Hilmar Kuehl MD, PhD, Presenter: Nothing to Disclose

Holger Eggebrecht MD, PhD, Abstract Co-Author: Nothing to Disclose

Tanja Boes MA, Abstract Co-Author: Nothing to Disclose

Sandra Rosenbaum MD, Abstract Co-Author: Nothing to Disclose

Gerald Antoch MD, Abstract Co-Author: Nothing to Disclose

Andreas Bockisch MD, Abstract Co-Author: Nothing to Disclose

Joerg Barkhausen MD, Abstract Co-Author: Research Consultant, Bayer AG

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

The majority of patients with acute aortic syndrome are treated conservatively, but a substantial number of patients with disease progression require invasive therapy. Our study aimed to assess the impact of PET/CT and serological markers of inflammation to identify patients at risk for disease progression.

33 patients with acute aortic syndrome (thoracic aortic aneurysm n = 5, thoracic aortic dissection n = 14, penetrating aortic ulcer n = 8, intramural hematoma n = 6) were included into this prospective study. One hour after iv. administration of [18F]Fluorodeoxyglucose (FDG) non-contrast enhanced PET/CT of the body trunk and CT angiography of the entire aorta were performed using the Biograph system (Siemens Medical Solutions). Serological markers of inflammation and thrombosis including D-dimers and C-reactive protein were measured in all patients. Follow-up imaging was performed in all patients to detect or exclude disease progression.

The PET/CT exam could successfully be performed in all 33 patients. 11(33%) of 33 patients showed elevated tracer uptake within the aortic pathology, whereas 22 patients were PET-negative. In 23 patients a level of CRP exceeding 1.0 mg/dl or a D-dimer level larger than 250 μg/l was found, respectively. The mean follow-up time was 224 ± 195 days. Nine of 11 PET-positive patients (82%) showed progression of AAS, requiring surgical or endovascular treatment in 3 of 11 patients (27%). In contrast, 55 % of PET-negative patients showed stable disease or regression of TAD-B or IMH during the follow up period. The Kaplan Meier Analysis showed a clear, but not yet significant trend to longer survival in PET-negative patients, whereas elevated CRP and D-dimers did not allow to distinguish high-risk patients.

FDG-PET/CT revealed an elevated glucose uptake indicating inflammation in about one third of patients with AAS. These patients seem to be at high risk for disease progression and require close follow up or immediate definite treatment.

PET/CT can help to identify patients at risk for disease progression in acute aortic syndrome.

Kuehl, H, Eggebrecht, H, Boes, T, Rosenbaum, S, Antoch, G, Bockisch, A, Barkhausen, J, et al, , et al, , Value of Dual Modality PET/CT and Markers of Inflammation in Patients with Acute Aortic Syndrome.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5006663.html