Evidence-based guideline of the European Association of Nuclear Medicine (EANM) on imaging infection in vascular grafts.
(2022) European Journal of Nuclear Medicine and Molecular Imaging — Vol. 49, n° 10, p. 3430-3451 (2022)
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Lauri, Chiara 
- Abstract
- (en) PURPOSE: Consensus on optimal imaging procedure for vascular graft/endograft infection (VGEI) is still lacking and the choice of a diagnostic test is often based on the experience of single centres. This document provides evidence-based recommendations aiming at defining which imaging modality may be preferred in different clinical settings and post-surgical time window. METHODS: This working group includes 6 nuclear medicine physicians appointed by the European Association of Nuclear Medicine, 4 vascular surgeons, and 2 radiologists. Vascular surgeons formulated 5 clinical questions that were converted into 10 statements and addressed through a systematic analysis of available literature by using PICOs (Population/problem-Intervention/Indicator-Comparator-Outcome) strategy. Each consensus statement was scored for level of evidence and for recommendation grade, according to the Oxford Centre for Evidence-based Medicine criteria. RESULTS: Sixty-six articles, published from January 2000 up to December 2021, were analysed and used for evidence-based recommendations. CONCLUSION: Computed tomography angiography (CTA) is the first-line imaging modality in suspected VGEI but nuclear medicine modalities are often needed to confirm or exclude the infection. Positron emission tomography/computed tomography (PET/CT) with 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) has very high negative predictive value but it should be performed preferably at least 4 months after surgery to avoid false positive results. Radiolabelled white blood cell (WBC) scintigraphy, given its high diagnostic accuracy, can be performed at any time after surgery.
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Lauri, C., Signore, A., Glaudemans, A. W. J. M., Treglia, G., Gheysens, O., Slart, R. H. J. A., Iezzi, R., Prakken, N. H. J., Debus, E. S., Honig, S., Lejay, A., & Chakfé, N. (2022). Evidence-based guideline of the European Association of Nuclear Medicine (EANM) on imaging infection in vascular grafts. European Journal of Nuclear Medicine and Molecular Imaging, 49(10), 3430-3451. https://doi.org/10.1007/s00259-022-05769-x (Original work published 2022)