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Non-calcified active atherosclerosis plaque detection with 18F-NaF and 18F-FDG PET/CT dynamic imaging

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Abstract

Arterial inflammation is an indicator of atheromatous plaque vulnerability to detach and to obstruct blood vessels in the heart or in the brain thus causing heart attack or stroke. To date, it is difficult to predict the plaque vulnerability. This study was aimed to assess the behavior of 18F-sodium fluoride (18F-NaF) and 18F-fluorodeoxyglucose (18F-FDG) uptake in the aorta and iliac arteries as a function of plaque density on CT images. We report metabolically active artery plaques associated to inflammation in the absence of calcification. 18 elderly volunteers were recruited and imaged with computed tomography (CT) and positron emission tomography (PET) with 18F-NaF and 18F-FDG. A total of 1338 arterial segments were analyzed, 766 were non-calcified and 572 had calcifications. For both 18F-NaF and 18F-FDG, the mean SUV values were found statistically significantly different between non-calcified and calcified artery segments. Clustering CT non-calcified segments, excluding blood, resulted in two clusters C1 and C2 with a mean density of 30.63 ± 5.06 HU in C1 and 43.06 ± 4.71 HU in C2 (P < 0.05), and their respective SUV were found statistically different in 18F-NaF and 18F-FDG. The 18F-NaF images showed plaques not detected on CT images, where the 18F-FDG SUV values were high in comparison to artery walls without plaques. The density on CT images alone corresponding to these plaques could be further investigated to see whether it can be an indicator of the active plaques.

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Acknowledgements

AD received a student fellowship from the Faculty of Medicine and Health Sciences, University of Sherbrooke. MSA received a financial support from University of Hail in kingdom of Saudi Arabia.

Funding

This study was funded by the Canadian Institutes of Health Research (CIHR, Grant Number 407104).

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Authors and Affiliations

  1. Department of Nuclear Medicine and Radiobiology, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12th Avenue North, Sherbrooke, QC, J1H 5N4, Canada

    Abdelillah Douhi, Mamdouh S. Al‑enezi, Nousra Berrahmoune, Eric Turcotte, Étienne Croteau & M’hamed Bentourkia

  2. Department of Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12th Avenue North, Sherbrooke, QC, J1H 5N4, Canada

    Abdelouahed Khalil, Tamas Fulop & Michel Nguyen

  3. Department of Diagnostic Radiology, College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia

    Mamdouh S. Al‑enezi

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  1. Abdelillah Douhi
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Correspondence to M’hamed Bentourkia.

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Douhi, A., Al‑enezi, M.S., Berrahmoune, N. et al. Non-calcified active atherosclerosis plaque detection with 18F-NaF and 18F-FDG PET/CT dynamic imaging. Phys Eng Sci Med 46, 295–302 (2023). https://doi.org/10.1007/s13246-023-01218-7

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