FDG-PET for the detection of infected vascular grafts

Graft infection following prosthetic vascular reconstruction is an uncommon but severe complication. The clinical presentation is often subtle and non-specific and may occur long after surgery. While defining a prosthetic vascular graft infection can be difficult, early diagnosis and treatment are essential for the correct choice of treatment in order to prevent further complications as well as the high morbidity and mortality associated with repeat surgery and removal of infected grafts. False positive results may lead to unnecessary surgery while failure to diagnose graft infection may have life-threatening sequels. Scarce literature that is currently available regarding the role of fluorodeoxyglucose (FDG) imaging for assessment of vascular graft infection suggests that this modality may represent reliable non-invasive imaging modality in this specific clinical setting. Hybrid positron emission tomography (PET)/computed tomography (CT), combining CT with PET, increases the test specificity and thus improves diagnostic accuracy. The precise anatomic localization of increased FDG uptake provided by PET/CT enables accurate differentiation between graft and adjacent soft tissue infection leading to more accurate diagnosis and subsequent optimized therapeutic strategy.