New insight of functional molecular imaging into the atheroma biology: 18F‐NaF and 18F‐FDG in symptomatic and asymptomatic carotid plaques after recent CVA. Preliminary results

Abstract

Active calcification and inflammation are simultaneous processes in the symptomatic and asymptomatic carotid atheroma. However, active calcification seems predominant over inflammation in both groups. In the symptomatic plaques, the highest 18F-NaF uptake does not correspond with the largest calcium content. These patterns open new insights on the role of 18F-NaF in the study of calcification and in the identification of the vulnerable carotid atheroma.

18F-sodium fluoride positron emission tomography assessed microcalcifications in culprit and non-culprit human carotid plaques

“…24 Age and sex distribution were comparable between these two studies and our study. Only Vesey et al provided information about the cardiovascular history and other cardiovascular risk factors of the included patients.…”

“…22 However, data on 18 F-NaF uptake in carotid plaques are limited and their usefulness for the prediction of future stroke is unclear. [23][24][25] Additionally, limited data have been published on the relation between active microcalcifications and established calcifications in human carotid plaques. 26,27 The primary objective of this study is to compare in vitro microPET assessed 18 F-NaF uptake between culprit and non-culprit carotid plaques from stroke patients, using non-macrocalcified renal arteries from healthy kidney donors as negative controls.…”

18 F-Fluoride and 18 F-Fluorodeoxyglucose Positron Emission Tomography After Transient Ischemic Attack or Minor Ischemic Stroke

“…Our findings confirm those of a smaller study of 9 patients by Quirce et al 23 that explored 18 F-fluoride and 18 F-FDG uptake in symptomatic patients. They showed that 18 F-fluoride uptake appeared to be higher in the symptomatic carotid and that 18-FDG uptake was nondiscriminatory.…”

“…In carotid atherosclerosis imaging, the most widely used tracer has been 18 F-fluorodeoxyglucose ( 18 F-FDG) 8–14 : Recently, we have described another radiotracer, 18 F-fluoride, in atherosclerosis imaging. 15,16 We 15–18 and others 19–23 have shown that this tracer has major potential in cardiovascular disease. 18 F-Fluoride can highlight culprit plaque in patients after myocardial infarction and high-risk plaques in patients with apparently stable coronary heart disease.…”

Coronary Atherosclerotic Vulnerable Plaque: Current Perspectives

“…This is achieved because of preferential binding of the tracer on hydroxyapatite crystals, whose exposed surface is much larger in areas of ongoing crystal formation. 116 PET is generally favored over SPECT because of lower artifact rates and improved spatial resolution as a result of detection of 2, as opposed to a single, oppositely moving photons.…”