Early-Dynamic Positron Emission Tomography (PET)/Computed Tomography and PET Angiography for Endoleak Detection After Endovascular Aneurysm Repair.

Published on Mar 22, 2017in Journal of Endovascular Therapy3.102
· DOI :10.1177/1526602817699397
Robert Drescher5
Estimated H-index: 5
Falk Gühne4
Estimated H-index: 4
Martin Freesmeyer14
Estimated H-index: 14
PURPOSE: To propose a positron emission tomography (PET)/computed tomography (CT) protocol including early-dynamic and late-phase acquisitions to evaluate graft patency and aneurysm diameter, detect endoleaks, and rule out graft or vessel wall inflammation after endovascular aneurysm repair (EVAR) in one examination without intravenous contrast medium. TECHNIQUE: Early-dynamic PET/CT of the endovascular prosthesis is performed for 180 seconds immediately after intravenous injection of F-18-fluorodeoxyglucose. Data are reconstructed in variable time frames (time periods after tracer injection) to visualize the arterial anatomy and are displayed as PET angiography or fused with CT images. Images are evaluated in view of vascular abnormalities, graft configuration, and tracer accumulation in the aneurysm sac. Whole-body PET/CT is performed 90 to 120 minutes after tracer injection. CONCLUSION: This protocol for early-dynamic PET/CT and PET angiography has the potential to evaluate vascular diseases, including the diagnosis of complications after endovascular procedures.
#1Qiang Guo (Sichuan University)H-Index: 2
#2Jichun Zhao (Sichuan University)H-Index: 22
Last. Xiaojiong Du (Sichuan University)H-Index: 1
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Purpose: To analyze the literature comparing ultrasound [duplex (DUS) or contrast-enhanced (CEUS)] or magnetic resonance imaging (MRI) with computed tomography angiography (CTA) for endoleak detection and aneurysm diameter measurement after endovascular aneurysm repair (EVAR). Methods: A systematic review identified 31 studies that included 3853 EVAR patients who had paired scans (DUS or CEUS vs CTA or MRI vs CTA) within a 1-month interval for identification of endoleaks during EVAR surveillance...
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Objective Positron emission tomography (PET) angiography utilizes early dynamic PET acquisitions for depiction of the arterial vasculature. The aim of this study was to assess image quality and to evaluate feasibility of F-18 FDG PET angiography of the abdominal arteries.
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Dynamic CT angiography after endovascular aneurysm repair revealed that the peak enhancement of the endoleaks is significantly different than that of the aorta and that endoleaks may not be adequately evaluated with conventional biphasic CT angiography protocols.
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Results The 30-day operative mortality was 1.8% in the endovascular-repair group and 4.3% in the open-repair group (adjusted odds ratio for endovascular repair as compared with open repair, 0.39; 95% confidence interval [CI], 0.18 to 0.87; P = 0.02). The endovascular-repair group had an early benefit with respect to aneurysm-related mortality, but the benefit was lost by the end of the study, at least partially because of fatal endo graft ruptures (adjusted hazard ratio, 0.92; 95% CI, 0.57 to 1....
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: We present a case of a type Ia endoleak detected using F-FDG PET/CT 10 years after an abdominal aortoiliac endovascular aneurysm repair in an 83-year-old man. The F-FDG PET/CT scan was performed to evaluate a solitary pulmonary nodule but, in addition, demonstrated unexpected blood pool activity outside the stent graft and within the abdominal aortic aneurysm sac, indicating an endoleak; no FDG activity should be present within the aneurysm sac after stent graft placement. A subsequent CT angi...
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