Imaging of Acute and Chronic Aortic Dissection by <sup>18</sup>F-FDG PET/CT

Reeps, Christian; Pelisek, Jaroslav; Bundschuh, Ralph A.; Gurdan, Manuela; Zimmermann, Alexander; Ockert, S.; Dobritz, Martin; Eckstein, H.‐H.; Essler, Markus

doi:10.2967/jnumed.109.072298

Cited by 44 publications

(20 citation statements)

References 13 publications

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“…1). We finally found 22 eligible articles11121314151617181920212223242526272829303132. Most studies were from Asian and European countries (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic test accuracy of D-dimer for acute aortic syndrome: systematic review and meta-analysis of 22 studies with 5000 subjects

Watanabe

Horita

Shibata

et al. 2016

Sci Rep

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Diagnostic test accuracy of D-dimer for acute aortic dissection (AAD) has not been evaluated by meta-analysis with the bivariate model methodology. Four databases were electrically searched. We included both case-control and cohort studies that could provide sufficient data concerning both sensitivity and specificity of D-dimer for AAD. Non-English language articles and conference abstract were allowed. Intramural hematoma and penetrating aortic ulcer were regarded as AAD. Based on 22 eligible articles consisting of 1140 AAD subjects and 3860 non-AAD subjects, the diagnostic odds ratio was 28.5 (95% CI 17.6–46.3, I2 = 17.4%) and the area under curve was 0.946 (95% CI 0.903–0.994). Based on 833 AAD subjects and 1994 non-AAD subjects constituting 12 studies that used the cutoff value of 500 ng/ml, the sensitivity was 0.952 (95% CI 0.901–0.978), the specificity was 0.604 (95% CI 0.485–0.712), positive likelihood ratio was 2.4 (95% CI 1.8–3.3), and negative likelihood ratio was 0.079 (95% CI 0.036–0.172). Sensitivity analysis using data of three high-quality studies almost replicated these results. In conclusion, D-dimer has very good overall accuracy. D-dimer <500 ng/ml largely decreases the possibility of AAD. D-dimer >500 ng/ml moderately increases the possibility of AAD.

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“…1). We finally found 22 eligible articles11121314151617181920212223242526272829303132. Most studies were from Asian and European countries (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…During the last 10 years, an increasing number of case-control and observational studies have reported the diagnostic accuracy of D-dimer for AAD11121314151617181920212223242526272829303132. In addition, a few systematic reviews and meta-analyses have calculated the pooled sensitivity and specificity using a univariate fixed- or random-model567891027.…”

mentioning

confidence: 99%

Diagnostic test accuracy of D-dimer for acute aortic syndrome: systematic review and meta-analysis of 22 studies with 5000 subjects

Watanabe

Horita

Shibata

et al. 2016

Sci Rep

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“…Inflammation plays a role in the pathophysiology of the disease [87,88]. In patients presenting with acute aortic syndrome who underwent acute FDG-PET imaging, there was a trend to less progression of disease in those with lower degrees of FDG uptake [89]. A study by Kato et al [90]., in subjects with both acute and chronic dissection, suggested worse outcomes in those with the highest aortic FDG uptake at the point of maximal dilatation.…”

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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“…IVUS has similarly been reported to have www.frontiersin.org both high sensitivity and specificity, however, is similarly compromised by its invasiveness (2,29). The use of positron emission tomography (PET) has also been reported; in the acute setting areas of elevated metabolic activity at freshly disrupted segments of aortic wall show increased uptake of radionuclide tracer (12). In asymptomatic patients with chronic aortic dissection, however, no noticeable uptake is detected, hindering its use as a prognostic indicator in this setting (12).…”

Section: Other Imaging Modalitiesmentioning

confidence: 99%

“…For type B dissection patients who have been medically managed, a persisting FL in the chronic phase correlates with an increased risk of aortic enlargement (11). Hence, regardless of the initial management in aortic dissection, careful follow-up with appropriate imaging is mandated (12). Several international guidelines recommend the close follow-up of these patients; however multiple imaging modalities are currently used without a clear consensus of the gold standard (2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%