FDG-PET/CT as a diagnostic tool in vascular graft infection

a systematic review and meta-analysis

Synnøve Klyve Sunde, Therese Beske, Oke Gerke, Lene Langhoff Clausen, Søren Hess

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Purpose
Vascular graft infection (VGI) in central grafts is a rare but dreaded complication with a high mortality. Several imaging modalities are employed, all with pros and cons. Computed tomography is the standard, but lacks sensitivity for low-grade infections. There is still no consensus regarding the diagnostic modality of choice. The study objective was to assess the role of combined positron emission tomography and computed tomography with fluorodeoxyglucose (FDG-PET/CT) in the diagnostic workup of VGI in central grafts.

Methods
A systematic review was conducted according to the PRISMA guidelines through a search in Embase, PubMed, and Cochrane databases. Meta-analysis on accuracy measures was carried out with random effects models for three parameters: focal uptake, visual grading scale (VGS), and maximum standardized uptake value (SUVmax). Heterogeneity among studies was assessed with the I-squared test.

Results
A total of 307 studies were identified and 9 were eligible for inclusion. The pooled estimates for sensitivity and specificity for focal uptake were 90.6% (95% CI 81.7–99.4%) and 82.8% (95% CI 71.3–94.3%), respectively, for VGS 86.8% (95% CI 59.3–100%) and 69.4% (95% CI 39.9–98.9%), respectively, for SUVmax 92.8% (95% CI 83.2–100%) and 69.7% (95% CI 52.4–86.9%), respectively. A single study employed tissue-to-background ratio (TBR) and found sensitivity and specificity of 71.8% (95% CI 54.6–84.4%) and 70.4% (95% CI 51.5–84.2%), respectively.

Conclusions
According to this systematic review and meta-analysis, FDG-PET/CT performs well especially when using focal versus diffuse FDG uptake to diagnose VGI.
OriginalsprogEngelsk
TidsskriftClinical and Translational Imaging
Vol/bind7
Udgave nummer4
Sider (fra-til)255-265
ISSN2281-5872
DOI
StatusUdgivet - aug. 2019

Fingeraftryk

Meta-Analysis
PubMed
Databases
Guidelines
Positron Emission Tomography Computed Tomography

Citer dette

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title = "FDG-PET/CT as a diagnostic tool in vascular graft infection: a systematic review and meta-analysis",
abstract = "PurposeVascular graft infection (VGI) in central grafts is a rare but dreaded complication with a high mortality. Several imaging modalities are employed, all with pros and cons. Computed tomography is the standard, but lacks sensitivity for low-grade infections. There is still no consensus regarding the diagnostic modality of choice. The study objective was to assess the role of combined positron emission tomography and computed tomography with fluorodeoxyglucose (FDG-PET/CT) in the diagnostic workup of VGI in central grafts.MethodsA systematic review was conducted according to the PRISMA guidelines through a search in Embase, PubMed, and Cochrane databases. Meta-analysis on accuracy measures was carried out with random effects models for three parameters: focal uptake, visual grading scale (VGS), and maximum standardized uptake value (SUVmax). Heterogeneity among studies was assessed with the I-squared test.ResultsA total of 307 studies were identified and 9 were eligible for inclusion. The pooled estimates for sensitivity and specificity for focal uptake were 90.6{\%} (95{\%} CI 81.7–99.4{\%}) and 82.8{\%} (95{\%} CI 71.3–94.3{\%}), respectively, for VGS 86.8{\%} (95{\%} CI 59.3–100{\%}) and 69.4{\%} (95{\%} CI 39.9–98.9{\%}), respectively, for SUVmax 92.8{\%} (95{\%} CI 83.2–100{\%}) and 69.7{\%} (95{\%} CI 52.4–86.9{\%}), respectively. A single study employed tissue-to-background ratio (TBR) and found sensitivity and specificity of 71.8{\%} (95{\%} CI 54.6–84.4{\%}) and 70.4{\%} (95{\%} CI 51.5–84.2{\%}), respectively.ConclusionsAccording to this systematic review and meta-analysis, FDG-PET/CT performs well especially when using focal versus diffuse FDG uptake to diagnose VGI.",
keywords = "CT, Computed tomography, Infections, PET, Positron emission tomography, Vascular graft",
author = "Sunde, {Synn{\o}ve Klyve} and Therese Beske and Oke Gerke and {Langhoff Clausen}, Lene and S{\o}ren Hess",
year = "2019",
month = "8",
doi = "10.1007/s40336-019-00336-1",
language = "English",
volume = "7",
pages = "255--265",
journal = "Clinical and Translational Imaging",
issn = "2281-5872",
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FDG-PET/CT as a diagnostic tool in vascular graft infection : a systematic review and meta-analysis. / Sunde, Synnøve Klyve; Beske, Therese; Gerke, Oke; Langhoff Clausen, Lene; Hess, Søren.

I: Clinical and Translational Imaging, Bind 7, Nr. 4, 08.2019, s. 255-265.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - FDG-PET/CT as a diagnostic tool in vascular graft infection

T2 - a systematic review and meta-analysis

AU - Sunde, Synnøve Klyve

AU - Beske, Therese

AU - Gerke, Oke

AU - Langhoff Clausen, Lene

AU - Hess, Søren

PY - 2019/8

Y1 - 2019/8

N2 - PurposeVascular graft infection (VGI) in central grafts is a rare but dreaded complication with a high mortality. Several imaging modalities are employed, all with pros and cons. Computed tomography is the standard, but lacks sensitivity for low-grade infections. There is still no consensus regarding the diagnostic modality of choice. The study objective was to assess the role of combined positron emission tomography and computed tomography with fluorodeoxyglucose (FDG-PET/CT) in the diagnostic workup of VGI in central grafts.MethodsA systematic review was conducted according to the PRISMA guidelines through a search in Embase, PubMed, and Cochrane databases. Meta-analysis on accuracy measures was carried out with random effects models for three parameters: focal uptake, visual grading scale (VGS), and maximum standardized uptake value (SUVmax). Heterogeneity among studies was assessed with the I-squared test.ResultsA total of 307 studies were identified and 9 were eligible for inclusion. The pooled estimates for sensitivity and specificity for focal uptake were 90.6% (95% CI 81.7–99.4%) and 82.8% (95% CI 71.3–94.3%), respectively, for VGS 86.8% (95% CI 59.3–100%) and 69.4% (95% CI 39.9–98.9%), respectively, for SUVmax 92.8% (95% CI 83.2–100%) and 69.7% (95% CI 52.4–86.9%), respectively. A single study employed tissue-to-background ratio (TBR) and found sensitivity and specificity of 71.8% (95% CI 54.6–84.4%) and 70.4% (95% CI 51.5–84.2%), respectively.ConclusionsAccording to this systematic review and meta-analysis, FDG-PET/CT performs well especially when using focal versus diffuse FDG uptake to diagnose VGI.

AB - PurposeVascular graft infection (VGI) in central grafts is a rare but dreaded complication with a high mortality. Several imaging modalities are employed, all with pros and cons. Computed tomography is the standard, but lacks sensitivity for low-grade infections. There is still no consensus regarding the diagnostic modality of choice. The study objective was to assess the role of combined positron emission tomography and computed tomography with fluorodeoxyglucose (FDG-PET/CT) in the diagnostic workup of VGI in central grafts.MethodsA systematic review was conducted according to the PRISMA guidelines through a search in Embase, PubMed, and Cochrane databases. Meta-analysis on accuracy measures was carried out with random effects models for three parameters: focal uptake, visual grading scale (VGS), and maximum standardized uptake value (SUVmax). Heterogeneity among studies was assessed with the I-squared test.ResultsA total of 307 studies were identified and 9 were eligible for inclusion. The pooled estimates for sensitivity and specificity for focal uptake were 90.6% (95% CI 81.7–99.4%) and 82.8% (95% CI 71.3–94.3%), respectively, for VGS 86.8% (95% CI 59.3–100%) and 69.4% (95% CI 39.9–98.9%), respectively, for SUVmax 92.8% (95% CI 83.2–100%) and 69.7% (95% CI 52.4–86.9%), respectively. A single study employed tissue-to-background ratio (TBR) and found sensitivity and specificity of 71.8% (95% CI 54.6–84.4%) and 70.4% (95% CI 51.5–84.2%), respectively.ConclusionsAccording to this systematic review and meta-analysis, FDG-PET/CT performs well especially when using focal versus diffuse FDG uptake to diagnose VGI.

KW - CT

KW - Computed tomography

KW - Infections

KW - PET

KW - Positron emission tomography

KW - Vascular graft

U2 - 10.1007/s40336-019-00336-1

DO - 10.1007/s40336-019-00336-1

M3 - Journal article

VL - 7

SP - 255

EP - 265

JO - Clinical and Translational Imaging

JF - Clinical and Translational Imaging

SN - 2281-5872

IS - 4

ER -