Increased 18F-fluorodeoxyglucose uptake in abdominal aortic aneurysms in positron emission/computed tomography is associated with inflammation, aortic wall instability, and acute symptoms

Reeps, Christian; Essler, Markus; Pelisek, Jaroslav; Seidl, Stefan; Eckstein, H.‐H.; Krause, Bernd-Joachim

doi:10.1016/j.jvs.2008.03.059

Cited by 163 publications

(154 citation statements)

References 24 publications

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“…Maximum fluorodeoxyglucose ( 18 F‐FDG) uptake after positron emission tomography scanning was studied as a marker for expansion in 3 studies67, 68, 69 and in 1 study as a marker for rupture 70. All 3 studies demonstrated significant inverse correlations with aneurysm expansion ( r =−0.50 [medium bias risk], r =−0.38 [low bias risk], and r =−0.32 [medium bias risk]; total n=104).…”

Section: Resultsmentioning

confidence: 99%

“…It therefore seems contradictive that an inverse correlation was found between 18 F‐FDG uptake and expansion in all 3 studies. The current explanation is that an inflammatory period precedes a phase of rapid growth and is then followed by a period of stasis with low metabolic activity 67, 68, 69, 70. However, this phenomenon is clearly not fully explained yet.…”

Section: Discussionmentioning

confidence: 95%

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Systematic Review of Circulating, Biomechanical, and Genetic Markers for the Prediction of Abdominal Aortic Aneurysm Growth and Rupture

Groeneveld

Meekel

Rubinstein

et al. 2018

JAHA

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BackgroundThe natural course of abdominal aortic aneurysms (AAA) is growth and rupture if left untreated. Numerous markers have been investigated; however, none are broadly acknowledged. Our aim was to identify potential prognostic markers for AAA growth and rupture.Methods and ResultsPotential circulating, biomechanical, and genetic markers were studied. A comprehensive search was conducted in PubMed, Embase, and Cochrane Library in February 2017, following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Study selection, data extraction, and methodological quality assessment were conducted by 2 independent researchers. Plausibility of markers was based on the amount of publications regarding the marker (more than 3), pooled sample size (more than 100), bias risk and statistical significance of the studies. Eighty‐two studies were included, which examined circulating (n=40), biomechanical (n=27), and genetic markers (n=7) and combinations of markers (n=8). Factors with an increased expansion risk included: AAA diameter (9 studies; n=1938; low bias risk), chlamydophila pneumonia (4 studies; n=311; medium bias risk), S‐elastin peptides (3 studies; n=205; medium bias risk), fluorodeoxyglucose uptake (3 studies; n=104; medium bias risk), and intraluminal thrombus size (5 studies; n=758; medium bias risk). Factors with an increased rupture risk rupture included: peak wall stress (9 studies; n=579; medium bias risk) and AAA diameter (8 studies; n=354; medium bias risk). No meta‐analysis was conducted because of clinical and methodological heterogeneity.ConclusionsWe identified 5 potential markers with a prognostic value for AAA growth and 2 for rupture. While interpreting these data, one must realize that conclusions are based on small sample sizes and clinical and methodological heterogeneity. Prospective and methodological consonant studies are strongly urged to further study these potential markers.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 95%

Systematic Review of Circulating, Biomechanical, and Genetic Markers for the Prediction of Abdominal Aortic Aneurysm Growth and Rupture

Groeneveld

Meekel

Rubinstein

et al. 2018

JAHA

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“…Current guidelines for stable patients recommend surgical or endovascular intervention based largely on aortic dimensions [82,83], although it is well known that rupture can occur in small aneurysms as well. It has been shown that abdominal aortic FDG uptake is associated with higher wall stress [84] and correlates with instability, symptoms and with macrophage infiltration [85]. Whether FDG uptake can identify patients who will benefit from earlier intervention than that dictated by size remains the subject of several ongoing studies.…”

Section: The Potential Of Fdg-pet Imaging In Aortic Aneurysm and Aortmentioning

confidence: 99%

Vascular imaging with positron emission tomography

Joshi

Rosenbaum

Bordes

et al. 2011

Journal of Internal Medicine

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Atherosclerosis is an inflammatory disease that causes most myocardial infarctions, strokes and acute coronary syndromes. Despite the identification of multiple risk factors and widespread use of drug therapies, it still remains a global health concern with associated costs. Although angiography is established as the gold standard means of detecting coronary artery stenosis, it does not image the vessel wall itself, reporting only on its consequences such as luminal narrowing and obstruction. MRI and computed tomography provide more information about the plaque structure, but recently positron emission tomography (PET) imaging using [ 18 F]-fluorodeoxyglucose (FDG) has been advocated as a means of measuring arterial inflammation. This results from the ability of FDG-PET to highlight areas of high glucose metabolism, a feature of macrophages within atherosclerosis, particularly in high-risk plaques. It is suggested that the degree of FDG accumulation in the vessel wall reflects underlying inflammation levels and that tracking any changes in FDG uptake over time or with drug therapy might be a way of getting an early efficacy readout for novel anti-atherosclerotic drugs. Early reports also demonstrate that FDG uptake is correlated with the number of cardiovascular risk factors and possibly even the risk of future cardiovascular events. This review will outline the evidence base, shortcomings and emerging applications for FDG-PET in vascular imaging. Alternative PET tracers and other candidate imaging modalities for measuring vascular inflammation will also be discussed.

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“…In patients with abdominal aortic aneurysm (AAA), Reeps et al found that the intensity of FDG uptake in AAA was associated with progression and correlates with the number of macrophage and T-cell, higher local MMP tissue activities, and extracellular matrix degradation. 12,13 Similarly, Kuehl et al showed, in 33 patients with AAS, that vessel wall inflammation depicted by FDG-PET was found in one third of the patients.…”

Section: What Is the Rationale For Using Fdg-pet In Aas?mentioning

confidence: 92%

Can FDG-PET imaging play a role in guiding indications to endovascular treatments in patients presenting acute aortic syndromes?

Soussan

Hyafil

2019

Journal of Nuclear Cardiology

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Increased 18F-fluorodeoxyglucose uptake in abdominal aortic aneurysms in positron emission/computed tomography is associated with inflammation, aortic wall instability, and acute symptoms

Cited by 163 publications

References 24 publications

Systematic Review of Circulating, Biomechanical, and Genetic Markers for the Prediction of Abdominal Aortic Aneurysm Growth and Rupture

Systematic Review of Circulating, Biomechanical, and Genetic Markers for the Prediction of Abdominal Aortic Aneurysm Growth and Rupture

Vascular imaging with positron emission tomography

Can FDG-PET imaging play a role in guiding indications to endovascular treatments in patients presenting acute aortic syndromes?

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