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Longitudinal analysis of atherosclerotic plaques evolution: an 18F-NaF PET/CT study

  • ORIGINAL ARTICLE
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Journal of Nuclear Cardiology Aims and scope

Abstract

Purpose

18F-NaF-PET/CT can detect mineral metabolism within atherosclerotic plaques. To ascertain whether their 18F-NaF uptake purports progression, this index was compared with subsequent morphologic evolution.

Methods

71 patients underwent two consecutive 18F-NaF-PET/CTs (PET1/PET2). In PET1, non-calcified 18F-NaF hot spots were identified in the abdominal aorta. Their mean/max HU was compared with those of a non-calcified control region (CR) and with corresponding areas in PET2. A target-to-background ratio (TBR), mean density (HU), and calcium score (CS) were calculated on calcified atherosclerotic plaques in PET1 and compared with those in PET2. A VOI including the entire abdominal aorta was drawn; mean TBR and total CS were calculated on PET1 and compared with those PET2.

Results

Hot spots in PET1 (N = 179) had a greater HU than CR (48 ± 8 vs 37 ± 9, P < .01). Mean hot spots HU increased to 59 ± 12 in PET2 (P < .001). New calcifications appeared at the hot spots site in 73 cases (41%). Baseline atherosclerotic plaque’s (N = 375) TBR was proportional to percent HU and CS increase (P < .01 for both). Aortic CS increased (P < .001); the whole-aorta TBR in PET1 correlated with the CS increase between the baseline and the second PET/CT (R = .63, P < .01).

Conclusions

18F-NaF-PET/CT depicts the early stages of plaques development and tracks their evolution over time.

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Abbreviations

18F-NaF-PET/CT:

Sodium fluoride positron emission tomography/X-ray computed tomography

CR:

Control region

HU:

Hounsfield units

CS:

Calcium score

TBR:

Target-to-background ratio

CVD:

Cardiovascular disease

NDHUavg/max%:

Normalized delta-uptake average/max percent

NDCS%:

Normalized delta calcium score percent

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Authors’ Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Francesco Fiz, Gianluca Bottoni, Arnoldo Piccardo, Silvia Morbelli and Michele Piana. The first draft of the manuscript was written by Francesco Fiz and all authors contributed to the manuscript revision. All authors read and approved the final manuscript.

Funding

The present work received no funding.

Data Availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Disclosures

Dr. Francesco Fiz acts as a paid external consultant for the firm “Sharp&Dohme LLC”. All other authors have no conflict of interest to disclose.

Ethical Approval

Ethical approval was waived by the regional Ethics Committee (Comitato Etico Regionale – Regione Liguria) in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

Author information

Authors and Affiliations

  1. Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, Via Manzoni, 56, Rozzano, 20089, Milan, Italy

    Francesco Fiz

  2. Nuclear Medicine Unit, E. O. Ospedali Galliera, Mura delle Cappuccine, 14, 16128, Genoa, Italy

    Arnoldo Piccardo, Gianluca Bottoni & Manlio Cabria

  3. IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy

    Silvia Morbelli & Gianmario Sambuceti

  4. Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Via Antonio Pastore, 1, 16132, Genoa, Italy

    Silvia Morbelli & Gianmario Sambuceti

  5. Department of Mathematics, University of Genoa, Via Dodecaneso, 35, 16146, Genoa, Italy

    Michele Piana

  6. Department of Internal Medicine and Medical specialties, University of Genoa, Viale Benedetto XV, 10, 16132, Genoa, Italy

    Marcello Bagnasco

Authors
  1. Francesco Fiz
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  2. Arnoldo Piccardo
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Correspondence to Francesco Fiz.

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Fiz, F., Piccardo, A., Morbelli, S. et al. Longitudinal analysis of atherosclerotic plaques evolution: an 18F-NaF PET/CT study. J. Nucl. Cardiol. 29, 1713–1723 (2022). https://doi.org/10.1007/s12350-021-02556-3

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  • DOI: https://doi.org/10.1007/s12350-021-02556-3

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