title: (Tissue PET) Vascular metabolic imaging and peripheral plasma biomarkers in the evolution of chronic aortic dissections.
abstract: OBJECTIVE
  Despite adequate medical management, dissection of the descending aorta (type B) may develop complications, including aneurysmal progression and eventually rupture. Partial false lumen thrombosis has been identified as a marker of adverse evolution in chronic dissection. The aim of this study was to test the ability of complementary information, provided by (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) and peripheral biomarkers, to add pathophysiological significance and a prognostic value to morphological data.
  
  
  RESULTS
  We explored serial aortic (18)F-FDG uptake by PET/CT imaging and plasma biomarkers in a series of 23 patients with type B dissection to predict complications from initial data and to investigate potential associations with aneurysmal expansion during follow-up. Complications occurred in 17 patients. Acute initial characteristics associated with complications were male gender (P = 0.021), arterial hypertension (P = 0.040), aortic dissection diameter (P = 0.0086), partial thrombosis of the false channel (P = 0.0046), and enhanced focal (18)F-FDG uptake (P = 0.045). During follow-up (mean 16.7 ± 8.0 months), aneurysmal expansion was associated with false lumen morphology (P< 0.0001), quantitative (18)F-FDG uptake, (P = 0.0029), elevated plasma concentrations of biomarkers of platelets (P-selectin, P = 0.0009) and thrombin activation (TAT complexes, P = 0.0075), and fibrinolysis (PAP complexes, P < 0.0001; D-dimers, P = 0.0006). Plasma markers of coagulation and fibrinolysis were related to false channel morphology, suggesting that thrombus biological dynamics may drive progressive expansion of type B dissections.
  
  
  CONCLUSIONS
  Enhanced FDG uptake may be considered as a complementary imaging marker associated with secondary complications in type B dissections. During follow-up, aneurysmal progression is related to PET/CT and biomarkers of thrombus renewal and lysis.
authors.affiliation: Cardiovascular and Thoracic Surgery Department, University Hospital, Sart Tilman B35, Liège 4000, Belgium nsaka@chu.ulg.ac.be.
authors.forename: Natzi
authors.initials: N
authors.lastname: Sakalihasan
authors.affiliation: University Heart Center Rostock, University of Rostock, Rostock, Germany.
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Nienaber
authors.affiliation: Nuclear Medicine Department, University Hospital, Liège, Belgium.
authors.forename: Roland
authors.initials: R
authors.lastname: Hustinx
authors.affiliation: Nuclear Medicine Department, University Hospital, Liège, Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Lovinfosse
authors.affiliation: Radiology Department, University Hospital, Liège, Belgium.
authors.forename: Mounia
authors.initials: M
authors.lastname: El Hachemi
authors.affiliation: Cardiovascular and Thoracic Surgery Department, University Hospital, Sart Tilman B35, Liège 4000, Belgium.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Cheramy-Bien
authors.affiliation: Biostatistics, University Hospital of Liège, Liège, Belgium.
authors.forename: Laurence
authors.initials: L
authors.lastname: Seidel
authors.affiliation: Cardiovascular and Thoracic Surgery Department, University Hospital, Sart Tilman B35, Liège 4000, Belgium.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Lavigne
authors.affiliation: Cardiovascular and Thoracic Surgery Department, University Hospital, Sart Tilman B35, Liège 4000, Belgium.
authors.forename: Janine
authors.initials: J
authors.lastname: Quaniers
authors.affiliation: Cardiovascular and Thoracic Surgery Department, University Hospital, Sart Tilman B35, Liège 4000, Belgium.
authors.forename: Marie-Ange
authors.initials: MA
authors.lastname: Kerstenne
authors.affiliation: Cardiovascular and Thoracic Surgery Department, University Hospital, Sart Tilman B35, Liège 4000, Belgium.
authors.forename: Audrey
authors.initials: A
authors.lastname: Courtois
authors.affiliation: Cardiovascular and Thoracic Surgery Department, University Hospital, Sart Tilman B35, Liège 4000, Belgium.
authors.forename: Annie
authors.initials: A
authors.lastname: Ooms
authors.affiliation: Biostatistics, University Hospital of Liège, Liège, Belgium.
authors.forename: Adelin
authors.initials: A
authors.lastname: Albert
authors.affiliation: Cardiovascular and Thoracic Surgery Department, University Hospital, Sart Tilman B35, Liège 4000, Belgium.
authors.forename: Jean-Olivier
authors.initials: JO
authors.lastname: Defraigne
authors.affiliation: UMR 1148 Inserm-Paris7 University, Hôpital Xavier Bichat, Paris, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Michel
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging*; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D015415:Biomarkers; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG; D-dimers; PET/CT; Plasmin; Platelet; Thrombin; Type B dissections