Peri-Coronary Adipose Tissue Density Is Associated With 18F-Sodium Fluoride Coronary Uptake in Stable Patients With High-Risk Plaques

Kwieciński, Jacek; Dey, Damini; Cadet, Sebastien; Lee, Sang-Eun; Otaki, Yuka; Huynh, Phi T.; Doris, Mhairi; Eisenberg, Evann; Yun, Mijin; Jansen, Maurits A.; Williams, Michelle; Tamarappoo, Balaji; Friedman, John D.; Dweck, Marc R; Newby, David E.; Chang, Hyuk Jae; Slomka, Piotr J.; Berman, Daniel S.

doi:10.1016/j.jcmg.2018.11.032

Cited by 137 publications

(110 citation statements)

References 24 publications

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“…We found 35 eligible articles. Three on the aortic valve ( n = 3) and seven on methodology ( n = 7) were excluded based on the abovementioned criteria, leaving 25 dealing with the coronary arteries [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ], femoral artery [ 12 , 13 , 14 , 15 ], abdominal aorta [ 16 , 17 , 18 ], carotid arteries [ 19 , 20 ], thoracic aorta [ 21 ], and intracranial [ 22 ], renal [ 23 ], and penile arteries [ 24 ]. One study focused on the carotid and cerebral arteries [ 25 ], another on the carotids, the aortic arch, and coronary arteries [ 26 ], and a third on several major arteries [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…One study focused on the carotid and cerebral arteries [ 25 ], another on the carotids, the aortic arch, and coronary arteries [ 26 ], and a third on several major arteries [ 27 ]. Below (and in Supplementary Materials Tables S1–S5 ), the literature is summarized in six sections before being debated in the discussion: Disease mechanisms and targeting [ 10 ], Early detection and prevalence of NaF uptake in the heart and major arteries [ 5 , 23 , 24 , 25 , 27 ], NaF uptake in vulnerable, high risk, and ruptured plaque [ 6 , 7 , 8 , 9 , 19 , 20 ], Influence of age, sex, and other factors on NaF uptake [ 3 , 16 , 22 ], Association between NaF uptake and cardiovascular risk factors [ 4 , 15 , 21 ], NaF uptake and disease progression [ 11 , 12 , 13 , 14 , 17 , 18 , 26 ]. …”

Section: Resultsmentioning

confidence: 99%

“…Kwiecinski et al reported in two publications NaF uptake in high-risk coronary plaques. In a study of 51 lesions in 23 patients (56%), increased NaF uptake was significantly associated with increased CT density of peri-coronary adipose tissue, which tends to co-localize with culprit lesions in patients with acute coronary syndromes [ 6 ]. In a study of patients screened for high-risk coronary plaques, 29 had plaques with positive remodeling, while 26 had low attenuation plaques.…”

Section: Resultsmentioning

confidence: 99%

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Atherosclerosis Imaging with 18F-Sodium Fluoride PET

et al. 2020

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The evidence on atherosclerosis imaging with 18F-sodium-fluoride (NaF) positron emission tomography (PET) is hotly debated because of the different patient characteristics, methodology, vascular beds, etc. in reported studies. This review is a continuation of a previous review on this topic, which covered the period 2010–2018. The purpose was to examine whether some of the most important questions that the previous review had left open had been elucidated by the most recent literature. Using principles of a systematic review, we ended analyzing 25 articles dealing with the carotids, coronary arteries, aorta, femoral, intracranial, renal, and penile arteries. The knowledge thus far can be summarized as follows: by targeting active arterial microcalcification, NaF uptake is considered a marker of early stage atherosclerosis, is age-dependent, and consistently associated with cardiovascular risk. Longitudinal studies on NaF uptake, conducted in the abdominal aorta only, showed unchanged uptake in postmenopausal women for nearly four years and varying uptake in prostate cancer patients over 1.5 years, despite constant or increasing calcium volume detected by computed tomography (CT). Thus, uncertainty remains about the transition from active arterial wall calcification marked by increased NaF uptake to less active or consolidated calcification detected by CT. The question of whether early-phase atherosclerosis and calcification can be modified remains also unanswered due to lack of intervention studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Atherosclerosis Imaging with 18F-Sodium Fluoride PET

et al. 2020

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“…Nonetheless, a number of observations, listed below, may hold true, whereas other questions remain unanswered. Most 2019 papers on NaF-PET imaging focus on unstable or what is designated vulnerable plaque morphology and detection in predominantly the coronary arteries often employing advanced methodologies [49,56,[58][59][60][61][62][63]. In August 2019, the first study on the efficacy of therapy judged by NaF-PET imaging appeared.…”

Section: Limitationsmentioning

confidence: 99%

Atherosclerosis imaging with 18F-sodium fluoride PET: state-of-the-art review

Høilund‐Carlsen

Sturek

Alavi

et al. 2019

Eur J Nucl Med Mol Imaging

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Purpose We examined the literature to elucidate the role of 18F-sodium fluoride (NaF)-PET in atherosclerosis. Methods Following a systematic search of PubMed/MEDLINE, Embase, and Cochrane Library included articles underwent subjective quality assessment with categories low, medium, and high. Of 2811 records, 1780 remained after removal of duplicates. Screening by title and abstract left 41 potentially eligible full-text articles, of which 8 (about the aortic valve (n = 1), PET/ MRI feasibility (n = 1), aortic aneurysms (n = 1), or quantification methodology (n = 5)) were dismissed, leaving 33 published 2010-2012 (n = 6), 2013-2015 (n = 11), and 2016-2018 (n = 16) for analysis. Results They focused on coronary (n = 8), carotid (n = 7), and femoral arteries (n = 1), thoracic aorta (n = 1), and infrarenal aorta (n = 1). The remaining 15 studies examined more than one arterial segment. The literature was heterogeneous: few studies were designed to investigate atherosclerosis, 13 were retrospective, 9 applied both FDG and NaF as tracers, 24 NaF only. Subjective quality was low in one, medium in 13, and high in 19 studies. The literature indicates that NaF is a very specific tracer that mimics active arterial wall microcalcification, which is positively associated with cardiovascular risk. Arterial NaF uptake often presents before CT-calcification, tends to decrease with increasing density of CT-calcification, and appears, rather than FDG-avid foci, to progress to CT-calcification. It is mainly surface localized, increases with age with a wide scatter but without an obvious sex difference. NaF-avid microcalcification can occur in fatty streaks, but the degree of progression to CT-calcification is unknown. It remains unknown whether medical therapy influences microcalcification. The literature held no therapeutic or randomized controlled trials. Conclusion The literature was heterogeneous and with few clear cut messages. NaF-PET is a new approach to detect and quantify microcalcification in early-stage atherosclerosis. NaF uptake correlates with cardiovascular risk factors and appears to be a good measure of the body's atherosclerotic burden, potentially suited also for assessment of anti-atherosclerotic therapy.

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“…In particular, increased 18F-NaF uptake has been demonstrated in high-risk and culprit coronary and carotid plaques. [9][10][11][12] It is also associated with faster aortic stenosis disease progression 13,14 and bioprosthetic aortic valve degeneration. 15 As such, there is appeal in using this imaging biomarker to investigate calcification activity in both aortic stenosis and coronary atherosclerosis.…”

Section: The Studymentioning

confidence: 99%