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What is the relationship between 18F-FDG aortic aneurysm uptake on PET/CT and future growth rate?

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Abstract

Purpose

In this study we investigate the relationship between 18F-fluorodeoxyglucose (FDG) metabolism and future aneurysm expansion measured by serial duplex ultrasound. Current screening programmes are increasing the identification of patients with abdominal aortic aneurysm (AAA). The management of these patients remains challenging and methods of risk stratification are sought.

Methods

Thirty-four consecutive patients [31 men, 3 women, median age 75 years, interquartile range (IQR) 71–78] with aortic aneurysms under routine surveillance with serial ultrasound were prospectively recruited for 18F-FDG positron emission tomography (PET)/CT. A whole vessel type analysis was performed measuring the highest aortic wall 18F-FDG uptake (standardized uptake value or SUVmax), and target to background ratio (TBR) for each axial image and median SUVmax and TBR value were calculated. Institutional Review Board permission and informed patient consent were obtained.

Results

Nine patients failed to undergo 12-month follow-up study (deceased n = 2, withdrew n = 1, failed to attend ultrasound scan n = 5, emergency aneurysm repair n = 1) leaving 25 patients for analysis. The median whole vessel SUVmax was 1.70 (IQR 1.45–2.08). The median whole vessel TBR was 1.15 (IQR 1.00–1.40). The median aneurysm expansion at 12 months was 2.0 mm (IQR 0.5–5.0). The correlation (r) between 18F-FDG SUVmax and ultrasound expansion at 1 year was −0.501 (p = 0.011).

Conclusion

The preliminary findings from this observational longitudinal pilot study suggest that there is an inverse trend between 18F-FDG uptake on PET and future AAA expansion. Aortic aneurysms with lower metabolic activity may therefore be more likely to expand.

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Acknowledgments

We thank Dr. Gareth Ambler, Biostatistician, Joint UCLH/UCL Research and Development Department, for statistical advice. Furthermore, we thank the members of the vascular unit at the Royal Sussex County Hospital, Brighton for contributing to this study.

Funding

This study was part funded by the Sussex Stroke and Circulation Fund and the Royal College of Radiologists. UCLH/UCL receives a proportion of funding from the Department of Health’s NIHR Biomedical Research Centre’s funding scheme.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Vascular Surgery, Brighton and Sussex University Hospital, Eastern Road, Brighton, BN2 5BE, UK

    Carl W. Kotze, Richard Harvey & Syed W. Yusuf

  2. Institute of Nuclear Medicine, University College London, University College Hospital, 5th Floor, 235 Euston Road, London, NW1 2BU, UK

    Ashley M. Groves, Leon J. Menezes, Raymondo Endozo, Irfan A. Kayani & Peter J. Ell

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  1. Carl W. Kotze
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Correspondence to Ashley M. Groves.

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Kotze, C.W., Groves, A.M., Menezes, L.J. et al. What is the relationship between 18F-FDG aortic aneurysm uptake on PET/CT and future growth rate?. Eur J Nucl Med Mol Imaging 38, 1493–1499 (2011). https://doi.org/10.1007/s00259-011-1799-8

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  • DOI: https://doi.org/10.1007/s00259-011-1799-8

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