Key Points
- The aim was to determine the effectiveness of 18F-FDG PET/CT in imaging inflammation in coronary arteries to identify vulnerable plaque.
- Retrospective analysis of 32 patients treated for malignancy who underwent 18F-FDG PET/CT and cardiac catheterization.
- Patients consumed a low-carbohydrate, high-fat meal before the procedure to suppress myocardial uptake.
- Assessment of myocardial uptake suppression and its correlation with angiographically apparent plaque.
- In 63% of patients, myocardial suppression was classified as good or adequate.
- A trend was observed between angiographic disease and 18F-FDG signal in coronary vessels (P = 0.07; 80 vessels examined).
- 15 patients exhibited detectable 18F-FDG uptake in coronary segments, indicating potential vulnerability.
Structured PICO
Does 18F-FDG PET/CT with a low-carbohydrate, high-fat preparation allow for the imaging of inflamed coronary plaque in patients undergoing coronary angiography?
PPopulation32 consecutive patients treated for malignancy who underwent clinically indicated 18F-FDG PET/CT and concomitant invasive coronary angiograms within 3 months.
IIntervention18F-FDG PET/CT imaging using a low-carbohydrate, high-fat meal preparation and vegetable oil drink to suppress myocardial uptake.
CComparatorStandard fasting preparation (in a secondary comparison cohort).
OOutcomeAdequacy of myocardial uptake suppression and correlation of angiographically apparent plaque with 18F-FDG uptake in major coronary arteries.surrogate
A low-carbohydrate, high-fat dietary preparation successfully suppresses myocardial 18F-FDG uptake, demonstrating the potential for noninvasive PET/CT imaging of inflamed and vulnerable coronary plaques.
Limitations
- Retrospective nature
- Dietary noncompliance by many patients
- Up to 3 months between PET/CT scan and angiogram
- Lack of respiratory or cardiac gating
- Partial-volume averaging