The International Journal of Cardiovascular Imaging

, Volume 31, Issue 8, pp 1677–1685 | Cite as

Prognostic value of 18F-fluorodeoxyglucose PET-CT imaging in acute aortic syndromes: comparison with serological biomarkers of inflammation

  • Riccardo Gorla
  • Raimund ErbelEmail author
  • Hilmar Kuehl
  • Philipp Kahlert
  • Konstantinos Tsagakis
  • Heinz Jakob
  • Amir-Abbas Mahabadi
  • Thomas Schlosser
  • Andreas Bockisch
  • Holger Eggebrecht
  • Eduardo Bossone
  • Rolf Alexander Jánosi
Original Paper


Aim of this study was to investigate the relationship between 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) findings and serological biomarkers of inflammation and the related discriminant value of unfavourable outcome during follow-up in patients with acute aortic syndromes (AAS). Sixty patients with AAS underwent PET-CT imaging during the hospitalization along with measurement of C-reactive protein (CRP) and D-dimer (D-d) serum levels. An aortic wall pathology was considered PET-positive by a maximum standardized uptake value (SUVmax) >2.5. A combined endpoint of major adverse events (MAE) including aorta-related mortality, disease progression and re-intervention was used to compare patient subgroups at 3-year follow-up. PET-CT detected an elevated FDG uptake within the aortic wall in 25 (41.7 %) patients. PET-positive patients showed significantly increased CRP levels (10.0 ± 6.6 mg/dL) and tended to higher D-d levels (5.1 ± 3.9 mg/L), compared to PET-negative patients (5.8 ± 6.1 mg/dL and 3.1 ± 4.7 mg/L respectively; P = 0.048, P = 0.19). At 3-year follow-up, all-cause mortality and MAE were higher in the PET-positive (21.7 and 47.8 % respectively) than PET-negative group (0.0 and 13.3 % respectively; P = 0.012, P = 0.006). On Kaplan–Meier analysis, PET-positive patients were at higher risk of MAE (P = 0.031). This tendency was more evident by combining PET results with D-d levels at a cutoff value of 4.8 mg/L (P < 0.001). In patients with AAS, a pathological glucose uptake in aortic wall lesions by PET-CT was associated with high CRP levels and increased mortality and MAE at 3-year follow-up. The combination of PET results with D-d levels had the best discriminant value of MAE.


PET-CT Acute aortic syndromes D-dimer C-reactive protein 



The authors would like to thank Dr. Luca Carannante for his technical support during the study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

For this type of study formal consent is not required.


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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Riccardo Gorla
    • 1
    • 7
  • Raimund Erbel
    • 1
    • 8
    Email author
  • Hilmar Kuehl
    • 2
  • Philipp Kahlert
    • 1
  • Konstantinos Tsagakis
    • 3
  • Heinz Jakob
    • 3
  • Amir-Abbas Mahabadi
    • 1
  • Thomas Schlosser
    • 4
  • Andreas Bockisch
    • 2
  • Holger Eggebrecht
    • 5
  • Eduardo Bossone
    • 6
  • Rolf Alexander Jánosi
    • 1
  1. 1.Department of Cardiology, West-German Heart and Vascular Center EssenUniversity Duisburg-EssenEssenGermany
  2. 2.Department of Nuclear Medicine, University Hospital EssenUniversity Duisburg-EssenEssenGermany
  3. 3.Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center EssenUniversity Duisburg-EssenEssenGermany
  4. 4.Department of Radiology, University Hospital EssenUniversity Duisburg-EssenEssenGermany
  5. 5.Cardioangiological Center BethanienFrankfurt am MainGermany
  6. 6.“Heart” DepartmentUniversity HospitalSalernoItaly
  7. 7.Cardiology Clinic, “Ospedale di Circolo” VareseUniversity of InsubriaVareseItaly
  8. 8.West-German Heart and Vascular Center EssenUniversity Clinic of CardiologyEssenGermany

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