What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Subclinical atherosclerosis (n=115). Intervention: Elevated cardiovascular disease risk vs. Healthy volunteers. Primary outcome: Carotid artery radiotracer uptake (aSUVmean) of 18F-NaF and 18F-FDG (10-22% higher NaF and 16-27% higher FDG uptake, p=<0.05).

February 13, 2025Open Access

Associations of subclinical microcalcification and inflammation with carotid atheroma development: a dual-tracer PET/CT study

Q: What are the key findings of this study?

Relative to healthy volunteers, subjects at risk for cardiovascular disease had 10-22% higher 18F-NaF and 16-27% higher 18F-FDG uptake in the carotid arteries.

Key Result

Relative to healthy volunteers, subjects at risk for cardiovascular disease had 10-22% higher 18F-NaF and 16-27% higher 18F-FDG uptake in the carotid arteries.

Study Design

Type

Cross-Sectional (n=115)

Multicenter

Structured PICO

Does 18F-NaF and 18F-FDG PET/CT imaging correlate with cardiovascular and thromboembolic risk in patients with subclinical atherosclerosis?

Population

115 subjects (73 healthy volunteers and 42 at-risk for CVD) aged 21-75 years underwent 18F-NaF and 18F-FDG PET/CT imaging to evaluate carotid artery microcalcification and inflammation.

Exposure

18F-NaF and 18F-FDG PET/CT imaging (dual-tracer approach) to assess arterial inflammation and vascular calcification.

Comparator

Healthy volunteers (n=73) compared to at-risk patients (n=42).

Outcome

Relationship between arterial inflammation (18F-FDG) and vascular calcification (18F-NaF) in the left and right common carotid arteries, and their association with 10-year CVD risk (Framingham Risk Score) and thromboembolic risk (CHA2DS2-VASc score).surrogate

18F-NaF PET/CT may serve as a useful prognostic imaging biomarker for carotid microcalcification and subclinical atherosclerosis, correlating well with established cardiovascular risk scores.

Main Result

Effect estimate: 10-22% higher NaF and 16-27% higher FDG uptake

p-value: p=<0.05

Limitations

Risk of CVD and thromboembolism were calculated using FRS and CHA2DS2-VASc scores, which are susceptible to under- or over-estimation.
Cross-sectional design limits the evaluation of temporal relationships between atheroma development and vascular inflammation/microcalcification.
Several subjects were under statin therapy, which may influence plaque retention of FDG and NaF.
Manual segmentation was used to quantify tracer uptake, which may introduce technical error.

Abstract

PURPOSE: Carotid artery atherosclerosis, a significant manifestation of cardiovascular disease (CVD) and leading cause of stroke, develops through a gradual process of arterial inflammation and calcification. This study explores the relationship between arterial inflammation (18 F-FDG PET/CT) and vascular calcification (18 F-NaF PET/CT) in the left and right common carotid arteries (LCC/RCC) and their association with CVD and thromboembolic risk in patients with subclinical atherosclerosis. METHODS: A cohort of 115 subjects (73 healthy volunteers, 42 at-risk for CVD) underwent 18 F-NaF and 18 F-FDG PET/CT imaging. Radiotracer uptake was quantitatively assessed by measuring the average blood-pool-corrected mean standardized uptake value (aSUVmean). RESULTS: Relative to healthy volunteers, at-risk subjects had greater uptake of NaF and FDG (10-22% and 16-27% higher, respectively, in both arteries, p 0.05). CONCLUSION: 18 F-NaF PET/CT may serve as a prognostic tool for carotid microcalcification and subclinical atherosclerosis, while the utility of 18 F-FDG PET/CT remains uncertain. CLINICAL TRIAL REGISTRATION: "Cardiovascular Molecular Calcification Assessed by 18F-NaF PET CT (CAMONA)", NCT01724749, https://clinicaltrials.gov/study/NCT01724749 .

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Cite This Study

Patil et al. (Thu,) conducted a cross-sectional in Subclinical atherosclerosis (n=115). Elevated cardiovascular disease risk vs. Healthy volunteers was evaluated on Carotid artery radiotracer uptake (aSUVmean) of 18F-NaF and 18F-FDG (10-22% higher NaF and 16-27% higher FDG uptake, p=<0.05). Relative to healthy volunteers, subjects at risk for cardiovascular disease had 10-22% higher 18F-NaF and 16-27% higher 18F-FDG uptake in the carotid arteries.

synapsesocial.com/papers/6a1eb76c989adebfe89a7e65 https://doi.org/https://doi.org/10.1007/s00259-025-07127-z

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