Bennett P, Tomas MB, Koch CF, Nichols KJ, Palestro CJ. Appearance of aseptic vascular grafts after endovascular aortic repair on [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography. World J Radiol 2023; 15(8): 241-249 [PMID: 37662425 DOI: 10.4329/wjr.v15.i8.241]
Corresponding Author of This Article
Paige Bennett, MD, Professor, Department of Radiology, LIJMC Northwell Health, Rm C204, 27005 76th Avenue, New Hyde Park, NY 11040, United States. pbennett1@northwell.edu
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Aug 28, 2023; 15(8): 241-249 Published online Aug 28, 2023. doi: 10.4329/wjr.v15.i8.241
Appearance of aseptic vascular grafts after endovascular aortic repair on [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography
Paige Bennett, Maria Bernadette Tomas, Christopher F Koch, Kenneth J Nichols, Christopher J Palestro
Paige Bennett, Department of Radiology, LIJMC Northwell Health, New Hyde Park, NY 11040, United States
Paige Bennett, Maria Bernadette Tomas, Kenneth J Nichols, Christopher J Palestro, Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, United States
Christopher F Koch, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Northwell Health, New Hyde Park, NY 11040, United States
Author contributions: Bennett P and Nichols KJ wrote the manuscript; Palestro C, Nichols KJ, and Tomas MB designed the research study; Tomas MB performed image analysis and chart review; Koch CF performed chart review; Nichols KJ, Tomas MB and Palestro C analyzed the data; and all authors have read and approved the final manuscript.
Institutional review board statement: Our Institutional Review Board approved this retrospective study. All data were handled in compliance with the Health Insurance Portability and Accountability Act of 1996.
Informed consent statement: The requirement to obtain informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The original anonymous dataset is available upon reasonable request from the corresponding author at pbennett1@northwell.edu.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Paige Bennett, MD, Professor, Department of Radiology, LIJMC Northwell Health, Rm C204, 27005 76th Avenue, New Hyde Park, NY 11040, United States. pbennett1@northwell.edu
Received: March 28, 2023 Peer-review started: March 28, 2023 First decision: June 1, 2023 Revised: June 15, 2023 Accepted: July 27, 2023 Article in press: July 27, 2023 Published online: August 28, 2023 Processing time: 148 Days and 13.3 Hours
ARTICLE HIGHLIGHTS
Research background
On [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), the inflammatory response caused by endoprosthetic stent grafts after endovascular aneurysm repair (EVAR) can show increased 18F-FDG uptake. However, the visual, semiquantitative, and temporal characteristics of uninfected, or aseptic, endovascular aneurysm grafts has not been fully elucidated.
Research motivation
Characterization of aseptic vascular stent grafts on 18F-FDG PET/CT is important to distinguish the normal inflammatory response to graft material vs vascular graft infection.
Research objectives
The purpose of this study was to characterize aseptic vascular stent grafts over time.
Research methods
In this observational retrospective cohort study, patients with EVAR who underwent 18F-FDG PET/CT for routine oncologic indications were included. Any patients with suspected or confirmed vascular stent graft infection were excluded. Visual and semiquantitative region of interest (ROI) analysis with maximum standardized uptake value (SUVmax) and graft-to-background ascending aorta uptake ratios (URs) of the grafts were obtained. We compared visual analysis and semiquantitative values, grouped by age of grafts, ROI locations, and graft materials.
Research results
Characteristics of an aseptic vascular stent graft on 18F-FDG PET/CT include graft SUVmax values within 10%-20% of the ascending aorta background SUVmax. The SUVmax of older aseptic grafts can be as much as 30% above background. The visual uptake pattern of diffuse, homogeneous uptake less than liver was seen in 98% of aseptic vascular stent grafts.
Research conclusions
Aseptic vascular stent grafts post endovascular repair show mildly increased 18F-FDG uptake, with mean graft-to-background URs of 1.1-1.2. Diffuse homogeneous 18F-FDG uptake less than liver in vascular stent grafts is particularly reassuring as a sign of an uninfected graft.
Research perspectives
This study reinforces prior research in characterizing aseptic vascular grafts on 18F-FDG PET/CT.
