18F-FDG PET scanning of abdominal aortic aneurysms and correlation with molecular characteristics: a systematic review

PURPOSE The purpose of this study is to give an overview of studies investigating the role of fludeoxyglucose F18 ((18)F-FDG) positron emission tomography (PET) scanning in patients with aortic aneurysms with a focus on molecular characteristics of the aneurysm wall. METHODS MEDLINE, EMBASE, and the Cochrane database were searched for relevant articles. After inclusion and exclusion, we selected 18 relevant articles reporting on (18)F-FDG PET scanning of aortic aneurysms. RESULTS The sample size of studies is limited, and there are no standardized imaging protocols and quantification methods. (18)F-FDG PET scanning was shown to display molecular characteristics of the aortic wall. Different studies showed contradictory findings of aortic (18)F-FDG uptake in aneurysm patients compared to controls. CONCLUSIONS Non-invasively determining molecular characteristics of aortic wall weakening might lead to better rupture and growth prediction. This might influence the decision of the surgeon between conservative and surgical treatment of aneurysms. To date, there is conflicted evidence regarding the use of (18)F-FDG PET scanning to predict aneurysm rupture and growth. The role of (18)F-FDG PET scanning in rupture risk prediction needs to be further investigated, and standardized imaging protocols and quantification methods need to be implemented.