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Nuclear Medicine Imaging of Vascular Graft Infections

  • Chiara Lauri
  • Maurizio Taurino
  • Alberto Signore
Chapter

Abstract

Vascular graft infections represent a non-common but severe complication of vascular surgery being associated with a bad prognosis and high risk of mortality. To correctly and promptly identify the infection and its extent is crucial for adequate treatment and prognostication of the patient. Several radiological and NM imaging modalities are available, each with its pros and cons, but a unanimous consensus on which is the best strategy to diagnose a VGI is not still defined. Moreover, well-standardized acquisition protocols and interpretative criteria are still needed in order to make the diagnostic approach uniform worldwide.

In this chapter, we will examine the most useful NM modalities for imaging VGI with a big emphasis on radiolabelled WBC scan and FDG PET/CT.

Keywords

Graft infections FDG-PET/CT Autologous WBC SPECT/CT 

References

  1. 1.
    Swain TW III, Calligaro KD, Dougherty MD. Management of infected aortic prosthetic grafts. Vasc Endovascular Surg. 2004;38(1):75–82.PubMedCrossRefGoogle Scholar
  2. 2.
    Annovazzi A, Bagni B, Burroni L, D’Alessandria C, Signore A. Nuclear medicine imaging of inflammatory/infective disorders of the abdomen. Nucl Med Commun. 2005;26(7):657–64.PubMedCrossRefGoogle Scholar
  3. 3.
    Legout L, D’Elia PV, Sarraz-Bournet B, Haulon S, Meybeck A, Senneville E, Leroy O. Diagnosis and management of prosthetic vascular graft infections. Med Mal Infect. 2012;42(3):102–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Seeger JM. Management of patients with prosthetic vascular graft infection. Am Surg. 2000;66(2):166–77.PubMedGoogle Scholar
  5. 5.
    FitzGerald SF, Kelly C, Humphreys H. Diagnosis and treatment of prosthetic aortic graft infections: confusion and inconsistency in the absence of evidence or consensus. J Antimicrob Chemother. 2005;56(6):996–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Antonios VS, Noel AA, Steckelberg JM, et al. Prosthetic vascular graft infection: a risk factor analysis using a case-control study. J Infect. 2006;53(1):49–55.PubMedCrossRefGoogle Scholar
  7. 7.
    Reilly LM, Stoney RJ, Goldstone J, Ehrenfeld WK. Improved management of aortic graft infection: the influence of operation sequence and staging. J Vasc Surg. 1987;5(3):421–31.PubMedCrossRefGoogle Scholar
  8. 8.
    Clagett GP, Valentine RJ, Hagino RT. Autogenous aortoiliac/femoral reconstruction from superficial femoral–popliteal veins: feasibility and durability. J. Vasc. Surg. 1997;25(2):255–70.PubMedCrossRefGoogle Scholar
  9. 9.
    O’Hara PJ, Hertzer NR, Beven EG, Krajewski LP. Surgical management of infected abdominal aortic grafts: review of a 25-year experience. J. Vasc. Surg. 1996;3(5):725–31.CrossRefGoogle Scholar
  10. 10.
    Lyons OTA, Baguneid M, Barwick TD, Bell RE, Foster N, Homer-Vanniasinkam S, Hopkins S, Hussain A, Katsanos K, Modarai B, Sandoe JAT, Thomas S, Price NM. Diagnosis of aortic graft infection: a case definition by the Management of Aortic Graft Infection Collaboration (MAGIC). Eur J Vasc Endovasc Surg. 2016;52(6):758–63.PubMedCrossRefGoogle Scholar
  11. 11.
    Sood A, Bhattacharya A, Aggarwal P, Basher RK, Mittal BR. 18F-FDG-labeled autologous leukocyte PET-CT in a patient with aortic valve-tube graft infection after Bentall procedure. Clin Nucl Med. 2019;44(3):e161–2.PubMedCrossRefGoogle Scholar
  12. 12.
    Bar-Shalom R, Yefremov N, Guralnik L, Keidar Z, Engel A, Nitecki S, Israel O. SPECT/CT using 67Ga and 111In-labeled leukocyte scintigraphy for diagnosis of infection. J Nucl Med. 2006;47(4):587–94.PubMedGoogle Scholar
  13. 13.
    Roll D, Hierholzer J, Cordes M, Hepp W, Langer M, Zwicker C, Felix R. Diagnostic evaluation of radioimmunoscintigraphy (RIS) using 123I-labeled monoclonal antibodies against human granulocytes (Mab-47) for the detection of prosthetic vascular graft infection. Int J Radiat Appl Instrum B Nucl Med Biol. 1991;18(1):135–40.CrossRefGoogle Scholar
  14. 14.
    Cordes M, Hepp W, Langer R, Pannhorst J, Hierholzer J, Felix R. Vascular graft infection: detection by 123I-labeled antigranulocyte antibody (anti-NCA95) scintigraphy. Nucl Med. 1991;30:173–7.Google Scholar
  15. 15.
    Cordes M, Hepp W, Barzen G, Langer R. Diagnostic evaluation of radioimmunoscintigraphy (RIS) with use of iodine 123-labeled antibodies against human granulocytes (123I-Anti-NCA95) for the detection of prosthetic vascular graft infection. J Vasc Surg. 1991;14(5):703–4.PubMedCrossRefGoogle Scholar
  16. 16.
    Venz S, Cordes M, Hepp W. (123I)-anti-NCA95 antibodies in diagnosis of bacterial wound infections after prosthetic vascular replacement. Comparison with computerized tomography. Vasa. 1994;23:138–44.PubMedGoogle Scholar
  17. 17.
    Tronco GG, Love C, Rini JN, Yu AK, Bhargava KK, Nichols KJ, Pugliese PV, Palestro CJ. Diagnosing prosthetic vascular graft infection with the antigranulocyte antibody 99mTc-fanolesomab. Nucl Med Commun. 2007;28(4):297–300.PubMedCrossRefGoogle Scholar
  18. 18.
    Roca M, de Vries EFJ, Jamar F, Israel O, Signore A. Guidelines for the labelling of leucocytes with 111In-oxine. Eur J Nucl Med Mol Imaging. 2010;37(4):835–41.PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    de Vries EFJ, Roca M, Jamar F, Israel O, Signore A. Guidelines for the labelling of leucocytes with 99mTc-HMPAO. Eur J Nucl Med Mol Imaging. 2010;37(4):842–8.PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Erba PA, Glaudemans AWJM, Veltman NC, Sollini M, Pacilio M, Galli F, Dierckx RAJO, Signore A. Image acquisition and interpretation criteria for 99mTc-HMPAO-labelled white blood cell scintigraphy: results of a multicentre study. Eur J Nucl Med Mol Imaging. 2014;41(4):615–23.PubMedCrossRefGoogle Scholar
  21. 21.
    Signore A, Jamar F, Israel O, Buscombe J, Martin-Comin J, Lazzeri E. Clinical indications, image acquisition and data interpretation for white blood cells and anti-granulocyte monoclonal antibody scintigraphy: an EANM procedural guideline. Eur J Nucl Med Mol Imaging. 2018;45(10):1816–31.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Khaja MS, Sildiroglu O, Hagspiel K, Rehm PK, Cherry KJ, Turba UC. Prosthetic vascular graft infection imaging. Clin Imaging. 2013;37(2):239–44.PubMedCrossRefGoogle Scholar
  23. 23.
    Erba PA, Leo G, Sollini M, Tascini C, Boni R, Berchiolli RN, Menichetti F, Ferrari M, Lazzeri E, Mariani G. Radiolabelled leucocyte scintigraphy versus conventional radiological imaging for the management of late, low-grade vascular prosthesis infections. Eur J Nucl Med Mol Imaging. 2014;41(2):357–68.PubMedCrossRefGoogle Scholar
  24. 24.
    Liberatore M, Iurilli AP, Ponzo F, et al. The clinical usefulness of technetium- 99m-HMPAO-labelled leukocyte scintigraphies in prosthetic vascular graft infection. J Nucl Med. 1998;39:875–9.PubMedGoogle Scholar
  25. 25.
    Liberatore M, Misuraca M, Calandri E, Rizzo L, Speziale F, Iurilli AP, Anagnostou C. White blood cell scintigraphy in the diagnosis of infection of endovascular prostheses within the first month after implantation. Med Sci Monit. 2006;12(3):MT5–9.PubMedGoogle Scholar
  26. 26.
    Jamar F, Buscombe J, Chiti A, Christian PE, Delbeke D, Donohoe KJ, Israel O, Martin-Comin J, Signore A. EANM/SNMMI guideline for 18F-FDG use in inflammation and infection. J Nucl Med. 2013;54(4):647–58.PubMedCrossRefGoogle Scholar
  27. 27.
    Husmann L, Huellner MW, Ledergerber B, Anagnostopoulos A, Stolzmann P, Sah B-R, Burger IA, Rancic Z, Hasse B. Comparing diagnostic accuracy of 18F-FDG-PET/CT, contrast enhanced CT and combined imaging in patients with suspected vascular graft infections. Eur J Nucl Med Mol Imaging. 2019;46(6):1359–68.PubMedCrossRefGoogle Scholar
  28. 28.
    Spacek M, Belohlavek O, Votrubova J, Sebesta P, Stadler P. Diagnostics of “non-acute” vascular prosthesis infection using 18F-FDG PET/CT: our experience with 96 prostheses. Eur J Nucl Med Mol Imaging. 2009;36(5):850–8.PubMedCrossRefGoogle Scholar
  29. 29.
    Tokuda Y, Oshima H, Araki Y, Narita Y, Mutsuga M, Kato K, Usui A. Detection of thoracic aortic prosthetic graft infection with 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Eur J Cardiothorac Surg. 2013;43(6):1183–7.PubMedCrossRefGoogle Scholar
  30. 30.
    Keidar Z, Pirmisashvili N, Leiderman M, Nitecki S, Israel O. 18F-FDG uptake in noninfected prosthetic vascular grafts: incidence, patterns, and changes over time. J Nucl Med. 2014;55(3):392–5.PubMedCrossRefGoogle Scholar
  31. 31.
    Saleem BR, Berger P, Vaartjes I, de Keizer B, Vonken E-JPA, Slart RHJA, de Borst GJ, Zeebregts CJ. Modest utility of quantitative measures in 18 F-fluorodeoxyglucose positron emission tomography scanning for the diagnosis of aortic prosthetic graft infection. J Vasc Surg. 2015;61(4):965–71.PubMedCrossRefGoogle Scholar
  32. 32.
    Bruggink JLM, Glaudemans AWJM, Saleem BR, Meerwaldt R, Alkefaji H, Prins TR, Slart RHJA, Zeebregts CJ. Accuracy of FDG-PET–CT in the diagnostic work-up of vascular prosthetic graft infection. Eur J Vasc Endovasc Surg. 2010;40(3):348–54.PubMedCrossRefGoogle Scholar
  33. 33.
    Keidar Z, Engel A, Hoffman A, Israel O, Nitecki S. Prosthetic vascular graft infection: the role of 18F-FDG PET/CT. J Nucl Med. 2007;48(8):1230–6.PubMedCrossRefGoogle Scholar
  34. 34.
    Saleem BR, Pol RA, Slart RHJA, Reijnen MMPJ, Zeebregts CJ. BioMed Res Int. 2014;2014:1–8.Google Scholar
  35. 35.
    Kim S-J, Lee S-W, Jeong SY, Pak K, Kim K. A systematic review and meta-analysis of 18F-fluorodeoxyglucose positron emission tomography or positron emission tomography/computed tomography for detection of infected prosthetic vascular grafts. J Vasc Surg. 2019;70(1):307–13.PubMedCrossRefGoogle Scholar
  36. 36.
    Dumarey N, Egrise D, Blocklet D, Stallenberg B, Remmelink M, del Marmol V, Van Simaeys G, Jacobs F, Goldman S. Imaging infection with 18F-FDG–labeled leukocyte PET/CT: initial experience in 21 patients. J Nucl Med. 2006;47:625–32.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Chiara Lauri
    • 1
  • Maurizio Taurino
    • 2
  • Alberto Signore
    • 1
  1. 1.Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine“Sapienza” University of RomeRomeItaly
  2. 2.Vascular Surgery Unit, Department of Clinical and Molecular Medicine“Sapienza” University of RomeRomeItaly

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