Combined application of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging in early diagnosis of vulnerable carotid atherosclerotic plaques

Abstract

Thin or ruptured plaques, lipid-rich plaques and haemorrhagic plaques possess high inflammatory activity. The combination of (18)F-FDG PET/CT and MRI could be useful for qualitative and quantitative diagnosis of carotid atherosclerotic plaques.

Association Between 18-FDG Positron Emission Tomography and MRI Biomarkers of Plaque Vulnerability in Patients With Symptomatic Carotid Stenosis

“…In 18 patients with cryptogenic stroke and non-stenosing carotid atheroma, the presence and size of MRI-measured lipid core in ipsilateral carotid plaque were associated with FDG uptake ( 12 ). Similar findings were reported in a Chinese MRI/PET study of asymptomatic patients with non-stenosing carotid plaque ( 13 ).…”

“…Few data exist relating other MRI morphological features with FDG uptake. Inverse associations were observed between FDG uptake and ipsilateral carotid plaque fibrous cap thickness in patients with cryptogenic stroke and non-stenosing plaque, and in asymptomatic Chinese patients thicker caps and calcification were associated with lower FDG uptake ( 12 , 13 ). We found no association between FDG uptake and IPH, unlike 2 earlier studies that reported positive associations ( 12 , 14 ).…”

Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors

“…Thin or ruptured, lipid-rich, and hemorrhagic plaques have high inflammatory activity, which manifests as high FDG uptake at imaging (85). Increased FDG uptake seen in carotid plaques (Fig 9) has been shown to be a predictive factor in plaque rupture (86) and ischemic events.…”

Diagnosis of Carotid Plaque Using FDG-PET

“…21) A study compared FDG-PET with MRI findings and indicated that the TBR was high at the sites of plaque with a ruptured fibrous cap, lipid-rich plaque, and intra-plaque hemorrhage. 22) Furthermore, another study compared FDG-PET with carotid CT and reported that the presence or absence of three factors (positive remodeling, irregular lumen, and low attenuation) characterizing vulnerable plaque on CT, as well as the number of factors, were correlated with FDG accumulation. 23)…”