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Delayed sodium 18F-fluoride PET/CT imaging does not improve quantification of vascular calcification metabolism: Results from the CAMONA study

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

This study aimed to determine if delayed sodium 18F-fluoride (Na18F) PET/CT imaging improves quantification of vascular calcification metabolism. Blood-pool activity can disturb the arterial Na18F signal. With time, blood-pool activity declines. Therefore, delayed imaging can potentially improve quantification of vascular calcification metabolism.

Methods and Results

Twenty healthy volunteers and 18 patients with chest pain were prospectively assessed by triple time-point PET/CT imaging at approximately 45, 90, and 180 minutes after Na18F administration. For each time point, global uptake of Na18F was determined in the coronary arteries and thoracic aorta by calculating the blood-pool-corrected maximum standardized uptake value (cSUVMAX). A target-to-background ratio (TBR) was calculated to determine the contrast resolution at 45, 90, and 180 minutes. Furthermore, we assessed whether the acquisition time-point affected the relation between cSUVMAX and the estimated 10-year risk for fatal cardiovascular disease (SCORE %). Coronary cSUVMAX (P = .533) and aortic cSUVMAX (P = .654) remained similar with time, whereas the coronary TBR (P < .0001) and aortic TBR (P < .0001) significantly increased with time. Even though the contrast resolution improved with time, positive correlations between SCORE % and coronary cSUVMAX (P < .020) and aortic cSUVMAX (P < .005) were observed at all investigated time points.

Conclusions

Delayed Na18F PET/CT imaging does not improve quantification of vascular calcification metabolism. Although contrast resolution improves with time, arterial Na18F avidity is invariant to the time between Na18F administration and PET/CT acquisition. Therefore, the optimal PET/CT acquisition time-point to quantify vascular calcification metabolism is achieved as early as 45 minutes after Na18F administration.

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Acknowledgements

Björn A. Blomberg is financially supported by the MD/PhD “Alexandre Suerman” program of the University Medical Center Utrecht, Utrecht, The Netherlands, and the Anna Marie and Christian Rasmussen’s Memorial Foundation, University of Southern Denmark, Odense, Denmark. We thank the staff and participants of the CAMONA study for their valuable contributions.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark

    Björn A. Blomberg MD, MSc, Anders Thomassen MD, Mie H. Vilstrup MD, Søren Hess MD, Anne L. Nielsen MD & Poul F. Høilund-Carlsen MD, DMSc

  2. Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands

    Björn A. Blomberg MD, MSc & Richard A. P. Takx MD, MSc

  3. Department of Cardiology, Odense University Hospital, Odense, Denmark

    Axel C. P. Diederichsen MD, PhD & Hans Mickley MD, DMSc

  4. Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Abass Alavi MD, PhD, DSc

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  1. Björn A. Blomberg MD, MSc
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  2. Anders Thomassen MD
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Correspondence to Björn A. Blomberg MD, MSc.

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Blomberg, B.A., Thomassen, A., Takx, R.A.P. et al. Delayed sodium 18F-fluoride PET/CT imaging does not improve quantification of vascular calcification metabolism: Results from the CAMONA study. J. Nucl. Cardiol. 21, 293–304 (2014). https://doi.org/10.1007/s12350-013-9829-5

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  • DOI: https://doi.org/10.1007/s12350-013-9829-5

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