Correlation of fluorine 18-labeled sodium fluoride uptake and arterial calcification on whole-body PET/CT in cancer patients. Issue 6 (June 2019)

• Record Type: Journal Article
• Authors: Dai, Dong; Chuang, Hubert H.; Macapinlac, Homer A.; Li, Tengfei; Pan, Tinsu
• Is Part Of: Nuclear medicine communications. Volume 40:Issue 6(2019:Jun.)
• Publication Date: 2019-06
• Subjects: atherosclerosis -- calcification -- fluorine-18-sodium fluoride -- PET/CT; Nuclear medicine -- Periodicals; 616.07575
• DOI: 10.1097/MNM.0000000000000986
• Languages: English
• ISSNs: 0143-3636

Abstract

Abstract : Background: Fluorine-18-labeled sodium fluoride ( 18 F-NaF) uptake measured with PET in the vessel walls can indicate active microcalcification, a potential biomarker of higher-risk plaques, which are not indicated by macrocalcification measured with computed tomography (CT). The aim of this study was to determine the extent to which 18 F-NaF uptake is correlated with calcification at arterial plaques in cancer patients undergoing whole-body PET/CT imaging. Patients and methods: Image data from 179 patients who underwent 18 F-NaF PET/CT were evaluated retrospectively. Plaques were categorized into four groups by calcium score (CS) on CT: CS1 (≥1000); CS2 (400–999); CS3 (100–399), and CS4 (<100) and into three groups by 18 F-NaF target-to-background ratio (TBR) on PET: TBRlow (⩽1.0), TBRmedium (1.0–1.5), and TBRhigh (>1.5). Correlations between 18 F-NaF uptake and CS were evaluated. Results: Plaques with 18 F-NaF uptake or arterial calcification were observed in 122 (76%) of the 179 patients. We found a weak but statistically significant positive correlation between CS and 18 F-NaF uptake. The TBR in CS1 plaques was higher than those in CS3 and CS4 plaques, and the TBR in CS2 plaques was higher than that in CS3 plaques ( P <0.05). Compared with patients whose plaques were with 18 F-NaF uptake (TBR>1.5) or arterial calcification (CS>0), patients without plaques of 18 F-NaF uptake or calcification were significantly younger ( P =0.00) or with significantly more women ( P =0.02). Conclusion: Our finding of a weak but significant positive correlation between 18 F-NaF uptake and arterial calcification suggests that 18 F-NaF PET/CT could provide complementary information of active microcalcification for atherosclerosis evaluation in cancer patients.