Prognostic value of 18fluorodeoxyglucose-positron emission tomography/computed tomography in type A aortic intramural hematoma

Abstract OBJECTIVES In this study, we aimed to assess 18fluorodeoxyglucose (18 F-FDG) uptake in patients with type A aortic intramural haematoma (IMH) to establish its association with disease progression. METHODS Patients with type A IMH receiving medical management were included. After the patient agreed to participate, 18 F-FDG PET/CT was performed. The aortic 18 F-FDG uptake was measured in standardized uptake value (SUV). The primary outcome was disease progression, which was defined as a condition requiring aortic intervention. The median follow-up was calculated by the inverse Kaplan–Meier method. RESULTS A total of 32 patients were included in this study. During a median follow-up of 28.3 months (95% CI 4.8–51.7), 14 events occurred in 14 patients (43.8%). Patients with disease progression had significantly higher SUVmax compared to the stable group (4.9 ± 1.1 vs 3.5 ± 1.0, p =0.001). ROC curve analysis revealed that an SUVmax cut-off of 4.25 had a sensitivity of 78.6% and specificity of 77.8% for predicting disease progression, with an area under the curve (AUC) of 0.806 (95% CI: 0.653–0.958). The 2-year progression-free survival rates for the SUVmax increased (>4.25) and non-increased (≤4.25) were 20.7% and 75.0% (p = 0.019), respectively. CONCLUSIONS Increased aortic 18 F-FDG uptake was associated with high risk for adverse aortic events in type A IMH. The SUVmax of 18 F-FDG should be considered in the risk stratification and management of these patients.