Coronary 18F-NaF uptake was significantly higher in patients with coronary atherosclerosis compared to controls (1.64 vs. 1.23; p=0.003) and correlated with calcium score.
Observational (n=119)
Does 18F-NaF and 18F-FDG PET/CT imaging identify active plaque calcification and inflammation in patients with coronary atherosclerosis compared to those without?
18F-NaF PET/CT imaging is a promising noninvasive marker of active coronary plaque calcification that correlates with coronary atherosclerosis and prior cardiovascular events.
Absolute Event Rate: 1.64% vs 1.23%
p-value: p=0.003
OBJECTIVES With combined positron emission tomography and computed tomography (CT), we investigated coronary arterial uptake of 18F-sodium fluoride (18F-NaF) and 18F-fluorodeoxyglucose (18F-FDG) as markers of active plaque calcification and inflammation, respectively. BACKGROUND The noninvasive assessment of coronary artery plaque biology would be a major advance particularly in the identification of vulnerable plaques, which are associated with specific pathological characteristics, including micro-calcification and inflammation. METHODS We prospectively recruited 119 volunteers (72 ± 8 years of age, 68% men) with and without aortic valve disease and measured their coronary calcium score and 18F-NaF and 18F-FDG uptake. Patients with a calcium score of 0 were used as control subjects and compared with those with calcific atherosclerosis (calcium score >0). RESULTS Inter-observer repeatability of coronary 18F-NaF uptake measurements (maximum tissue/background ratio) was excellent (intra-class coefficient 0.99). Activity was higher in patients with coronary atherosclerosis (n = 106) versus control subjects (1.64 ± 0.49 vs. 1.23 ± 0.24; p = 0.003) and correlated with the calcium score (r = 0.652, p 1,000 displayed normal uptake. Patients with increased coronary 18F-NaF activity (n = 40) had higher rates of prior cardiovascular events (p = 0.016) and angina (p = 0.023) and higher Framingham risk scores (p = 0.011). Quantification of coronary 18F-FDG uptake was hampered by myocardial activity and was not increased in patients with atherosclerosis versus control subjects (p = 0.498). CONCLUSIONS 18F-NaF is a promising new approach for the assessment of coronary artery plaque biology. Prospective studies with clinical outcomes are now needed to assess whether coronary 18F-NaF uptake represents a novel marker of plaque vulnerability, recent plaque rupture, and future cardiovascular risk. (An Observational PET/CT Study Examining the Role of Active Valvular Calcification and Inflammation in Patients With Aortic Stenosis; NCT01358513).
Dweck et al. (Sun,) conducted a observational in Coronary atherosclerosis (n=119). 18F-sodium fluoride (18F-NaF) PET/CT vs. Control subjects (calcium score of 0) was evaluated on Coronary 18F-NaF uptake (maximum tissue/background ratio) (p=0.003). Coronary 18F-NaF uptake was significantly higher in patients with coronary atherosclerosis compared to controls (1.64 vs. 1.23; p=0.003) and correlated with calcium score.