Prosthetic vascular graft infection: A systematic review and meta-analysis on diagnostic accuracy of 18FDG PET/CT.

INTRODUCTION: There is a high risk of mortality and morbidity associated with Vascular Graft Infections (VGI) which requires early diagnosis. The aim of the present systematic review and meta-analysis was to evaluate the diagnostic accuracy, sensitivity and specificity of 18FDG PET/CT in diagnosing VGI. METHODS: A systematic review was conducted according to the PRISMA guidelines through a search in Embase, PubMed, and Cochrane databases. We evaluated five parameters including specificity, sensitivity, negative and positive predictive values (NPV and PPV), and accuracy. We used STATA/MP 15.0 (StataCorp, College Station, TX) for all of our analyses. RESULTS: Overall 10 studies including 320 patients undergone 18FDG PET/CT were included. The sensitivity, specificity, positive and negative likelihood ratios along with their 95% CI were 0.92 (95% CI 0.88-0.95), 0.76 (95% CI 0.76-0.70), 3.49 (95% CI 3.49-2.32) and 0.14 (95% CI 0.09-0.23), respectively. The diagnostic odds ratio (DOR) for diagnosis of VGI was 37.12 (95% CI 14.84-92.82). The mean cut-off value of the maximum standardized uptake value (SUVmax) for diagnosis of VGI was 5.39 while the overall mean SUVmax among patients with VGI was 8.47. CONCLUSION: According to our results, 18FDG PET/CT is a useful diagnostic method in detecting active VGI with high diagnostic accuracy. Because of its ability to evaluate morphology and main texture using SUVmax, the 18FDG PET/CT provides an objective assessment of aspects and extent of disease activity, which results in preventing unnecessary surgery, proper treatment planning, and evaluating the effectiveness of treatment.