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

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Abstract

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.

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Acknowledgments

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

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Authors and Affiliations

  1. Department of Cardiology, West-German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany

    Riccardo Gorla, Raimund Erbel, Philipp Kahlert, Amir-Abbas Mahabadi & Rolf Alexander Jánosi

  2. Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany

    Hilmar Kuehl & Andreas Bockisch

  3. Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany

    Konstantinos Tsagakis & Heinz Jakob

  4. Department of Radiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany

    Thomas Schlosser

  5. Cardioangiological Center Bethanien, Frankfurt am Main, Germany

    Holger Eggebrecht

  6. “Heart” Department, University Hospital, Salerno, Italy

    Eduardo Bossone

  7. Cardiology Clinic, “Ospedale di Circolo” Varese, University of Insubria, Varese, Italy

    Riccardo Gorla

  8. West-German Heart and Vascular Center Essen, University Clinic of Cardiology, Hufelandstrasse 55, 45147, Essen, Germany

    Raimund Erbel

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  1. Riccardo Gorla
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  2. Raimund Erbel
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  3. Hilmar Kuehl
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  6. Heinz Jakob
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  7. Amir-Abbas Mahabadi
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  8. Thomas Schlosser
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  9. Andreas Bockisch
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  10. Holger Eggebrecht
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  11. Eduardo Bossone
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  12. Rolf Alexander Jánosi
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Correspondence to Raimund Erbel.

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Gorla, R., Erbel, R., Kuehl, H. et al. Prognostic value of 18F-fluorodeoxyglucose PET-CT imaging in acute aortic syndromes: comparison with serological biomarkers of inflammation. Int J Cardiovasc Imaging 31, 1677–1685 (2015). https://doi.org/10.1007/s10554-015-0725-8

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  • DOI: https://doi.org/10.1007/s10554-015-0725-8

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