A Head-to-Head Comparison Between [(18)F]Fluorodeoxyglucose ([(18)F]FDG) Positron Emission Tomography/Computed Tomography (PET/CT) and (99m)Technetium-Hexamethylpropylene Amine Oxime (HMPAO)-Labeled Leukocyte Scintigraphy in a Case Series of Patients with Suspected Vascular Prosthesis Infection: To Trust Is Good, but to Check Is Better

在疑似血管假体感染病例系列中,对[(18)F]氟代脱氧葡萄糖([(18)F]FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)和(99m)锝-六甲基丙烯胺肟(HMPAO)标记白细胞闪烁显像进行直接比较:信任固然好,但核实更佳

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Abstract

Background: Prosthetic vascular graft infection (PVGI) is a serious complication associated with vascular prostheses. Nuclear medicine techniques, including [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and (99m)technetium-hexamethylpropylene amine oxime (HMPAO)-labeled leukocyte (WBC) scintigraphy, are part of the MAGIC diagnostic criteria for PVGI. Methods: In this retrospective study, we analyzed eight patients with suspected PVGI who underwent both [(18)F]FDG PET/CT and WBC scintigraphy within an average of 8 days. Results: Of all eight patients (median age 69 years), three showed concordant positive results with both PET/CT and WBC, and their final diagnosis confirmed the presence of infection; five showed discordant results: in all five of these patients, PET/CT showed false-positive findings, whereas WBC correctly identified five true-negative cases. Conclusions: [(18)F]FDG PET/CT is highly sensitive but prone to false positives. WBC scintigraphy, combined with SPECT/CT, particularly in the evaluation of the treatment response, showed greater specificity, and it may warrant consideration as a MAGIC major diagnostic criterion for PVGI.

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