Key result
Symptomatic carotid disease is linked to significantly higher 18F-FDG uptake on PET/CT versus asymptomatic disease.
Why the study?
The role of PET/CT in determining arterial wall inflammation and its relation to plaque stability in carotid artery disease is not well defined.
Does 18F-FDG uptake on PET/CT differ between symptomatic and asymptomatic carotid artery disease?
Meta-Analysis (n=539)
Does 18F-FDG uptake on PET/CT differ between symptomatic and asymptomatic carotid artery disease?
Standardized Mean Difference: 0.94 (95% CI 0.58–1.13)
p-value: p=< .0001
18F-FDG PET/CT demonstrates significantly higher carotid plaque inflammation in symptomatic compared to asymptomatic carotid disease.
May aid risk stratification via plaque inflammation detection; leaves open whether PET/CT alters revascularization decisions.
Introduction The role of positron emission tomography (PET)/computed tomography (CT) in the determination of inflammation in arterial disease is not well defined. This can provide information about arterial wall inflammation in atherosclerotic disease, and may give insight into plaque stability. The aim of this review was to perform a meta-analysis of PET/CT with 18 F-FDG (fluorodeoxyglucose) uptake in symptomatic and asymptomatic carotid artery disease. Methods This was a systematic review, following PRISMA guidelines, which interrogated the MEDLINE database from January 2001 to May 2017. The search combined the terms, "inflammation", "FDG", and "stroke". The search criteria included all types of studies, with a primary outcome of the degree of arterial vascular inflammation determined by 18 F-FDG uptake. Analysis involved an inverse weighted variance estimate of pooled data, using a random effects model. Results A total of 14 articles (539 patients) were included in the meta-analysis. Comparing carotid artery 18 F-FDG uptake in symptomatic versus asymptomatic disease yielded a standard mean difference of 0.94 (95% CI 0.58–1.130; p < .0001; I 2 = 65%). Conclusions PET/CT using 18 F-FDG can demonstrate carotid plaque inflammation, and is a marker of symptomatic disease. Further studies are required to understand the clinical implication of PET/CT as a risk prediction tool.
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Chowdhury et al. (2018) conducted a meta-analysis in Carotid artery disease (n=539). Symptomatic carotid disease vs. Asymptomatic carotid disease was evaluated on Degree of arterial vascular inflammation determined by 18F-FDG uptake (SMD 0.94, 95% CI 0.58-1.130, p=< .0001). Symptomatic carotid artery disease was associated with significantly higher 18F-FDG uptake on PET/CT compared to asymptomatic disease (SMD 0.94; 95% CI 0.58-1.130; p < .0001).
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