PT  - JOURNAL ARTICLE
AU  - Medricka, Monika
AU  - Janeckova, Jana
AU  - Koranda, Pavel
AU  - Buriankova, Eva
AU  - Bachleda, Petr
TI  - <sup>18</sup>F-FDG PET/CT and <sup>99m</sup>Tc-HMPAO-WBC SPECT/CT effectively contribute to early diagnosis of infection of arteriovenous graft for hemodialysis
DP  - 2019 Dec 11
TA  - Biomedical papers
PG  - 341--348
VI  - 163
IP  - 4
AID - 10.5507/bp.2019.025
IS  - 12138118
AB  - Objective: An arteriovenous graft (AVG) is indicated in hemodialysis patients with failed arteriovenous access. Early treatment of AVG infection is important because an advanced prosthetic infection leads to the removal of the prosthesis. The aim of this study was to evaluate the benefits of <sup>18</sup>F-FDG PET/CT and <sup>99m</sup>Tc-HMPAO-WBC SPECT/CT in early detection of AVG infections. Subjects and Methods: Fifty-one AVGs were evaluated. <sup>18</sup>F-FDG PET/CT and <sup>99m</sup>Tc-HMPAO-WBC SPECT/CT studies were performed at intervals of 10, 20-30, and 40-50 weeks after AVG insertion. Agreement between the imaging methods and reference parameters (i.e. clinical presentation, C-reactive protein and microbiological findings on the hemodialysis cannula extracted after hemodialysis from AVG) was evaluated. Results: The study results showed that focal accumulation of the radiopharmaceuticals can be considered a sign of AVG infection. At 10 weeks after AVG implantation, the focal <sup>18</sup>F-FDG findings showed the best agreement with the reference parameters (agreement coefficients AC1 - clinical status: 0.693, CRP: 0.605, cannula microbiology: 0.518, respectively). At 20 to 30 weeks after AVG implantation, the diagnostic value of focal <sup>99m</sup>Tc-HMPAO-WBC accumulation increased (AC1 coefficients: 0.658, 0.658, 0.408) and was similar to that of focal <sup>18</sup>F-FDG uptake (AC1s: 0.656, 0.570, 0.409). Between 40 and 50 weeks since AVG implantation, the diagnostic significance of focal <sup>99m</sup>Tc-HMPAO-WBC accumulation (AC1 coefficients: 0.771, 0.811, 0.611) slightly exceeded the diagnostic value of focal <sup>18</sup>F-FDG accumulation (AC1 coefficients: 0.524, 0.456, 0.569). Conclusion: <sup>18</sup>F-FDG PET/CT and <sup>99m</sup>Tc-HMPAO-WBC SPECT/CT can both serve as important tools contributing to early diagnosis of AVG infection.