Edinburgh Imaging

06 Jun 17. Award to Dr Forsythe

Congratulations Rachael, for being awarded the 2017 Thomas J Fogarty Award at the Vascular Annual Meeting of the Society for Vascular Surgery.

Vascular Surgery

Rachael is a speciality registrar in Vascular Surgery, having recently completed a 3 year research fellowship under the supervision of Prof Newby.

After graduating from the University of Edinburgh in 2008, and completing her core surgical training in Bristol, she will shortly be submitting her PhD thesis - which focusses on the role of molecular imaging in abdominal aortic aneurysms.  She now hopes to continue pursuing her research interests in Edinburgh.

The team were delighted to be awarded the 2017 Thomas J Fogarty Award at the Vascular Annual Meeting of the Society for Vascular Surgery, which is the pre-eminent vascular society in the USA. Rachael presented their study, Sodium Fluoride Imaging in Abdominal Aortic Aneurysms (SoFIA3), which is the first study to investigate the use of a particular scanning technique in abdominal aortic aneurysm (AAA).

Abdominal aortic aneurysm

An abdominal aortic aneurysm (AAA) is a swelling of the main artery in the body (the aorta) and is considered a ’silent killer’ by some, as it can lie undiagnosed until it becomes life-threatening. It is the 13th commonest cause of death in older males, and yet some people have not heard of this condition. AAAs tend to grow larger over time, and the most feared complication is rupture of the aorta, which is fatal in up to 90% of cases. The main way to prevent rupture is to repair the AAA either by surgery or keyhole technique, and the decision on when to do this is made based on the size of the AAA. However, whilst we know that larger AAAs are at increased risk of rupture, up to 20% of ruptured AAAs may occur at a size smaller than that which is recommended for repair. AAA biology is a key part of AAA expansion and rupture, but is incompletely understood and is not routinely assessed in current practice.

The SoFIA3 study

In the SoFIA3 study, we used a mildly radioactive dye called sodium fluoride (18F-NaF), which lights up areas of biological activity in the wall of an AAA, and produces a bright picture when imaged using a PET-CT scanner.

Using our imaging technique, we have shown that 18F-NaF PET-CT is an independent predictor of future AAA expansion, over and above the known risk factors that we routinely assess in clinical practice, including AAA diameter. This means that our technique appears to add significant value to our ability to predict AAA progression and we are the first group in the world that have reported on this technique. This has the potential to change our assessment and management of patients with AAA and, we hope, to help reduce the number of fatal AAA ruptures.

We were delighted that our PET-CT study in AAA was recognised as the best International Fast Talk at the Society for Vascular Surgery in San Diego, and we are excited about the potential future use of this technique to help improve the management of patients with AAA

Speciality Registrar in Vascular SurgeryRachael Forsythe MBChB MRCS