Positron Emission Tomography (PET) Evaluation of Abdominal Aortic Aneurysm (AAA)

AbstractBackground: aneurysmal disease is associated with an inflammatory cell infiltrate and enzymatic degradation of the vessel wall.Aim of the study: to detect increased metabolic activity in abdominal aortic aneurysms (AAA) by means of positron emission tomography (PET-imaging).Study design: twenty-six patients with AAA underwent PET-imagingResults: in ten patients, PET-imaging revealed increased fluoro-deoxy-glucose (18-FDG) uptake at the level of the aneurysm. Patients with positive PET-imaging had one or more of the following elements in their clinical history: history of recent non-aortic surgery (n = 4), a painful inflammatory aortic aneurysm (n = 2), moderate low back pain (n = 2), rapid (> 2;5mm in 6 months) expansion (n = 4), discovery by PET-scan of a previously undiagnosed lung cancer (n = 3) or parotid tumour (n = 1). Five patients with a positive PET scan required urgent surgery within two to 30 days. Among the 16 patients with negative PET-imaging of their aneurysm, only one had recent non-aortic surgery, none of them required urgent surgery, only two had a rapidly expanding AAA, and in only one patient, PET-imaging revealed an unknown lung cancer.Conclusion: these data suggest a possible association between increased 18-FDG uptake and AAA expansion and rupture