Abstract
Inflammatory-proteolytic processes in the vessel wall are essential in the pathophysiology of abdominal aortic aneurysm (AAA). It has been demonstrated that, 18F-FDG-PET/CT may be useful for detection of pathological wall metabolism and therefore risk stratification. Quantification of the FDG-uptake in AAA wall is hampered by partial-volume (PV)-effects. For correction and accurate quantitative 18F-FDG-uptake analysis we designed and validated a novel IDL-based software in correlation to phantom studies, histopathology and clinical presentation of AAA patients. For in vivo studies 23 patients with symptomatic and asymptomatic AAA underwent 18F-FDG-PET/CT before surgery. In areas with 18F-FDG-uptake the maximum and mean standardized uptake values in the vessel wall with (PVC-SUVmax, PVC-SUVmean) and without (SUVmax, SUVmean) PV-correction were determined. Results were correlated with clinical presentation, corresponding macrophage-infiltration and MMP-2- and -9-expression in surgical specimens. In patients, SUVmax, SUVmean as well as PVC-SUVmax or PVC-SUVmean enabled a highly significant (p < 0.005) discrimination of symptomatic and asymptomatic AAA. Uncorrected and corrected SUVs showed comparable correlations with macrophage-infiltration and MMP-9 expression. No correlation of 18F-FDG-uptake and MMP-2 was found. In vivo correlations of detected FDG-uptake with clinical and histological results showed comparable results for corrected and uncorrected SUVs. PV-correction is not mandatory for qualitative clinical assessment of glucose metabolism in the vessel wall of AAA-patients but may be necessary to establish quantitative cut off values to stratify patients for aneurysm repair.
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The study was funded in line with the budget of the institutional departments.
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The authors declare that they do not have any conflict of interest.
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Christian Reeps and Ralph A. Bundschuh contributed equally to the manuscript.
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Reeps, C., Bundschuh, R.A., Pellisek, J. et al. Quantitative assessment of glucose metabolism in the vessel wall of abdominal aortic aneurysms: correlation with histology and role of partial volume correction. Int J Cardiovasc Imaging 29, 505–512 (2013). https://doi.org/10.1007/s10554-012-0090-9
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DOI: https://doi.org/10.1007/s10554-012-0090-9