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Jean-baptiste Pinaquy - One of the best experts on this subject based on the ideXlab platform.
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retrospective study comparing wbc scan and 18f fdg pet ct in patients with suspected Prosthetic Vascular Graft infection
European Journal of Vascular and Endovascular Surgery, 2019Co-Authors: M. Puges, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Jean-baptiste Ruiz, Frederic Debordeaux, Arnaud Desclaux, Arnaud Hocquelet, Jean-baptiste PinaquyAbstract:Objectives Prosthetic Vascular Graft infections (PVGIs) are associated with high mortality rates. To improve treatment outcome, an early and definite diagnosis is critical, and current diagnostic criteria are often insufficient. The accuracy of 2-deoxy-2-[fluorine-18]-fluoro- d -glucose positron emission tomography integrated with computed tomography (18F-FDG PET/CT) and white blood cell (WBC) scan for the diagnosis of PVGI were compared. Methods A retrospective single centre study was conducted on patients undergoing WBC scan and 18F-FDG PET/CT for a suspected PVGI between April 2013 and June 2016 at the Bordeaux University Hospital, France. The diagnostic value of both imaging tests was assessed for all Grafts, using receiver operating characteristic (ROC) curve analysis. Images were independently interpreted by two nuclear medicine physicians blinded to the patients’ clinical and other imaging data. Results Thirty-nine patients were included, of whom 15 had PVGI. Antibiotic treatment was started before nuclear imaging for 16 patients, including nine patients with a PVGI. The 96 Grafts of these patients were analysed, and 19 were infected. The diagnostic value of the WBC scan was significantly higher than 18F-FDG PET/CT (ROC AUC = 0.902, 95% CI 0.824–0.980, and 0.759, CI 95% (0.659–0.858), respectively, p = .0071). Interobserver agreement was good for 18F-FDG PET/CT and excellent for WBC scan (kappa value of 0.76, 95% CI 0.62–0.9, and 0.97, 95% CI 0.92–1, respectively). Only one patient had a false negative 18F-FDG PET/CT result under antibiotic therapy. Conclusion The WBC scan has a better diagnostic value than 18F-FDG PET/CT for PVGI diagnosis.
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Retrospective Study Comparing WBC scan and 18F-FDG PET/CT in Patients with Suspected Prosthetic Vascular Graft Infection
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 2019Co-Authors: M. Puges, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Jean-baptiste Ruiz, Frederic Debordeaux, Arnaud Desclaux, Arnaud Hocquelet, Jean-baptiste PinaquyAbstract:Objectives Prosthetic Vascular Graft infections (PVGIs) are associated with high mortality rates. To improve treatment outcome, an early and definite diagnosis is critical, and current diagnostic criteria are often insufficient. The accuracy of 2-deoxy-2-[fluorine-18]-fluoro- d -glucose positron emission tomography integrated with computed tomography (18F-FDG PET/CT) and white blood cell (WBC) scan for the diagnosis of PVGI were compared. Methods A retrospective single centre study was conducted on patients undergoing WBC scan and 18F-FDG PET/CT for a suspected PVGI between April 2013 and June 2016 at the Bordeaux University Hospital, France. The diagnostic value of both imaging tests was assessed for all Grafts, using receiver operating characteristic (ROC) curve analysis. Images were independently interpreted by two nuclear medicine physicians blinded to the patients’ clinical and other imaging data. Results Thirty-nine patients were included, of whom 15 had PVGI. Antibiotic treatment was started before nuclear imaging for 16 patients, including nine patients with a PVGI. The 96 Grafts of these patients were analysed, and 19 were infected. The diagnostic value of the WBC scan was significantly higher than 18F-FDG PET/CT (ROC AUC = 0.902, 95% CI 0.824–0.980, and 0.759, CI 95% (0.659–0.858), respectively, p = .0071). Interobserver agreement was good for 18F-FDG PET/CT and excellent for WBC scan (kappa value of 0.76, 95% CI 0.62–0.9, and 0.97, 95% CI 0.92–1, respectively). Only one patient had a false negative 18F-FDG PET/CT result under antibiotic therapy. Conclusion The WBC scan has a better diagnostic value than 18F-FDG PET/CT for PVGI diagnosis.
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An unexpected case of Bartonella alsatica Prosthetic Vascular Graft infection
Infection and Drug Resistance, 2019Co-Authors: Mathilde Puges, Armelle Ménard, Xavier Berard, Magalie Geneviève, Jean-baptiste Pinaquy, Sophie Edouard, Sabine Pereyre, Charles CazanaveAbstract:Bartonella alsatica is a wild rabbit pathogen causing bacteremia rarely reported in humans, with only three cases published so far, including one lymphadenitis and two endocarditis cases. Here, we report the case of a 66-year-old man who suffered from acute renal failure due to a membranoproliferative glomerulonephritis. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) showed diffuse FDG uptake around the aortobifemoral Graft with no indication of infection. A white blood cell scan showed an accumulation of labeled neutrophils on the left femoral part of the Graft. The patient underwent surgery and an abscess around the left iliac part of the Graft was found intraoperatively. Intraoperative samples were all negative, but 16S rRNA gene-based PCR was positive, and the sequence was positioned among the Bartonella species cluster. Specific PCRs targeting groEL/hsp60, rpoB and gltA genes were performed and led to the identification of B. alsatica. Accordingly, indirect immunofluorescence serological analyses were positive for Bartonella henselae and Bartonella quintana. The patient had a history of regularly hunting wild rabbits. He was treated with 100 mg of doxycycline twice a day for six months and his renal function significantly improved with no sign of persistent infection. This case highlights the contribution of serology assays and molecular-based methods in Prosthetic Vascular Graft infection diagnosis.
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Should White Blood Cell Scan be Replaced by 18F-FDG PET-CT in the Diagnosis of Prosthetic Vascular Graft Infection?
Annals of vascular surgery, 2015Co-Authors: Jean-baptiste Pinaquy, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Ghoufrane Tlili, Fatima M’zali, Stéphane Mayeux, Charles CazanaveAbstract:Diagnosis of Prosthetic Vascular Graft infection (PVGI) is a clinical challenge requiring accurate diagnostic methods for their optimal management. A 65-year-old patient with suspected PVGI was explored by fluorodeoxyglucose positron emission tomography combined with computed tomography ( 18 F-FDG PET-CT) for pretreatment staging. Standard imaging was unrevealing but PET images showed multiple foci with increased uptake suggesting Prosthetic infection. While routine results from the diagnostic laboratory were negative, prosthesis sonication before standard culture revealed the same bacterium as a culture of preoperative lymphocele aspiration. 18 F-FDG PET-CT and preliminary sonication of the Prosthetic Graft could be very helpful in the diagnosis of PVGI especially for highlighting biofilm bacteria.
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Should white blood cell scan be replaced by (18)F-FDG PET-CT in the diagnosis of Prosthetic Vascular Graft infection?
Annals of Vascular Surgery, 2015Co-Authors: Jean-baptiste Pinaquy, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Ghoufrane Tlili, Stéphane Mayeux, Fatima M'zali, Charles CazanaveAbstract:Diagnosis of Prosthetic Vascular Graft infection (PVGI) is a clinical challenge requiring accurate diagnostic methods for their optimal management. A 65-year-old patient with suspected PVGI was explored by fluorodeoxyglucose positron emission tomography combined with computed tomography ((18)F-FDG PET-CT) for pretreatment staging. Standard imaging was unrevealing but PET images showed multiple foci with increased uptake suggesting Prosthetic infection. While routine results from the diagnostic laboratory were negative, prosthesis sonication before standard culture revealed the same bacterium as a culture of preoperative lymphocele aspiration. (18)F-FDG PET-CT and preliminary sonication of the Prosthetic Graft could be very helpful in the diagnosis of PVGI especially for highlighting biofilm bacteria.
Charles Cazanave - One of the best experts on this subject based on the ideXlab platform.
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An unexpected case of Bartonella alsatica Prosthetic Vascular Graft infection
Infection and Drug Resistance, 2019Co-Authors: Mathilde Puges, Armelle Ménard, Xavier Berard, Magalie Geneviève, Jean-baptiste Pinaquy, Sophie Edouard, Sabine Pereyre, Charles CazanaveAbstract:Bartonella alsatica is a wild rabbit pathogen causing bacteremia rarely reported in humans, with only three cases published so far, including one lymphadenitis and two endocarditis cases. Here, we report the case of a 66-year-old man who suffered from acute renal failure due to a membranoproliferative glomerulonephritis. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) showed diffuse FDG uptake around the aortobifemoral Graft with no indication of infection. A white blood cell scan showed an accumulation of labeled neutrophils on the left femoral part of the Graft. The patient underwent surgery and an abscess around the left iliac part of the Graft was found intraoperatively. Intraoperative samples were all negative, but 16S rRNA gene-based PCR was positive, and the sequence was positioned among the Bartonella species cluster. Specific PCRs targeting groEL/hsp60, rpoB and gltA genes were performed and led to the identification of B. alsatica. Accordingly, indirect immunofluorescence serological analyses were positive for Bartonella henselae and Bartonella quintana. The patient had a history of regularly hunting wild rabbits. He was treated with 100 mg of doxycycline twice a day for six months and his renal function significantly improved with no sign of persistent infection. This case highlights the contribution of serology assays and molecular-based methods in Prosthetic Vascular Graft infection diagnosis.
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Should White Blood Cell Scan be Replaced by 18F-FDG PET-CT in the Diagnosis of Prosthetic Vascular Graft Infection?
Annals of vascular surgery, 2015Co-Authors: Jean-baptiste Pinaquy, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Ghoufrane Tlili, Fatima M’zali, Stéphane Mayeux, Charles CazanaveAbstract:Diagnosis of Prosthetic Vascular Graft infection (PVGI) is a clinical challenge requiring accurate diagnostic methods for their optimal management. A 65-year-old patient with suspected PVGI was explored by fluorodeoxyglucose positron emission tomography combined with computed tomography ( 18 F-FDG PET-CT) for pretreatment staging. Standard imaging was unrevealing but PET images showed multiple foci with increased uptake suggesting Prosthetic infection. While routine results from the diagnostic laboratory were negative, prosthesis sonication before standard culture revealed the same bacterium as a culture of preoperative lymphocele aspiration. 18 F-FDG PET-CT and preliminary sonication of the Prosthetic Graft could be very helpful in the diagnosis of PVGI especially for highlighting biofilm bacteria.
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Should white blood cell scan be replaced by (18)F-FDG PET-CT in the diagnosis of Prosthetic Vascular Graft infection?
Annals of Vascular Surgery, 2015Co-Authors: Jean-baptiste Pinaquy, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Ghoufrane Tlili, Stéphane Mayeux, Fatima M'zali, Charles CazanaveAbstract:Diagnosis of Prosthetic Vascular Graft infection (PVGI) is a clinical challenge requiring accurate diagnostic methods for their optimal management. A 65-year-old patient with suspected PVGI was explored by fluorodeoxyglucose positron emission tomography combined with computed tomography ((18)F-FDG PET-CT) for pretreatment staging. Standard imaging was unrevealing but PET images showed multiple foci with increased uptake suggesting Prosthetic infection. While routine results from the diagnostic laboratory were negative, prosthesis sonication before standard culture revealed the same bacterium as a culture of preoperative lymphocele aspiration. (18)F-FDG PET-CT and preliminary sonication of the Prosthetic Graft could be very helpful in the diagnosis of PVGI especially for highlighting biofilm bacteria.
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18F-FDG PET-CT in suspected Prosthetic Vascular Graft infection.
Annals of vascular surgery, 2014Co-Authors: Jean-baptiste Pinaquy, Charles Cazanave, Laurent Stecken, Laurence Bordenave, Ghoufrane Tlili, Xavier BerardAbstract:Background Diagnosis of Prosthetic Vascular Graft infections is a clinical challenge, and surgical therapy is associated with comorbidity. Therefore, accurate diagnostic methods are required for their optimal management. Methods A 61-year-old-patient presented with erysipelas of the right lower limb 7 months after receiving a hybrid femoropopliteal bypass composed of a saphenous vein distally and external supported polytetrafluoroethylene proximally. He had been first treated for suspicious of septic arterial thrombosis or false aneurysm with antibiotics. A computed tomography (CT) angiogram was performed to detect any potential infection of the bypass and to explore erysipelas. It revealed a subcutaneous infiltration and an infiltration of the right groin but no anastomotic pseudoaneurysm or thrombosis of the bypass. The 2-[18F]-fluoro-2-desoxy- d -glucose positron emission tomography (18F-FDG PET) evidenced a significant uptake of cutaneous and subcutaneous tissue but no uptake on the Vascular Prosthetic Graft. Therefore, the bypass was considered as noninfected and antibiotics were continued for 3 months. A physical examination on antibiotic cessation revealed a nonerythematous thigh with a C-reactive protein level significantly decreased to 36 mg/L and a normal white blood cell count. A PET scan confirmed this clinical improvement as attested by a dramatically decreased uptake of cutaneous and subcutaneous tissues and still no uptake of the Graft. Conclusions In conclusion, this case highlights the role that 18F-FDG PET-CT may play in excluding suspected Prosthetic Graft infection, thanks to its high sensitivity and in avoiding needless revision surgery with subsequent comorbidities.
Xavier Berard - One of the best experts on this subject based on the ideXlab platform.
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retrospective study comparing wbc scan and 18f fdg pet ct in patients with suspected Prosthetic Vascular Graft infection
European Journal of Vascular and Endovascular Surgery, 2019Co-Authors: M. Puges, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Jean-baptiste Ruiz, Frederic Debordeaux, Arnaud Desclaux, Arnaud Hocquelet, Jean-baptiste PinaquyAbstract:Objectives Prosthetic Vascular Graft infections (PVGIs) are associated with high mortality rates. To improve treatment outcome, an early and definite diagnosis is critical, and current diagnostic criteria are often insufficient. The accuracy of 2-deoxy-2-[fluorine-18]-fluoro- d -glucose positron emission tomography integrated with computed tomography (18F-FDG PET/CT) and white blood cell (WBC) scan for the diagnosis of PVGI were compared. Methods A retrospective single centre study was conducted on patients undergoing WBC scan and 18F-FDG PET/CT for a suspected PVGI between April 2013 and June 2016 at the Bordeaux University Hospital, France. The diagnostic value of both imaging tests was assessed for all Grafts, using receiver operating characteristic (ROC) curve analysis. Images were independently interpreted by two nuclear medicine physicians blinded to the patients’ clinical and other imaging data. Results Thirty-nine patients were included, of whom 15 had PVGI. Antibiotic treatment was started before nuclear imaging for 16 patients, including nine patients with a PVGI. The 96 Grafts of these patients were analysed, and 19 were infected. The diagnostic value of the WBC scan was significantly higher than 18F-FDG PET/CT (ROC AUC = 0.902, 95% CI 0.824–0.980, and 0.759, CI 95% (0.659–0.858), respectively, p = .0071). Interobserver agreement was good for 18F-FDG PET/CT and excellent for WBC scan (kappa value of 0.76, 95% CI 0.62–0.9, and 0.97, 95% CI 0.92–1, respectively). Only one patient had a false negative 18F-FDG PET/CT result under antibiotic therapy. Conclusion The WBC scan has a better diagnostic value than 18F-FDG PET/CT for PVGI diagnosis.
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Retrospective Study Comparing WBC scan and 18F-FDG PET/CT in Patients with Suspected Prosthetic Vascular Graft Infection
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 2019Co-Authors: M. Puges, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Jean-baptiste Ruiz, Frederic Debordeaux, Arnaud Desclaux, Arnaud Hocquelet, Jean-baptiste PinaquyAbstract:Objectives Prosthetic Vascular Graft infections (PVGIs) are associated with high mortality rates. To improve treatment outcome, an early and definite diagnosis is critical, and current diagnostic criteria are often insufficient. The accuracy of 2-deoxy-2-[fluorine-18]-fluoro- d -glucose positron emission tomography integrated with computed tomography (18F-FDG PET/CT) and white blood cell (WBC) scan for the diagnosis of PVGI were compared. Methods A retrospective single centre study was conducted on patients undergoing WBC scan and 18F-FDG PET/CT for a suspected PVGI between April 2013 and June 2016 at the Bordeaux University Hospital, France. The diagnostic value of both imaging tests was assessed for all Grafts, using receiver operating characteristic (ROC) curve analysis. Images were independently interpreted by two nuclear medicine physicians blinded to the patients’ clinical and other imaging data. Results Thirty-nine patients were included, of whom 15 had PVGI. Antibiotic treatment was started before nuclear imaging for 16 patients, including nine patients with a PVGI. The 96 Grafts of these patients were analysed, and 19 were infected. The diagnostic value of the WBC scan was significantly higher than 18F-FDG PET/CT (ROC AUC = 0.902, 95% CI 0.824–0.980, and 0.759, CI 95% (0.659–0.858), respectively, p = .0071). Interobserver agreement was good for 18F-FDG PET/CT and excellent for WBC scan (kappa value of 0.76, 95% CI 0.62–0.9, and 0.97, 95% CI 0.92–1, respectively). Only one patient had a false negative 18F-FDG PET/CT result under antibiotic therapy. Conclusion The WBC scan has a better diagnostic value than 18F-FDG PET/CT for PVGI diagnosis.
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An unexpected case of Bartonella alsatica Prosthetic Vascular Graft infection
Infection and Drug Resistance, 2019Co-Authors: Mathilde Puges, Armelle Ménard, Xavier Berard, Magalie Geneviève, Jean-baptiste Pinaquy, Sophie Edouard, Sabine Pereyre, Charles CazanaveAbstract:Bartonella alsatica is a wild rabbit pathogen causing bacteremia rarely reported in humans, with only three cases published so far, including one lymphadenitis and two endocarditis cases. Here, we report the case of a 66-year-old man who suffered from acute renal failure due to a membranoproliferative glomerulonephritis. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) showed diffuse FDG uptake around the aortobifemoral Graft with no indication of infection. A white blood cell scan showed an accumulation of labeled neutrophils on the left femoral part of the Graft. The patient underwent surgery and an abscess around the left iliac part of the Graft was found intraoperatively. Intraoperative samples were all negative, but 16S rRNA gene-based PCR was positive, and the sequence was positioned among the Bartonella species cluster. Specific PCRs targeting groEL/hsp60, rpoB and gltA genes were performed and led to the identification of B. alsatica. Accordingly, indirect immunofluorescence serological analyses were positive for Bartonella henselae and Bartonella quintana. The patient had a history of regularly hunting wild rabbits. He was treated with 100 mg of doxycycline twice a day for six months and his renal function significantly improved with no sign of persistent infection. This case highlights the contribution of serology assays and molecular-based methods in Prosthetic Vascular Graft infection diagnosis.
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Should White Blood Cell Scan be Replaced by 18F-FDG PET-CT in the Diagnosis of Prosthetic Vascular Graft Infection?
Annals of vascular surgery, 2015Co-Authors: Jean-baptiste Pinaquy, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Ghoufrane Tlili, Fatima M’zali, Stéphane Mayeux, Charles CazanaveAbstract:Diagnosis of Prosthetic Vascular Graft infection (PVGI) is a clinical challenge requiring accurate diagnostic methods for their optimal management. A 65-year-old patient with suspected PVGI was explored by fluorodeoxyglucose positron emission tomography combined with computed tomography ( 18 F-FDG PET-CT) for pretreatment staging. Standard imaging was unrevealing but PET images showed multiple foci with increased uptake suggesting Prosthetic infection. While routine results from the diagnostic laboratory were negative, prosthesis sonication before standard culture revealed the same bacterium as a culture of preoperative lymphocele aspiration. 18 F-FDG PET-CT and preliminary sonication of the Prosthetic Graft could be very helpful in the diagnosis of PVGI especially for highlighting biofilm bacteria.
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Should white blood cell scan be replaced by (18)F-FDG PET-CT in the diagnosis of Prosthetic Vascular Graft infection?
Annals of Vascular Surgery, 2015Co-Authors: Jean-baptiste Pinaquy, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Ghoufrane Tlili, Stéphane Mayeux, Fatima M'zali, Charles CazanaveAbstract:Diagnosis of Prosthetic Vascular Graft infection (PVGI) is a clinical challenge requiring accurate diagnostic methods for their optimal management. A 65-year-old patient with suspected PVGI was explored by fluorodeoxyglucose positron emission tomography combined with computed tomography ((18)F-FDG PET-CT) for pretreatment staging. Standard imaging was unrevealing but PET images showed multiple foci with increased uptake suggesting Prosthetic infection. While routine results from the diagnostic laboratory were negative, prosthesis sonication before standard culture revealed the same bacterium as a culture of preoperative lymphocele aspiration. (18)F-FDG PET-CT and preliminary sonication of the Prosthetic Graft could be very helpful in the diagnosis of PVGI especially for highlighting biofilm bacteria.
Sabine Pereyre - One of the best experts on this subject based on the ideXlab platform.
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retrospective study comparing wbc scan and 18f fdg pet ct in patients with suspected Prosthetic Vascular Graft infection
European Journal of Vascular and Endovascular Surgery, 2019Co-Authors: M. Puges, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Jean-baptiste Ruiz, Frederic Debordeaux, Arnaud Desclaux, Arnaud Hocquelet, Jean-baptiste PinaquyAbstract:Objectives Prosthetic Vascular Graft infections (PVGIs) are associated with high mortality rates. To improve treatment outcome, an early and definite diagnosis is critical, and current diagnostic criteria are often insufficient. The accuracy of 2-deoxy-2-[fluorine-18]-fluoro- d -glucose positron emission tomography integrated with computed tomography (18F-FDG PET/CT) and white blood cell (WBC) scan for the diagnosis of PVGI were compared. Methods A retrospective single centre study was conducted on patients undergoing WBC scan and 18F-FDG PET/CT for a suspected PVGI between April 2013 and June 2016 at the Bordeaux University Hospital, France. The diagnostic value of both imaging tests was assessed for all Grafts, using receiver operating characteristic (ROC) curve analysis. Images were independently interpreted by two nuclear medicine physicians blinded to the patients’ clinical and other imaging data. Results Thirty-nine patients were included, of whom 15 had PVGI. Antibiotic treatment was started before nuclear imaging for 16 patients, including nine patients with a PVGI. The 96 Grafts of these patients were analysed, and 19 were infected. The diagnostic value of the WBC scan was significantly higher than 18F-FDG PET/CT (ROC AUC = 0.902, 95% CI 0.824–0.980, and 0.759, CI 95% (0.659–0.858), respectively, p = .0071). Interobserver agreement was good for 18F-FDG PET/CT and excellent for WBC scan (kappa value of 0.76, 95% CI 0.62–0.9, and 0.97, 95% CI 0.92–1, respectively). Only one patient had a false negative 18F-FDG PET/CT result under antibiotic therapy. Conclusion The WBC scan has a better diagnostic value than 18F-FDG PET/CT for PVGI diagnosis.
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Retrospective Study Comparing WBC scan and 18F-FDG PET/CT in Patients with Suspected Prosthetic Vascular Graft Infection
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 2019Co-Authors: M. Puges, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Jean-baptiste Ruiz, Frederic Debordeaux, Arnaud Desclaux, Arnaud Hocquelet, Jean-baptiste PinaquyAbstract:Objectives Prosthetic Vascular Graft infections (PVGIs) are associated with high mortality rates. To improve treatment outcome, an early and definite diagnosis is critical, and current diagnostic criteria are often insufficient. The accuracy of 2-deoxy-2-[fluorine-18]-fluoro- d -glucose positron emission tomography integrated with computed tomography (18F-FDG PET/CT) and white blood cell (WBC) scan for the diagnosis of PVGI were compared. Methods A retrospective single centre study was conducted on patients undergoing WBC scan and 18F-FDG PET/CT for a suspected PVGI between April 2013 and June 2016 at the Bordeaux University Hospital, France. The diagnostic value of both imaging tests was assessed for all Grafts, using receiver operating characteristic (ROC) curve analysis. Images were independently interpreted by two nuclear medicine physicians blinded to the patients’ clinical and other imaging data. Results Thirty-nine patients were included, of whom 15 had PVGI. Antibiotic treatment was started before nuclear imaging for 16 patients, including nine patients with a PVGI. The 96 Grafts of these patients were analysed, and 19 were infected. The diagnostic value of the WBC scan was significantly higher than 18F-FDG PET/CT (ROC AUC = 0.902, 95% CI 0.824–0.980, and 0.759, CI 95% (0.659–0.858), respectively, p = .0071). Interobserver agreement was good for 18F-FDG PET/CT and excellent for WBC scan (kappa value of 0.76, 95% CI 0.62–0.9, and 0.97, 95% CI 0.92–1, respectively). Only one patient had a false negative 18F-FDG PET/CT result under antibiotic therapy. Conclusion The WBC scan has a better diagnostic value than 18F-FDG PET/CT for PVGI diagnosis.
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An unexpected case of Bartonella alsatica Prosthetic Vascular Graft infection
Infection and Drug Resistance, 2019Co-Authors: Mathilde Puges, Armelle Ménard, Xavier Berard, Magalie Geneviève, Jean-baptiste Pinaquy, Sophie Edouard, Sabine Pereyre, Charles CazanaveAbstract:Bartonella alsatica is a wild rabbit pathogen causing bacteremia rarely reported in humans, with only three cases published so far, including one lymphadenitis and two endocarditis cases. Here, we report the case of a 66-year-old man who suffered from acute renal failure due to a membranoproliferative glomerulonephritis. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) showed diffuse FDG uptake around the aortobifemoral Graft with no indication of infection. A white blood cell scan showed an accumulation of labeled neutrophils on the left femoral part of the Graft. The patient underwent surgery and an abscess around the left iliac part of the Graft was found intraoperatively. Intraoperative samples were all negative, but 16S rRNA gene-based PCR was positive, and the sequence was positioned among the Bartonella species cluster. Specific PCRs targeting groEL/hsp60, rpoB and gltA genes were performed and led to the identification of B. alsatica. Accordingly, indirect immunofluorescence serological analyses were positive for Bartonella henselae and Bartonella quintana. The patient had a history of regularly hunting wild rabbits. He was treated with 100 mg of doxycycline twice a day for six months and his renal function significantly improved with no sign of persistent infection. This case highlights the contribution of serology assays and molecular-based methods in Prosthetic Vascular Graft infection diagnosis.
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Should White Blood Cell Scan be Replaced by 18F-FDG PET-CT in the Diagnosis of Prosthetic Vascular Graft Infection?
Annals of vascular surgery, 2015Co-Authors: Jean-baptiste Pinaquy, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Ghoufrane Tlili, Fatima M’zali, Stéphane Mayeux, Charles CazanaveAbstract:Diagnosis of Prosthetic Vascular Graft infection (PVGI) is a clinical challenge requiring accurate diagnostic methods for their optimal management. A 65-year-old patient with suspected PVGI was explored by fluorodeoxyglucose positron emission tomography combined with computed tomography ( 18 F-FDG PET-CT) for pretreatment staging. Standard imaging was unrevealing but PET images showed multiple foci with increased uptake suggesting Prosthetic infection. While routine results from the diagnostic laboratory were negative, prosthesis sonication before standard culture revealed the same bacterium as a culture of preoperative lymphocele aspiration. 18 F-FDG PET-CT and preliminary sonication of the Prosthetic Graft could be very helpful in the diagnosis of PVGI especially for highlighting biofilm bacteria.
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Should white blood cell scan be replaced by (18)F-FDG PET-CT in the diagnosis of Prosthetic Vascular Graft infection?
Annals of Vascular Surgery, 2015Co-Authors: Jean-baptiste Pinaquy, Xavier Berard, Sabine Pereyre, Laurent Stecken, Laurence Bordenave, Ghoufrane Tlili, Stéphane Mayeux, Fatima M'zali, Charles CazanaveAbstract:Diagnosis of Prosthetic Vascular Graft infection (PVGI) is a clinical challenge requiring accurate diagnostic methods for their optimal management. A 65-year-old patient with suspected PVGI was explored by fluorodeoxyglucose positron emission tomography combined with computed tomography ((18)F-FDG PET-CT) for pretreatment staging. Standard imaging was unrevealing but PET images showed multiple foci with increased uptake suggesting Prosthetic infection. While routine results from the diagnostic laboratory were negative, prosthesis sonication before standard culture revealed the same bacterium as a culture of preoperative lymphocele aspiration. (18)F-FDG PET-CT and preliminary sonication of the Prosthetic Graft could be very helpful in the diagnosis of PVGI especially for highlighting biofilm bacteria.
M. De Roo - One of the best experts on this subject based on the ideXlab platform.
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Clinical usefulness of Tc-99m HMPAO labeled white blood cell imaging in Prosthetic Vascular Graft infections.
Clinical nuclear medicine, 1992Co-Authors: Luc J.m. Mortelmans, H. Verlooy, A. Nevelsteen, Guy Wilms, M. De RooAbstract:The reported frequency of Prosthetic Vascular Graft infections after reconstructive Vascular surgery is low. However, it is a serious and potentially catastrophic complication of this treatment, with high morbidity and mortality rates. Effective therapy involves Graft excision and replacement. Tc-99m HMPAO labeled leukocyte scintigraphy appears to be an accurate method of detecting Prosthetic Vascular Graft infections. The value of leukocyte scanning is illustrated by two case reports.
