Variability of [18F]FDG-PET/LDCT reporting in vascular graft and endograft infection

David J Liesker; Stijn Legtenberg; Paola A Erba; Andor W J M Glaudemans; Clark J Zeebregts; Jean-Paul P M De Vries; Nabil Chakfé; Ben R Saleem; Riemer H J A Slart

doi:10.1007/s00259-023-06349-3

Variability of [18F]FDG-PET/LDCT reporting in vascular graft and endograft infection

David J Liesker^*, Stijn Legtenberg, Paola A Erba, Andor W J M Glaudemans, Clark J Zeebregts, Jean-Paul P M De Vries, Nabil Chakfé, Ben R Saleem, Riemer H J A Slart

^*Corresponding author for this work

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Abstract

PURPOSE: 18F-fluoro-D-deoxyglucose positron emission tomography with low dose and/or contrast enhanced computed tomography ([ 18F]FDG-PET/CT) scan reveals high sensitivity for the diagnosis of vascular graft and endograft infection (VGEI), but lower specificity. Reporting [ 18F]FDG-PET/CT scans of suspected VGEI is challenging, reader dependent, and reporting standards are lacking. The aim of this study was to evaluate variability of [ 18F]FDG-PET/low dose CT (LDCT) reporting of suspected VGEI using a proposed standard reporting format.

METHODS: A retrospective cohort study was conducted including all patients with a suspected VGEI (according to the MAGIC criteria) without need for urgent surgical treatment who underwent an additional [ 18F]FDG-PET/LDCT scan between 2006 and 2022 at a tertiary referral centre. All [ 18F]FDG-PET/LDCT reports were scored following pre-selected criteria that were formulated based on literature and experts in the field. The aim was to investigate the completeness of [ 18F]FDG-PET/LDCT reports for diagnosing VGEI (proven according to the MAGIC criteria) and to evaluate if incompleteness of reports influenced the diagnostic accuracy.

RESULTS: Hundred-fifty-two patients were included. Median diagnostic interval from the index vascular surgical procedure until [ 18F]FDG-PET/LDCT scan was 35.5 (7.3-73.3) months. Grafts were in 65.1% located centrally and 34.9% peripherally. Based on the pre-selected reporting criteria, 45.7% of the reports included all items. The least frequently assessed criterion was FDG-uptake pattern (40.6%). Overall, [ 18F]FDG-PET/LDCT showed a sensitivity of 91%, a specificity of 72%, and an accuracy of 88% when compared to the gold standard (diagnosed VGEI). Lower sensitivity and specificity in reports including ≤ 8 criteria compared to completely evaluated reports were found (83% and 50% vs. 92% and 77%, respectively).

CONCLUSION: Less than half of the [ 18F]FDG-PET/LDCT reports of suspected VGEI met all pre-selected criteria. Incompleteness of reports led to lower sensitivity and specificity. Implementing a recommendation with specific criteria for VGEI reporting is needed in the VGEI-guideline update. This study provides a first recommendation for a concise and complete [ 18F]FDG-PET/LDCT report in patients with suspected VGEI.

Original language	English
Pages (from-to)	3880–3889
Number of pages	10
Journal	European Journal of Nuclear Medicine and Molecular Imaging
Volume	50
Early online date	29-Jul-2023
DOIs	https://doi.org/10.1007/s00259-023-06349-3
Publication status	Published - Nov-2023

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Liesker, D. J., Legtenberg, S., Erba, P. A., Glaudemans, A. W. J. M., Zeebregts, C. J., De Vries, J.-P. P. M., Chakfé, N., Saleem, B. R., & Slart, R. H. J. A. (2023). Variability of [18F]FDG-PET/LDCT reporting in vascular graft and endograft infection. European Journal of Nuclear Medicine and Molecular Imaging, 50, 3880–3889. https://doi.org/10.1007/s00259-023-06349-3

@article{90fa68d2f35b47abb8704ab39e539dd9,

title = "Variability of [18F]FDG-PET/LDCT reporting in vascular graft and endograft infection",

abstract = "PURPOSE: 18F-fluoro-D-deoxyglucose positron emission tomography with low dose and/or contrast enhanced computed tomography ([ 18F]FDG-PET/CT) scan reveals high sensitivity for the diagnosis of vascular graft and endograft infection (VGEI), but lower specificity. Reporting [ 18F]FDG-PET/CT scans of suspected VGEI is challenging, reader dependent, and reporting standards are lacking. The aim of this study was to evaluate variability of [ 18F]FDG-PET/low dose CT (LDCT) reporting of suspected VGEI using a proposed standard reporting format. METHODS: A retrospective cohort study was conducted including all patients with a suspected VGEI (according to the MAGIC criteria) without need for urgent surgical treatment who underwent an additional [ 18F]FDG-PET/LDCT scan between 2006 and 2022 at a tertiary referral centre. All [ 18F]FDG-PET/LDCT reports were scored following pre-selected criteria that were formulated based on literature and experts in the field. The aim was to investigate the completeness of [ 18F]FDG-PET/LDCT reports for diagnosing VGEI (proven according to the MAGIC criteria) and to evaluate if incompleteness of reports influenced the diagnostic accuracy. RESULTS: Hundred-fifty-two patients were included. Median diagnostic interval from the index vascular surgical procedure until [ 18F]FDG-PET/LDCT scan was 35.5 (7.3-73.3) months. Grafts were in 65.1% located centrally and 34.9% peripherally. Based on the pre-selected reporting criteria, 45.7% of the reports included all items. The least frequently assessed criterion was FDG-uptake pattern (40.6%). Overall, [ 18F]FDG-PET/LDCT showed a sensitivity of 91%, a specificity of 72%, and an accuracy of 88% when compared to the gold standard (diagnosed VGEI). Lower sensitivity and specificity in reports including ≤ 8 criteria compared to completely evaluated reports were found (83% and 50% vs. 92% and 77%, respectively). CONCLUSION: Less than half of the [ 18F]FDG-PET/LDCT reports of suspected VGEI met all pre-selected criteria. Incompleteness of reports led to lower sensitivity and specificity. Implementing a recommendation with specific criteria for VGEI reporting is needed in the VGEI-guideline update. This study provides a first recommendation for a concise and complete [ 18F]FDG-PET/LDCT report in patients with suspected VGEI. ",

author = "Liesker, {David J} and Stijn Legtenberg and Erba, {Paola A} and Glaudemans, {Andor W J M} and Zeebregts, {Clark J} and {De Vries}, {Jean-Paul P M} and Nabil Chakf{\'e} and Saleem, {Ben R} and Slart, {Riemer H J A}",

note = "{\textcopyright} 2023. The Author(s).",

year = "2023",

month = nov,

doi = "10.1007/s00259-023-06349-3",

language = "English",

volume = "50",

pages = "3880–3889",

journal = "European Journal of Nuclear Medicine and Molecular Imaging",

issn = "1619-7070",

publisher = "Springer",

}

TY - JOUR

T1 - Variability of [18F]FDG-PET/LDCT reporting in vascular graft and endograft infection

AU - Liesker, David J

AU - Legtenberg, Stijn

AU - Erba, Paola A

AU - Glaudemans, Andor W J M

AU - Zeebregts, Clark J

AU - De Vries, Jean-Paul P M

AU - Chakfé, Nabil

AU - Saleem, Ben R

AU - Slart, Riemer H J A

PY - 2023/11

Y1 - 2023/11

N2 - PURPOSE: 18F-fluoro-D-deoxyglucose positron emission tomography with low dose and/or contrast enhanced computed tomography ([ 18F]FDG-PET/CT) scan reveals high sensitivity for the diagnosis of vascular graft and endograft infection (VGEI), but lower specificity. Reporting [ 18F]FDG-PET/CT scans of suspected VGEI is challenging, reader dependent, and reporting standards are lacking. The aim of this study was to evaluate variability of [ 18F]FDG-PET/low dose CT (LDCT) reporting of suspected VGEI using a proposed standard reporting format. METHODS: A retrospective cohort study was conducted including all patients with a suspected VGEI (according to the MAGIC criteria) without need for urgent surgical treatment who underwent an additional [ 18F]FDG-PET/LDCT scan between 2006 and 2022 at a tertiary referral centre. All [ 18F]FDG-PET/LDCT reports were scored following pre-selected criteria that were formulated based on literature and experts in the field. The aim was to investigate the completeness of [ 18F]FDG-PET/LDCT reports for diagnosing VGEI (proven according to the MAGIC criteria) and to evaluate if incompleteness of reports influenced the diagnostic accuracy. RESULTS: Hundred-fifty-two patients were included. Median diagnostic interval from the index vascular surgical procedure until [ 18F]FDG-PET/LDCT scan was 35.5 (7.3-73.3) months. Grafts were in 65.1% located centrally and 34.9% peripherally. Based on the pre-selected reporting criteria, 45.7% of the reports included all items. The least frequently assessed criterion was FDG-uptake pattern (40.6%). Overall, [ 18F]FDG-PET/LDCT showed a sensitivity of 91%, a specificity of 72%, and an accuracy of 88% when compared to the gold standard (diagnosed VGEI). Lower sensitivity and specificity in reports including ≤ 8 criteria compared to completely evaluated reports were found (83% and 50% vs. 92% and 77%, respectively). CONCLUSION: Less than half of the [ 18F]FDG-PET/LDCT reports of suspected VGEI met all pre-selected criteria. Incompleteness of reports led to lower sensitivity and specificity. Implementing a recommendation with specific criteria for VGEI reporting is needed in the VGEI-guideline update. This study provides a first recommendation for a concise and complete [ 18F]FDG-PET/LDCT report in patients with suspected VGEI.

AB - PURPOSE: 18F-fluoro-D-deoxyglucose positron emission tomography with low dose and/or contrast enhanced computed tomography ([ 18F]FDG-PET/CT) scan reveals high sensitivity for the diagnosis of vascular graft and endograft infection (VGEI), but lower specificity. Reporting [ 18F]FDG-PET/CT scans of suspected VGEI is challenging, reader dependent, and reporting standards are lacking. The aim of this study was to evaluate variability of [ 18F]FDG-PET/low dose CT (LDCT) reporting of suspected VGEI using a proposed standard reporting format. METHODS: A retrospective cohort study was conducted including all patients with a suspected VGEI (according to the MAGIC criteria) without need for urgent surgical treatment who underwent an additional [ 18F]FDG-PET/LDCT scan between 2006 and 2022 at a tertiary referral centre. All [ 18F]FDG-PET/LDCT reports were scored following pre-selected criteria that were formulated based on literature and experts in the field. The aim was to investigate the completeness of [ 18F]FDG-PET/LDCT reports for diagnosing VGEI (proven according to the MAGIC criteria) and to evaluate if incompleteness of reports influenced the diagnostic accuracy. RESULTS: Hundred-fifty-two patients were included. Median diagnostic interval from the index vascular surgical procedure until [ 18F]FDG-PET/LDCT scan was 35.5 (7.3-73.3) months. Grafts were in 65.1% located centrally and 34.9% peripherally. Based on the pre-selected reporting criteria, 45.7% of the reports included all items. The least frequently assessed criterion was FDG-uptake pattern (40.6%). Overall, [ 18F]FDG-PET/LDCT showed a sensitivity of 91%, a specificity of 72%, and an accuracy of 88% when compared to the gold standard (diagnosed VGEI). Lower sensitivity and specificity in reports including ≤ 8 criteria compared to completely evaluated reports were found (83% and 50% vs. 92% and 77%, respectively). CONCLUSION: Less than half of the [ 18F]FDG-PET/LDCT reports of suspected VGEI met all pre-selected criteria. Incompleteness of reports led to lower sensitivity and specificity. Implementing a recommendation with specific criteria for VGEI reporting is needed in the VGEI-guideline update. This study provides a first recommendation for a concise and complete [ 18F]FDG-PET/LDCT report in patients with suspected VGEI.

U2 - 10.1007/s00259-023-06349-3

DO - 10.1007/s00259-023-06349-3

M3 - Article

C2 - 37507493

SN - 1619-7070

VL - 50

SP - 3880

EP - 3889

JO - European Journal of Nuclear Medicine and Molecular Imaging

JF - European Journal of Nuclear Medicine and Molecular Imaging

ER -

Variability of [18F]FDG-PET/LDCT reporting in vascular graft and endograft infection

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