Key result
Delayed 3-hour 18F-FDG PET linked to ~50% higher aortic target-to-background ratio vs 1-hour imaging.
Why the study?
The optimal circulation time of fluorine-18 fluorodeoxyglucose for detecting and quantifying atherosclerotic plaque inflammation with PET CT imaging was not established.
Observational (n=15)
Absolute Event Rate: 1.57% vs 1.05%
p-value: p=0.001
May support 3-hour protocols for vascular PET inflammation imaging; hypothesis-generating in small cohort, needs prospective validation.
OBJECTIVE: The aim of this study was to determine the ideal circulation time of fluorine-18 fluorodeoxyglucose (F-FDG) in order to detect and quantify atherosclerotic plaque inflammation with PET computed tomography (CT) imaging. METHODS: Fifteen patients underwent multiple time-point imaging at ∼60, 120, and 180 min after F-FDG administration. For each time point, global assessment of aortic and carotid F-FDG uptake was determined qualitatively by visual assessment and semiquantitatively by calculation of the mean and maximum standardized uptake values (SUV) and the corresponding target-to-background ratio (TBR). RESULTS: Delayed imaging achieved significant improvement in visualization of atherosclerotic plaque inflammation [Friedman's χ statistic (d.f.=2, n=15)=24.13, P<0.001, Kendall's W=0.80]. This observation was confirmed by semiquantitative image analysis. At 1 h, the aortic and carotid SUVmean-calculated TBR was 1.05 [95% confidence interval (CI)=0.98, 1.11] and 0.88 (95% CI=0.81, 0.96), respectively. At 3 h, the TBR significantly increased to 1.57 (95% CI=1.28, 1.86; P=0.001) for the aorta and to 1.61 (95% CI=1.36, 1.87; P<0.001) for the carotid arteries. SUVmax-calculated TBRs showed a similar increase over time. CONCLUSION: One- and 2-h F-FDG PET CT imaging is suboptimal for global assessment of atherosclerotic plaque inflammation compared with imaging at 3 h. Our data support the utilization of 3-h delayed imaging to obtain optimal data for the detection and quantification of atherosclerotic plaque inflammation in human arteries.
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Blomberg et al. (2013) conducted an observational in Atherosclerotic plaque inflammation (n=15). 3-hour delayed 18F-FDG PET CT imaging vs. 1-hour 18F-FDG PET CT imaging was evaluated on Aortic target-to-background ratio (TBR) (95% CI 1.28-1.86, p=0.001). Delayed 18F-FDG PET CT imaging at 3 hours significantly increased the target-to-background ratio for the aorta to 1.57 compared to 1.05 at 1 hour, optimizing the assessment of atherosclerotic plaque inflammation.
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