Background: Abdominal aortic aneurysm (AAA) is a life-threatening condition due to the risk of aneurysm growth and rupture. Biomarkers linked to AAA pathogenesis are attractive candidates for AAA diagnosis and prognosis. The aim of this study was to assess circulating biomarkers levels relationship with PET imaging positivity and their predictive value in AAA growth rate. Methods: A total of 164 patients with AAA had whole body [¹⁸F]FDG PET/CT examination and blood drawn for biomarkers analysis at inclusion. Of these, 121 patients had at least one follow-up imaging assessment for AAA progression. Median (quartiles) imaging follow-up period was 32.8 months (15.2–69.6 months). Results: At baseline, PET was visually positive in 28 (17%) patients. Among PET+ patients, female proportion was higher compared to PET−patients (respectively, n = 6, 21.4% vs. n = 11, 8.1%, p = 0.046). Biomarkers of inflammation (CRP, CCL18), of proteolytic activity (MMP9), of extracellular matrix, and calcification regulation (OPN, OPG) were all significantly increased in PET+ patients (p < 0.05). During follow-up, rapid AAA growth (increase in size ≥ 1 cm per year) was observed in 36 (29.8%) patients and several biomarkers (CRP, MMP9, OPN, and OPG) were increased in those patients compared to patients without rapid growth (p < 0.05). Conclusions: Although PET positivity at baseline was not associated with rapid growth, CRP levels showed a significant association.

Aortic endograft infection (EI) can result in potentially life-threatening vascular complications. Unfortunately, it is difficult to obtain a correct diagnosis at an early stage in many patients. This report aims at validating the use of [¹⁸F] FDG PET/CT imaging for suspected endograft infections in a prospectively collected cohort of patients treated with EVAR and TEVAR. During a 14-year period, 366 patients required aortic stent graft. All procedures were performed electively, except for one patient. Among these 366 patients, eleven patients (3%) were suspected to have aortic EI. Contrast-enhanced CT and FDG PET/CT were performed in all 11 patients. Medical charts and imaging were analysed for these 11 cases, with initial positive CT. The final diagnosis of EI was established in seven (1,9%) based on clinical features, laboratory investigations and a significant [¹⁸F] FDG uptake in the aortic graft as well as the aortic wall. The median time from the initial EVAR/TEVAR to diagnosed infection was 180 days. During follow-up, the seven patients had a second PET/CT that was compared with the initial evaluation, decreased uptake was correlated with clinical improvement. Contemporary diagnostic imaging for a potentially lethal endograft infection lacks precision, this observational study illustrates the potential clinical value of [¹⁸F] FDG PET/CT in the management of aortic EI. [¹⁸F] FDG PET/CT constitutes an imaging modality able to confirm the diagnosis, monitor disease progression as well as the effect of pharmaceutical treatment and detect relapse.

Rupture of an abdominal aortic aneurysm (AAA) remains a catastrophic event, with in-hospital mortality after emergency repair ranging from 40% to 50% [1]. Approximately 30% of patients with a ruptu...

Background: Abdominal aortic aneurysm (AAA) is a chronic inflammatory disease that poses several challenges. Given the increasing evidence that AAA patients are more likely to develop cancer and the importance of its early detection, we strived to develop a non-invasive tool based on serial FDG-PET/CT scan examinations to identify, among AAA patients, those at risk of cancer. Methods: Between 2006 and 2011 we recruited 149 AAA patients, free of cancer at baseline, and followed them until the end of 2021. All patients underwent an FDG-PET/CT scan at inclusion and possibly more scans during follow-up. At each medical imaging examination, the aneurysmal FDG uptake was recorded. Patients were stratified based on their aortic wall PET status (negative/positive). Any occurrence of cancer was reported. A Cox regression analysis and competing-risk modeling were applied to the data. Results: The proportion of AAA patients who developed cancer was 31.5% (mean time to diagnosis was 5.7 ± 3.4 years) and the death rate was 59%. A difference in cancer incidence between PET+ and PET− patients was detected (46.8% vs. 27.3%; HR = 1.96, 95%CI: 1.07–3.57, p = 0.028). Moreover, AAA patients undergoing surgical treatment had a lower risk of cancer than unoperated patients (28% vs. 50%; HR = 0.41, 95%CI: 0.21–0.80, p = 0.009). Conclusions: In AAA patients, diagnostic imaging with an FDG-PET/CT scan can help identify those patients at a higher risk of developing cancer. Moreover, the higher cancer risk in non-surgically treated patients calls for further analysis of associations between aneurysm growth and malignant disease.

Heart transplantation (HTx) in adults with congenital heart disease (ACHD) remains challenging because of structural anomalies and often previous procedure. The aim of this retrospective study was ...