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Temporal relationship between 18F-sodium fluoride uptake in the abdominal aorta and evolution of CT-verified vascular calcification

Journal of Nuclear Cardiology volume 28, pages 1936–1945 (2021)Cite this article

Abstract

Background

Fluoride-18 sodium fluoride (18F-NaF) localizes in microcalcifications in atheroma. The microcalcifications may aggregate, passing the resolution threshold to visualize on computed tomography (CT). We evaluated serial NaF positron emission tomography (PET)-CT scans to determine the temporal relationship between vascular NaF uptake and CT evident calcification in the abdominal aorta.

Methods

Prostate cancer patients who had at least 3 NaF PET-CT scans over at least 1.5 years were retrospectively enrolled. Regions of interest were traced in the abdominal aorta on both PET and CT images, excluding skeletal NaF activity. The maximum standardized uptake value (SUVmax) of NaF and the density and volume of calcium (exceeding 130 HU) were summed and divided by the number of slices to produce the SUVmax/slice and the mm3·slice−1 of calcium.

Results

Of 437 patients, 45 patients met criteria. NaF uptake waxed and waned between scans, while the calcium volume plateaued or increased over time. NaF uptake correlated with calcium volume on the baseline scan (P = .60, < .0001†) and calcium volume increment, especially from 1.0 to 1.5 years (r = .79, P < .0001†). Patients with persistently high NaF uptake showed a higher calcium volume increment (0-1.5 years) than patients with low or transiently high NaF uptake.

Conclusions

Abdominal aortic NaF uptake varied over time. NaF uptake on the baseline scans and high NaF uptake on the serial scans preceded an increase in calcium volume, especially by 1.0-1.5 years. Persistently high NaF uptake was associated with a greater increment in calcium volume than patients with transiently elevated or persistently low fluoride uptake.

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Abbreviations

18F-NaF:

Fluoride-18 sodium fluoride

CT:

Computed tomography

SUVmax :

The maximum standardized uptake value

mm3·slice−1·year−1 :

The increment in volume of vascular calcification

Plaque:

Atheroma

PET-CT:

Positron emission tomography/computed tomography

ROIs:

Regions of interest

IQR:

Inter quartile range

DSCF:

Dwass-Steel-Critchlow-Fligner

HTN:

Hypertension

CAD:

Coronary artery disease

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Acknowledgments

SNMMI Wagner-Torizuka Fellowship and Uehara Memorial Foundation Fellowship to TN. Thanks to Dr. J. Kalaigian and Dr. C. Qing for their technical support of workstations.

Disclosure

No relationships with industry for this study.

Author information

Affiliations

  1. Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Takehiro Nakahara MD, PhD, Jagat Narula MD, PhD & H. William Strauss MD

  2. Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Takehiro Nakahara MD, PhD, Josef J. Fox MD & H. William Strauss MD

  3. Department of Radiology, Keio University School of Medicine, Tokyo, Japan

    Takehiro Nakahara MD, PhD, Masahiro Jinzaki MD, PhD & H. William Strauss MD

Authors
  1. Takehiro Nakahara MD, PhD
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  2. Jagat Narula MD, PhD
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  3. Josef J. Fox MD
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  4. Masahiro Jinzaki MD, PhD
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  5. H. William Strauss MD
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Corresponding author

Correspondence to H. William Strauss MD.

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Nakahara, T., Narula, J., Fox, J.J. et al. Temporal relationship between 18F-sodium fluoride uptake in the abdominal aorta and evolution of CT-verified vascular calcification. J. Nucl. Cardiol. 28, 1936–1945 (2021). https://doi.org/10.1007/s12350-019-01934-2

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  • DOI: https://doi.org/10.1007/s12350-019-01934-2

Keywords

  • NaF (sodium fluoride)
  • vascular
  • calcification
  • time course
  • PET-CT