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Chronic prosthetic vascular graft infection visualized with technetium-99m-hexamethylpropyleneamine oxime-labeled
M Vorne1, R Laitinen, T Lantto
1Päijät-Häme Central Hospital, Lahti, Finland.
Abstract:
Technetium-99m-HMPAO labeled leukocytes demonstrated chronic femoro-femoral prosthetic vascular graft infection several times during an 18-mo period in a 77-yr-old man. The intensity and distribution of the uptake in the graft were fluctuating in different imaging occasions possibly indicating the strength and location of the infection. Gallium-67-citrate imaging showed negative results twice. The reason for negative 67Ga results remained obscure. The infected graft was removed and the patient did well 5 mo postoperatively.
Insights
Technetium-99m-HMPAO labeled leukocyte imaging effectively detected chronic prosthetic vascular graft infections. Fluctuating uptake patterns indicated infection severity, despite negative Gallium-67 scans.
Area of Science:
- Nuclear medicine
- Diagnostic imaging
- Infectious disease imaging
Background:
- Chronic prosthetic vascular graft infections pose significant diagnostic challenges.
- Accurate detection is crucial for timely intervention and improved patient outcomes.
Observation:
- A 77-year-old male patient with a history of femoro-femoral prosthetic vascular graft presented with suspected chronic infection.
- Serial imaging using Technetium-99m-HMPAO labeled leukocytes was performed over 18 months.
- Gallium-67-citrate imaging was also utilized but yielded negative results on two occasions.
Findings:
- Technetium-99m-HMPAO labeled leukocyte scintigraphy repeatedly demonstrated evidence of prosthetic vascular graft infection.
- The intensity and distribution of radiotracer uptake varied across imaging sessions, suggesting dynamic changes in infection.
- The discrepancy between positive leukocyte scans and negative Gallium-67 scans highlights potential limitations of Gallium-67 in certain infection scenarios.
Implications:
- Technetium-99m-HMPAO labeled leukocyte imaging is a valuable tool for diagnosing and monitoring chronic prosthetic vascular graft infections.
- Dynamic assessment of uptake patterns can provide insights into infection activity and extent.
- Further investigation may be warranted to understand the reasons for negative Gallium-67 results in the context of confirmed infection.