Molecular Imaging of Abdominal Aortic Aneurysms with Positron Emission Tomography: A Systematic Review.

OBJECTIVE

Previous studies on the relationship between positron emission tomography (PET) images and abdominal aortic aneurysm (AAA) progression have shown contradictory results, and the objective of this study was to systematically review the role of PET in predicting AAA prognosis.

DATA SOURCES

PubMed, Embase, and Web of Science were searched for studies evaluating the correlation between PET imaging results and AAA growth, repair, or rupture.

REVIEW METHODS

Two authors independently performed the study search, data extraction, and quality assessment following a standard method.

RESULTS

Of the 11 studies included in this review, nine used F-fluorodeoxyglucose (F-FDG) PET and computed tomography (CT) imaging, whereas the remaining two used F-sodium fluoride (F-NaF) PET/CT and F-FDG PET/magnetic resonance imaging (MRI). Findings from the F-FDG PET/CT studies were contradictory. Six studies found no significant association or correlation, and two studies found a significant negative correlation between F-FDG uptake and AAA expansion. Additionally, one study found that the F-FDG uptake was statistically positively related to the expansion rate in a specific AAA subgroup whose AAAs expanded significantly. Two studies suggested that increased F-FDG uptake was significantly associated with AAA repair, while the other studies either found no association between F-FDG uptake and AAA rupture or repair or failed to report the occurrence of clinical events. One PET/CT study that used F-NaF as a tracer showed that an increased tracer uptake was significantly associated with AAA growth and clinical events. Finally, the F-FDG PET/MRI study indicated that F-FDG uptake was not significantly correlated with AAA expansion.

CONCLUSION

A definitive role for F-FDG PET imaging for AAA prognosis awaits further investigation, and new PET tracers such as F-NaF have the potential to be a promising method for predicting AAA clinical outcomes.