactive protein at the time of baseline and follow-up (18)F-FDG PET/CT and the difference in maximum standardized uptake value (n = 11; R(2) = 0.67; P = 0.002).
CONCLUSION: (18)F-FDG PET/CT represents a useful tool in therapy monitoring of PVGI and has an impact on patient management.

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3 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:July 2015
Deposited On:22 Jul 2015 06:54
Last Modified:05 Apr 2016 19:18
Publisher:Society of Nuclear Medicine
ISSN:0161-5505
Publisher DOI:https://doi.org/10.2967/jnumed.115.156265
PubMed ID:25977463

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