Predictive Value of 18F‐Sodium Fluoride Positron Emission Tomography in Detecting High‐Risk Coronary Artery Disease in Combination With Computed Tomography. Issue 20 (16th October 2018)

• Record Type: Journal Article
• Authors: Kitagawa, Toshiro; Yamamoto, Hideya; Nakamoto, Yumiko; Sasaki, Ko; Toshimitsu, Shinya; Tatsugami, Fuminari; Awai, Kazuo; Hirokawa, Yutaka; Kihara, Yasuki
• Is Part Of: Journal of the American Heart Association. Volume 7:Issue 20(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-10-16
• Subjects: coronary artery disease -- coronary atherosclerosis -- coronary computed tomography angiography -- coronary event -- positron emission tomography -- sodium fluoride; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.118.010224
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: Application of 18 F‐sodium fluoride ( 18 F‐NaF) positron emission tomography (PET) to coronary artery disease has attracted interest. We investigated the utility of 18 F‐NaF uptake for predicting coronary events and evaluated the combined use of coronary computed tomography (CT) angiography (CCTA) and 18 F‐NaF PET/CT in coronary artery disease risk assessment. Methods and Results: This study included patients with ≥1 coronary atherosclerotic lesion detected on CCTA who underwent 18 F‐NaF PET/CT. High‐risk plaque on CCTA was defined as plaque with low density (<30 Hounsfield units) and high remodeling index (>1.1). Focal 18 F‐NaF uptake in each lesion was quantified using the maximum tissue:background ratio (TBRmax ), and maximum TBRmax per patient (M‐TBRmax ) was determined. Thirty‐two patients having a total of 112 analyzed lesions were followed for 2 years after 18 F‐NaF PET/CT scan, and 11 experienced coronary events (acute coronary syndrome and/or late coronary revascularization [after 3 months]). Patients with coronary events had higher M‐TBRmax than those without (1.39±0.18 versus 1.19±0.17, respectively; P =0.0034). The optimal M‐TBRmax cutoff to predict coronary events was 1.28 (area under curve: 0.79). Patients with M‐TBRmax ≥1.28 had a higher risk of earlier coronary events than those with lower M‐TBRmax ( P =0.0062 by log‐rank test). In patient‐based (n=41) and lesion‐based (n=143) analyses of CCTA findings that predicted higher coronary 18 F‐NaF uptake, the presence of high‐risk plaque was a significant predictor of both M‐TBRmax ≥1.28 and TBRmax ≥1.28. Conclusions: 18 F‐NaF PET/CT has the potential to detect high‐risk coronary artery disease and individual coronary lesions and to predict future coronary events when combined with CCTA. Clinical Trial Registration: URL: www.umin.ac.jp . Unique identifier: UMIN000013735.