Role of molecular imaging with positron emission tomographic in aortic aneurysms

Abstract

Aortic aneurysms (AA) are often asymptomatic before the occurrence of acute, potentially fatal complications including dissection and/or rupture. Beyond aortic size, the ability to assess aortic wall characteristics and processes contributing to aneurysm development may allow improved selection of patients who may benefit from prophylactic surgical intervention. Current risk stratification for aneurysms relies upon routine noninvasive imaging of aortic size without assessing the underlying pathophysiologic processes, including features such as inflammation, which may be associated with aneurysm development and progression. The use of molecular imaging modalities with positron emission tomographic (PET) scan allows characterization of aortic wall inflammatory activity. Elevated uptake of Fuorine-2-deoxy-D-glucose (FDG), a radiotracer with elevated avidity in highly-metabolic cells, has been correlated with the development and progression of both abdominal and thoracic AA in a number of animal models and clinical studies. Other novel PET radiotracers targeting matrix metalloproteinases (MMPs), mitochondrial translocator proteins (TSPO) and endothelial cell adhesion molecules are being investigated for clinical utility in identifying progression of disease in AA. By further defining the activation of molecular pathways in assessing aortic regions at risk for dilatation, this imaging modality can be integrated into future clinical decision-making models.

Can 18Fluoro-deoxy-glukose-Positron Emission Tomography/Computed Tomography be a Useful for Decision of Elective Surgery in Thoracic Aortic Aneurysm

“…As known, 18 FDG is a glucose analogue and if there is a high uptake in the aneurysm wall, rupture/dissection risk is increased. [ 2 3 7 ] Sakalihasan et al . reported that acute complication rate was 67% in 18 FDG-PET/CT-positive cases whereas this rate was 20% in negative ones.…”

“…It has been reported that 18 Fluoro-deoxy-glucose positron emission tomography/computed tomography ( 18 FDG-PET/CT) is associated with inflammatory response in aortic aneurysms and may be an independent parameter for the prediction of rupture. [ 2 3 ] However, its use is often overlooked except in malignant cases. We present an interesting case that, the decision of prophylactic surgery was facilitated by 18 FDG-PET/CT.…”

Risk Factors and Mouse Models of Abdominal Aortic Aneurysm Rupture

“…Imaging methods which combine a range of molecular and anatomical assessments are being developed. PET-CT camera systems which incorporate MRI are being studied for example [ 106 ]. PET-MRI hybrid imaging has been reported to reduce the scan time and seamlessly co-registers images acquired through the different modalities and permits synchronized evaluation of multiple imaging probes [ 101 , 103 , 107 , 108 ].…”

Molecular Imaging of Thoracic Aortic Aneurysm Inflammation: A Review of Clinical and Experimental Studies

“…Это достигается за счет активного поглощения глюкозы через систему белков-переносчиков (GLUT) [30,31,32]. Известно, что воспалительные клетки имеют более высокую скорость поглощения глюкозы, чем иные, находящиеся внутри артериальной стенки, что облегчает задачу исследователя в обнаружении воспалительного очага [33]. Поэтому эта техника визуализации наиболее актуальна в диагностике воспалительных заболеваний аорты на ранней стадии [34].…”