18F Sodium Fluoride PET CT in patients with Acute Aortic Syndrome
Research type
Research Study
Full title
18F Sodium Fluoride PET CT in patients with Acute Aortic Syndrome
IRAS ID
239677
Contact name
David Newby
Contact email
Sponsor organisation
University of Edinburgh
Clinicaltrials.gov Identifier
AC18044, ACCORD Sponsor Number
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Summary of Research
Acute aortic syndrome is a devastating clinical condition involving a tear in the largest blood vessel of the body - the aorta. Patients may require urgent surgery if the blood supply to limbs or organs is affected. Otherwise, usual treatment is with blood pressure lowering medication. However, despite these efforts, the weakened aorta is prone to expansion and the catastrophic consequence of rupture.
To date, there remains no way of predicting aortic expansion in acute aortic syndrome. Applying new technologies to imaging the aorta allows us to study specific disease processes. A biological tracer called 18F-Sodium Fluoride (18F-NaF) can be used with positron emission tomography (PET) scanning to visualise areas of tissue disease within the aorta. This tracer is safe and has been used in numerous human studies.
As part of our research, we will include PET imaging to the established surveillance pathway of patients with acute aortic syndrome (during their routine 30-day and 12-month CT scan). We will take this opportunity to perform a clinical assessment and blood tests on volunteers.
Finally, we will report:
(i) the distribution of 18F-NaF binding to the aorta;
(ii) associations between 18F-NaF and changes in the shape of the aorta;
(iii) associations between 18F-NaF and acute aortic syndrome-related complications.Summary of Results
The Aorta and Acute Aortic Syndrome
The aorta is the main blood vessel of the body that carries blood away from the heart.
In an aortic dissection, the wall of the aorta tears because it has become weak. Alternatively, the aortic wall may bleed into itself; this is called an intramural haematoma. In some cases, a small area of the aortic wall becomes inflamed and forms a penetrating aortic ulcer.
Together, these three conditions are known as acute aortic syndrome.
Acute aortic syndrome is a catastrophic condition in which the damaged aortic wall may expand or rupture, leading to life-threatening complications.
18F-Sodium Fluoride PET/CT in Acute Aortic Syndrome
18F-sodium fluoride positron emission tomography combined with computed tomography (PET/CT) is a specialised imaging scan that detects injury within the aortic wall.
This scan has never previously been performed in patients with acute aortic syndrome.
We invited patients with acute aortic syndrome to undergo 18F-sodium fluoride PET/CT to determine whether it could detect areas of current aortic wall injury and identify regions at risk of future damage.
We found that patients with acute aortic syndrome showed increased 18F-sodium fluoride signal, particularly at sites where the aorta had torn. Patients with higher 18F-sodium fluoride uptake were more likely to experience aortic growth over time. Finally, patients with a recently torn aorta and high 18F-sodium fluoride signal were more likely to develop aortic complications.
REC name
East of Scotland Research Ethics Service REC 2
REC reference
18/ES/0070
Date of REC Opinion
9 Jul 2018
REC opinion
Further Information Favourable Opinion