Analysis of the utility of 2-[18F]FDG PET/CT in the diagnosis of vascular graft infection

Background: As a result of constantly improving surgical methods, an increasing number of patients have medical devices implanted in the cardiovascular system (including vascular grafts and endografts). Such patients are characterised by their high risk of infectious complications due to the possibility of biofilm formation on implanted material. This work aims to analyse the utility of 2-[18F]FDG PET/CT in diagnosing vascular graft and endograft infections. Material and methods: The study was undertaken on a group of 58 patients, of whom 34 were in the study group, and 24 were in the control group. The 2-[18F]FDG PET/CT study was conducted in the Nuclear Medicine Department at the University Hospital of Lublin. The inclusion criteria for the study group were the presence of a vascular graft or endograft that encompasses the aorta, and strong clinical suspicion of its infection. The inclusion criteria for the control group were the presence of a vascular graft or endograft in the large arteries and the absence of signs of its infection on 2-[18F]FDG PET/CT, as well as the absence of clinically apparent signs and symptoms during six months of observation after 2-[18F]FDG PET/CT. All patients found in the database that met the criteria were included. Results: Vascular endografts were more common in the control group than in the study group. However, in the case of infection of the vascular endograft, signs of infection in 2-[18F]FDG PET/CT were more severe. Images in the study group were divided into three groups that represent image patterns based on CT and PET characteristics. The first pattern (P1) was recognised in six patients. The second (P2) and third (P3) were visible in 11 and 17 patients, respectively. Conclusions: Comparative analysis of the study and control groups demonstrates the utility of 2-[18F]FDG PET/CT in the diagnosis of vascular graft/endograft infection

Role of 18F-FDG PET/CT in the diagnosis of inflammatory and infectious vascular disease

This review article discusses the utility of 18F-FDG PET/CT in diagnosis and management of vascular disease. We stress usefulness of this method in large vessel inflammation and infection. In our work we based on the literature analysis and clinical cases diagnosed in our institution by use of 18F-FDG PET/CT. The literature exploration was focusing on vascular inflammation and infections and 18-FDG PET. The search was performed on PubMed database and cross referencing. We present the practical review with several images of vascular diseases like: Takayasu arteritis, giant cell arteritis, vascular graft infections, abdominal aortic aneurysm infections and cases of aortitis and periaortitis. From this work inflammation associated with atheromatic process and vulnerable atherosclerotic plaque we excluded. 18F-FGD PET/CT is a sensitive metabolic, reliable, non-invasive imaging modality suitable for diagnosis and follow-up of inflammation and infections in vascular system. This review article discusses the utility of 18F-FDG PET/CT in diagnosis and management of vascular disease. We stress usefulness of this method in large vessel inflammation and infection. In our work we based on the literature analysis and clinical cases diagnosed in our institution by use of 18F-FDG PET/CT. The literature exploration was focusing on vascular inflammation and infections and 18-FDG PET. The search was performed on PubMed database and cross referencing. We present the practical review with several images of vascular diseases like: Takayasu arteritis, giant cell arteritis, vascular graft infections, abdominal aortic aneurysm infections and cases of aortitis and periaortitis. From this work inflammation associated with atheromatic process and vulnerable atherosclerotic plaque we excluded. 18F-FGD PET/CT is a sensitive metabolic, reliable, non-invasive imaging modality suitable for diagnosis and follow-up of inflammation and infections in vascular system

Normal ranges of renal function parameters for 99mTc-EC renal scintigraphy

BACKGROUND: Dynamic renal scintigraphy remains the recognized method for evaluation of kidney function and perfusion.Although there is an extensive body of knowledge about the use of technetium-99m-mercaptoacetyltriglycine (99mTc-MAG3),much less has been written about renal technetium-99m-ethylenedicysteine (99mTc-EC) scintigraphy.The aim of this study was to determine the normal value of renal function parameters in 99mTc-EC dynamic renal scintigraphy:Tmax and T1/2. The effects of age, left or right side in the retroperitoneal space, and sex on those parameters were examined.MATERIAL AND METHODS: The research was conducted on 123 patients (F/M: 70/53; aged 2–71; averaging 14.8 years ofage) with at least one normal kidney. A total of 194 healthy kidneys were examined, including pediatric kidneys.RESULTS: According to this study, the normal value of Tmax is 2.85 min (± 1.16) and T1/2 is 8.7 min (± 3.61). Values calculatedfor pediatric studies are Tmax is 2.81 (± 1.16) and T1/2 is 8.63 (± 3.71).CONCLUSIONS: The normal value of secretory and excretory renal function parameters was calculated. Although the valueis slightly lower for children, this is not statistically significant, as globally there are no differences between the kidney-locationsides and sexes for any parameter

Patterns of vascular graft infection in 18F-FDG PET/CT

BACKGROUND: 18F-FDG PET/CT has become an important tool in diagnosis of prosthetic vascular graft infections (PVGI). The aim of the study was to identify the patterns of vascular graft infection in 18F-FDG PET/CT. MATERIAL AND METHODS: The study was performed in 24 patients with vascular graft infection, in 17 patients implanted in an open surgery mode and in 7 patients by endovascular aortic repair (EVAR). Vascular prostheses were evaluated by two visual scales and semi-quantitative analysis with maximum standardized uptake values (SUV max). RESULTS: In the 3-point scale: 23 patients were in grade 1 and one patient was in grade 2. In the 5-point scale: 19 patients were in grade 5 with the highest activity in the focal area, 4 patients were in grade 4 and one patient in grade 3. The visual evaluation of 18F-FDG PET/CT study revealed that peri-graft high metabolic activity was associated with occurrence of morphological abnormalities (n = 21) like gas bubbles and peri-graft fluid retention or without abnormal CT findings (n = 3). The presence of the gas bubbles was linked to higher uptake of 18F-FDG (p < 0.01, SUVmax 11.81 ± 4.35 vs 7.36 ± 2.80, 15 vs 9 pts). In EVAR procedure, the highest metabolic activity was greater than in classical prosthesis (SUVmax 21.5 vs 13). CONCLUSIONS: 18F-FDG PET/CT is a very useful tool for assessment of vascular graft infections. CT findings like gas bubbles, or peri-graft fluid retention were associated with significantly higher glucose metabolism; however, in some cases without anatomic alterations, increased metabolic activity was the only sign of infection

The usefulness of SPECT/CT in characterization of skeletal and soft tissue lesions — report of two cases

SPECT/CT imaging provides detailed information on the radiotracer distribution and enables simultaneous lesion morphology evaluation. This hybrid imaging delivers complementary information about patient’s disease. We present two cases in which SPECT/CT imaging and cooperation between the nuclear medicine physician and radiologist quickly clarified the diagnosis, sparing patient unnecessary diagnostic procedures or treatment

Subclinical hyperthyroidism in the course of autonomous nodules — clinical evaluation

Introduction: Subclinical hyperthyroidism (SCH), also known as mildly symptomatic hyperthyroidism, has recently been diagnosed more frequently. One of the main endogenous causes of this disorder is autonomously functioning thyroid nodule (AFTN). Despite the fact that it is usually asymptomatic, SCH entails repercussions on the cardiovascular system and bone, and it carries a risk of progression to overt hyperthyroidism with a typical clinical picture. Treatment is still controversial, and its benefits are widely debated in literature. Material and methods: From 459 patients authors selected a group of 49 patients (10.6% of all subjects with hyperthyroidism), 41 women (83.7%) with AFTN at the stage SCH treated in the Outpatient Endocrinological Clinic and the Department of Endocrinology of the Medical University of Lublin over a three-year period. The method applied in the study was a retrospective analysis of medical records with a particular account of medical history, physical examination, and additional tests obtained during the process of diagnostic and therapeutic procedures. Results: Forty-one patients (83.7%) suffered from typical symptoms of hyperthyroidism; only eight patients (16.3%) were asymptomatic. The most frequently reported symptoms were tachycardia in women (51.2%) and anxiety in men (50%). The type of thyrostatic drugs and the length of therapy did not affect the outcome of iodine-131 therapy. In the vast majority of the patients (87.8%) radioidodine therapy was effective; 30 patients (61.2%) reached euthyreosis and 13 patients (22.5%) developed hypothyroidism. Conclusions: Most patients with SCH in the course of AFTN suffered from typical symptoms of overt hyperthyroidism; only every sixth patient was asymptomatic. The volume of autonomous adenomas did not affect the result of 131I therapy; however, the impact of AFTN volume as well as the thyroid volume on RIT efficacy requires futher investigation. In the vast majority of patients 131I therapy was an effective method of treatment, and an earlier therapeutic effect was observed more often in the patients with focal lesions located in theright lobe.