DOI: 10.1007/s00259-017-3883-1Pages: 1-9

Low baseline and subsequent higher aortic abdominal aneurysm FDG uptake are associated with poor sac shrinkage post endovascular repair

1. CHRU-Nancy, Université de Lorraine, Nuclear Medecine & Nancyclotep Platform

2. INSERM, University of Lorraine, UMR 1116

3. CHRU-Nancy, Hôpitaux de BRABOIS, Service de Médecine Nucléaire

4. CHU-Rouen, Department of Vascular Surgery

5. CHRU-Nancy, Université de Lorraine, Department of Radiology

6. Hôpital Ambroise Paré, APHP, Chirurgie Vasculaire

7. CHU-Lille, Department of Vascular Surgery

8. INSERM, University of Lorraine, UMR 947

9. APHP, HEGP, Department of Vascular Surgery

10. CHRU-Nancy, Université de Lorraine, Vascular Surgery

11. CHU-Nantes, Department of Vascular Surgery

12. CHU-Besançon, Department of Nuclear Medecine

13. INSERM, CHRU-Nancy, Université de Lorraine, CIC-1433, FCRIN INI-CRCT

14. INSERM, Bichat, UMR 698

Correspondence to:
Pierre-Yves Marie
Tel: +(33)383153909
Email: py.marie@chru-nancy.fr

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Abstract

Purpose

The growth phases of medically treated abdominal aortic aneurysms (AAA) are frequently associated with an 18F–fluorodesoxyglucose positron emission tomography (FDG-PET) pattern involving low baseline and subsequent higher FDG uptake. However, the FDG-PET patterns associated with the endovascular aneurysm repair (EVAR) of larger AAA are presently unknown. This study aimed to investigate the relationship between serial AAA FDG uptake measurements, obtained before EVAR and 1 and 6 months post-intervention and subsequent sac shrinkage at 6 months, a well-recognized indicator of successful repair.

Methods

Thirty-three AAA patients referred for EVAR (maximal diameter: 55.4 ± 6.0 mm, total volume: 205.7 ± 63.0 mL) underwent FDG-PET/computed tomography (CT) before EVAR and at 1 and 6 months thereafter, with the monitoring of AAA volume and of a maximal standardized FDG uptake [SUVmax] averaged between the axial slices encompassing the AAA.

Results

Sac shrinkage was highly variable and could be stratified into three terciles: a first tercile in which shrinkage was absent or very limited (0–29 mL) and a third tercile with pronounced shrinkage (56–165 mL). SUVmax values were relatively low at baseline in the 1st tercile (SUVmax: 1.69 ± 0.33), but markedly increased at 6 months (2.42 ± 0.69, p = 0.02 vs. baseline). These SUV max values were by contrast much higher at baseline in the 3rd tercile (SUVmax: 2.53 ± 0.83 p = 0.009 vs. 1st tercile) and stable at 6 months (2.49 ± 0.80), while intermediate results were documented in the 2nd tercile. Lastly, the amount of sac shrinkage, expressed in absolute values or in percentages of baseline AAA volumes, was positively correlated with baseline SUVmax (p = 0.001 for both).

Conclusion

A low pre-EVAR FDG uptake and increased AAA FDG uptake at 6 months are associated with reduced sac shrinkage. This sequential FDG-PET pattern is similar to that already shown to accompany growth phases of medically treated AAA.

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  • Accepted: Nov 8, 2017
  • Online: Nov 21, 2017

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