Role of PET/CT in the Evaluation of Aortic Disease

Abstract

Positron emission tomography (PET) /computed tomography (CT) has been established as a standard imaging modality in the evaluation of malignancy. Although PET/CT has played a major role in the management of oncology patients, its clinical use has also increased for various disorders other than malignancy. Growing evidence shows that PET/CT images have many advantages in aortic disease as well. This review article addresses the potential role of PET/CT in diseases involving the aorta, emphasizing its usefulness with regard to acute thoracic aortic syndromes, aortic aneurysm, atherosclerotic lesions, aortitis and aortic tumors.

Keywords: Aneurysm; Aortitis; Atherosclerosis; Dissecting; Positron Emission Tomography Computed Tomography.

FIG. 1. Representative case of Takayasu arteritis. (A) PET and fused PET/CT images before therapy. The patient exhibited tubular ¹⁸F-fluorodeoxyglucose (FDG) uptake along the walls of the left common carotid artery, aortic arch, and ascending and descending thoracic aorta (arrows in A). (B) PET and fused PET/CT images after administration of corticosteroids. All vascular FDG uptakes were markedly improved.

FIG. 2. Comparison of ¹⁸F-fluorodeoxyglucose PET/CT images of infected abdominal aortic aneurysm (A) and non-infected abdominal aortic aneurysm (B). Arrows indicated in the site of abdominal aortic aneurysm.

FIG. 3. Angiosarcoma of the pulmonary trunk. ¹⁸F-fluorodeoxyglucose PET/CT demonstrated an intense hypermetabolic lesion (SUVmax: 10.1) in the pulmonary trunk, which corresponded to subtotal occlusion on chest CT. Arrows indicated in the site of malignant tumor.