18F-sodium fluoride positron emission tomography for molecular imaging of coronary atherosclerosis based on computed tomography analysis. (August 2017)

• Record Type: Journal Article
• Authors: Kitagawa, Toshiro; Yamamoto, Hideya; Toshimitsu, Shinya; Sasaki, Ko; Senoo, Atsuhiro; Kubo, Yumiko; Tatsugami, Fuminari; Awai, Kazuo; Hirokawa, Yutaka; Kihara, Yasuki
• Is Part Of: Atherosclerosis. Volume 263(2017)
• Page Start: 385
• Page End: 392
• Publication Date: 2017-08
• Subjects: 18F-sodium fluoride -- Positron emission tomography -- Cardiac computed tomography -- Coronary atherosclerosis; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2017.04.024
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: We aimed at evaluating the relation of 18 F-sodium fluoride ( 18 F-NaF) uptake on positron emission tomography (PET) to coronary atherosclerosis detected and assessed by computed tomography (CT). Methods: Thirty-two patients with one or more coronary atherosclerotic lesions detected on cardiac CT underwent 18 F-NaF PET/CT. Each coronary atherosclerotic lesion was evaluated on CT angiography for plaque types (calcified plaque [CP], non-calcified plaque [NCP], partially calcified plaque [PCP]), and the presence of CT-based high-risk features (minimum CT density <30 Hounsfield units and vascular remodeling index >1.1). Focal 18 F-NaF uptake of each lesion was quantified using maximum tissue-to-background ratio (TBRmax ). Results: A total of 111 lesions were studied. In a patient-based analysis, logarithmically transformed coronary calcium score correlated positively with maximum TBRmax per patient, and 15 patients with myocardial infarction or unstable angina history showed a higher maximum TBRmax per patient than those without (1.36 ± 0.15 versus 1.15 ± 0.15, p = 0.0006). In a lesion-based analysis, PCP showed a higher TBRmax than CP and NCP (1.17 ± 0.19 versus 1.00 ± 0.24 and 0.92 ± 0.18, respectively, p < 0.0001), and the lesions with high-risk features had a higher TBRmax than those without (1.20 ± 0.21 versus 1.02 ± 0.20, p = 0.0011). Conclusions: Coronary arterial 18 F-NaF uptake is related to total plaque burden, coronary event history, and specific features of coronary atherosclerosis based on CT analysis. 18 F-NaF PET/CT, in combination with cardiac CT, may provide a new molecular imaging approach to identify high-risk patients and coronary atherosclerotic lesions. Highlights: Coronary calcium score has a positive correlation with maximum coronary 18 F-NaF uptake per patient. The presence of coronary event history is related to higher coronary 18 F-NaF uptake per patient. Increased 18 F-NaF uptake in coronary atherosclerosis independently correlate with the partially calcified plaque on CCTA. CCTA-identified high-risk coronary plaques have higher 18 F-NaF uptake.