{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:42:51Z","timestamp":1786534971199,"version":"build-2736575974"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Molecular and cellular imaging biomarkers of abdominal aortic aneurysms (AAA) show promise as potential predictors of clinical events. This study assessed long-term clinical outcomes using ultrasmall superparamagnetic particles of iron oxide (USPIO) enhanced magnetic resonance imaging (MRI; ISRCTN76413758) and fluorine-18 sodium fluoride ([18F]NaF) positron emission tomography computed tomography (PET\/CT; NCT02229006).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A prospective multi-centre co-enrolled observational cohort studies of patients with asymptomatic AAA. Evaluation of aortic wall inflammation using USPIO-enhanced MRI in 338 patients was followed by [18F]NaF PET\/CT in a sub-group of 72 patients, to evaluate microcalcification. Aneurysms were classified according to aortic wall USPIO enhancement and into tertiles of [18F]NaF uptake. Aneurysm expansion, composite of rupture or repair, and overall survival were compared.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In 338 predominantly elderly (74\u00b17.2 years) men (85%) with mean aneurysm diameter 49.5\u00b17.3 mm, aneurysm expansion was increased in patients with USPIO enhancement (median [inter-quartile interval], 3.3 [2.0-4.6] versus 2.5 [1.4-3.6] mm\/y; p=.002) or high [18F]NaF uptake (4.0 [2.6-5.4] versus 1.9 [0.9-3.0] mm\/y; p&lt;.001), even when adjusted for hypertension, smoking and baseline AAA diameter (p=.04 and p=.003). After a median follow up of 102 [58-119] months, 63% patients met the composite endpoint of rupture or repair with high [18F]NaF uptake associated with more than two-fold higher risk (72% versus 36%; log rank p=.002). There was no association between USPIO enhancement and future rupture or repair.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Aortic wall USPIO enhancement and [18F]NaF uptake are independently associated with AAA expansion. These non-invasive imaging biomarkers provide an opportunity to identify those are at greatest risk of AAA progression and may help inform further research to determine optimal surveillance intervals.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/bjs\/znag100","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:54:50Z","timestamp":1785412490000},"source":"Crossref","is-referenced-by-count":0,"title":["Macrophage-mediated inflammation and microcalcification are associated with abdominal aortic aneurysm progression and clinical events"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3311-9599","authenticated-orcid":false,"given":"Rachael O","family":"Forsythe","sequence":"first","affiliation":[{"name":"Edinburgh Vascular Unit, Royal Infirmary of Edinburgh, 51 Little France Crescent , Edinburgh EH16 4SA ,","place":["United Kingdom"]},{"name":"Centre for Cardiovascular Science, University of Edinburgh , 49 Little France Crescent, Edinburgh EH16 4SB ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia M B","family":"McBride","sequence":"additional","affiliation":[{"name":"Ninewells Vascular Unit, Ninewells Hospital, James Arrott Drive , Dundee DD2 1SG ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M J","family":"Robson","sequence":"additional","affiliation":[{"name":"Leeds Vascular Institute, Leeds General Infirmary , Great George Street, Leeds LS1 3EX ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex T","family":"Vesey","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital Hairmyres , 218 Eaglesham Road, East Kilbride, Glasgow G75 8RG ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1135-4993","authenticated-orcid":false,"given":"Allison C","family":"Winarski","sequence":"additional","affiliation":[{"name":"Edinburgh Vascular Unit, Royal Infirmary of Edinburgh, 51 Little France Crescent , Edinburgh EH16 4SA ,","place":["United Kingdom"]},{"name":"Centre for Cardiovascular Science, University of Edinburgh , 49 Little France Crescent, Edinburgh EH16 4SB ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Callum","family":"Weston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Debono","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Queen Elizabeth University Hospital , 1345 Govan Road, Glasgow G51 4TF ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott I","family":"Semple","sequence":"additional","affiliation":[{"name":"Edinburgh Imaging Facility, Queen\u2019s Medical Research Institute, University of Edinburgh , Edinburgh, EH16 4SB ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2816-4707","authenticated-orcid":false,"given":"Calum D","family":"Gray","sequence":"additional","affiliation":[{"name":"Edinburgh Imaging Facility, Queen\u2019s Medical Research Institute, University of Edinburgh , Edinburgh, EH16 4SB ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J","family":"MacGillivray","sequence":"additional","affiliation":[{"name":"Edinburgh Imaging Facility, Queen\u2019s Medical Research Institute, University of Edinburgh , Edinburgh, EH16 4SB ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Brittenden","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Queen Elizabeth University Hospital , 1345 Govan Road, Glasgow G51 4TF ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giles","family":"Roditi","sequence":"additional","affiliation":[{"name":"School of Cardiovascular & Metabolic Health, Glasgow Cardiovascular Research Centre, 126 University Place , Glasgow G12 8TA ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley","family":"Stuart","sequence":"additional","affiliation":[{"name":"School of Cardiovascular & Metabolic Health, Glasgow Cardiovascular Research Centre, 126 University Place , Glasgow G12 8TA ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin J R","family":"van Beek","sequence":"additional","affiliation":[{"name":"Edinburgh Imaging Facility, Queen\u2019s Medical Research Institute, University of Edinburgh , Edinburgh, EH16 4SB ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew L","family":"Tambyraja","sequence":"additional","affiliation":[{"name":"Edinburgh Vascular Unit, Royal Infirmary of Edinburgh, 51 Little France Crescent , Edinburgh EH16 4SA ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle C","family":"Williams","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Science, University of Edinburgh , 49 Little France Crescent, Edinburgh EH16 4SB ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc R","family":"Dweck","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Science, University of Edinburgh , 49 Little France Crescent, Edinburgh EH16 4SB ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E","family":"Newby","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Science, University of Edinburgh , 49 Little France Crescent, Edinburgh EH16 4SB ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,12]]},"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjs\/advance-article-pdf\/doi\/10.1093\/bjs\/znag100\/70617199\/znag100.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/advance-article-pdf\/doi\/10.1093\/bjs\/znag100\/70617199\/znag100.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:25:21Z","timestamp":1786533921000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/advance-article\/doi\/10.1093\/bjs\/znag100\/8759486"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/bjs\/znag100","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]},"article-number":"znag100"}}