117 Optimisation and Reproducibility of 18F-Fluoride Positron Emission Tomography and Computed Tomography in Patients with Aortic Stenosis. (3rd June 2016)

• Record Type: Journal Article
• Authors: Pawade, Tania; Cartlidge, Timothy; Newby, David; Marc, Dweck
• Is Part Of: Heart. Volume 102(2016)Supplement 6
• Page Start: A82
• Page End: A82
• Publication Date: 2016-06-03
• Subjects: Aortic Stenosis -- 18F-Fluoride Positron Emission Tomography -- Computed Tomography; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2016-309890.117
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: 18F-Fluoride positron emission tomography (PET) and computed tomography (CT) can measure disease activity and progression in aortic stenosis. We aimed to optimise imaging methodology, analysis and scan-rescan reproducibility. Methods: Fifteen patients with aortic stenosis underwent 18F-fluoride PET-CT twice within 1 month. We compared non-gated PET and non-contrast CT, with a modified approach that incorporated contrast CT and ECG-gated PET. We explored a range of image analysis techniques including estimation of blood pool activity at differing vascular sites and a most-diseased segment (MDS) approach. Results: Contrast-enhanced ECG-gated PET-CT provided superior spatial localisation of 18F-fluoride uptake that permitted localisation to individual valve leaflets (Figure ). Scan-rescan reproducibility was markedly improved using enhanced analysis techniques leading to a reduction in variability from 25% to <10% (tissue-to-background MDS: mean value 1.55, difference 0.05, limits of agreement -0·10 to 0·20). Conclusion: Optimised 18F-fluoride PET-CT provides excellent spatial resolution and scan-rescan reproducibility. It holds major promise as a marker of disease activity in aortic stenosis and has major potential as a biomarker end-point of trials of novel therapies in aortic stenosis.