Why the study?
Advances in imaging technologies have significantly improved AAA detection, risk stratification, and management, necessitating periodic updates to clinical guidelines alongside evolving screening strategies.
What are the roles of various imaging modalities in the diagnosis, risk assessment, and screening of abdominal aortic aneurysm?
What are the roles of various imaging modalities in the diagnosis, risk assessment, and screening of abdominal aortic aneurysm?
Advances in imaging technologies, including AI and PET-CT, alongside traditional US and CTA, are shifting AAA management towards targeted screening and personalized risk stratification.
Imaging advances may refine AAA risk stratification; leaves open prospective validation before guideline updates.
Abdominal aortic aneurysm (AAA) is a potentially life-threatening vascular condition, with rupture carrying a high mortality risk. Advances in imaging technologies have significantly improved the detection, risk stratification, and management of AAA, necessitating periodic updates to international clinical guidelines. This review examines recent advancements in AAA imaging modalities, their role in diagnosis and risk assessment, and evolving screening strategies in response to changing epidemiological trends. A systematic literature search was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, identifying key studies on diagnostic imaging techniques such as ultrasonography (US), computed tomography angiography (CTA), magnetic resonance angiography (MRA), intravascular US (IVUS), positron emission tomography-computed tomography (PET-CT), and artificial intelligence (AI)-driven imaging. US remains the preferred screening tool due to its cost-effectiveness, while CTA is the gold standard for preoperative planning. MRA is an alternative for patients with renal impairment, and emerging technologies such as AI-based imaging, IVUS, and PET-CT enhance risk prediction and surgical decision-making. Declining AAA prevalence, attributed to reduced smoking rates and improved cardiovascular risk management, has led to a shift from population-wide screening to targeted screening based on individual risk factors. Additionally, the standardization of imaging protocols and caliper placement techniques is crucial for accurate measurements and consistent clinical decision-making. As imaging technology continues to evolve, integrating AI, genetic markers, and biomarkers into screening and diagnostic protocols may enable more precise and personalized AAA management. Future research should focus on refining imaging-based risk stratification models to optimize screening and treatment strategies.
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Sidik et al. (2025) studied this question.
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