Uptake of F-18 FDG and ultrasound analysis of carotid plaque

Choi, Yun‐Seok; Youn, Ho‐Joong; Chung, Woo-Baek; Hwang, Hui‐Jeong; Lee, Donghyeon; Park, Chul‐Soo; Lee, Jaebeom; Kim, Pum-Joon; Chung, Wook-Sung; Lee, Man-Young; Seung, Kie-Bae; Chung, Yong-Ahn

doi:10.1007/s12350-011-9338-3

Cited by 22 publications

(18 citation statements)

References 16 publications

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“…Although 18 F-FDG uptake and circulating hsCRP are both markers of inflammation, there is no clear consensus regarding their relation in atherosclerosis patients (19)(20)(21). Given the widely recognized role of hsCRP in predicting cardiovascular events, lack of correlation with 18 F-FDG uptake suggests that the 2 markers may represent different aspects of atherosclerotic inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, there have been only a few studies with relatively small numbers of subjects that compared circulating hsCRP and 18 F-FDG uptake, and the findings have shown mixed results (19)(20)(21). In this study, we thus evaluated a large cohort of asymptomatic adults to investigate the relation of carotid artery 18 F-FDG uptake, hsCRP concentration, and estimated risk based on general cardiovascular Framingham risk scores (FRSs).…”

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confidence: 99%

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Relation of Carotid Artery ¹⁸F-FDG Uptake to C-Reactive Protein and Framingham Risk Score in a Large Cohort of Asymptomatic Adults

et al. 2013

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We investigated the relation of carotid 18 F-FDG uptake to high-sensitivity C-reactive protein (hsCRP) and Framingham risk score (FRS) in a large cohort of asymptomatic adults. Methods: Carotid artery 18 F-FDG uptake was measured on the PET/CT scans of 1,181 asymptomatic subjects, and maximum target-to-background ratio (M-TBR) and intima-media thickness (IMT) were compared with clinical risk factors and hsCRP. The estimated 10-y risk for general cardiovascular disease was calculated by FRS. Results: FRS increased from 11.5% 6 7.8% to 14.8% 6 10.5% in subjects with an M-TBR $ 1.7, compared with , 1.7, and the odds ratio for an FRS $ 10% was 1.9 (95% confidence interval [CI], 1.4-2.5). Adjusting for age confirmed a significant association of M-TBR and IMT with FRS. Independent determinants of high M-TBR were abdominal fat (b coefficient [B], 1.1040; P , 0.0001), low-density lipoprotein (LDL) (B, 0.0006; P , 0.05), and FRS (B, 0.0025; P , 0.05) for subjects , 50 y and abdominal fat (B, 0.9740; P , 0.0001), age (B, 0.0040; P 5 0.0001), LDL (B, 0.0008; P 5 0.0001), and IMT (B, 0.1097; P , 0.01) for subjects $ 50 y. Although hsCRP also stratified subjects for FRS-based risk, no correlation was found between hsCRP and M-TBR or IMT, suggesting that they may have different inferences. Importantly, in the low-hsCRP (14.2% 6 9.7% vs. 11.3% 6 7.4%) and high-hsCRP groups (18.8% 6 14.3% vs. 13.3% 6 10.2%), FRS was significantly greater for subjects with high M-TBR than for those with low M-TBR. The odds ratio for FRS $ 10% between subjects with high and low M-TBR was 1.20 (95% CI, 0.90-1.60; P 5 0.209) in the low-hsCRP group and 2.95 (95% CI, 1.48-5.86; P 5 0.002) in the high-hsCRP group. Conclusion: High carotid 18 F-FDG uptake in asymptomatic adults is associated with increased clinical risk factors and FRS. Furthermore, it appears to reflect aspects of atherosclerotic inflammation distinct from hsCRP concentration and may offer incremental information regarding cardiovascular risk.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Relation of Carotid Artery ¹⁸F-FDG Uptake to C-Reactive Protein and Framingham Risk Score in a Large Cohort of Asymptomatic Adults

et al. 2013

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“…Arterial uptake in one vascular region correlates strongly with its anatomical pair, and more strongly with neighbouring regions than more distally. Plaques with high-risk features on MRI (large lipid core [49] or intraplaque haemorrhage [63]) or ultrasound [64,65] (echolucency) have higher FDG than more stable phenotypes. Aortic uptake has been shown to correlate with circulating biomarkers matrix metalloproteases 1, 3 and 9 [54,66], and an inverse correlation has been reported with the atheroprotective biomarkers adiponectin and plasminogen activator inhibitor 1 [54,66].…”

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confidence: 99%

Vascular imaging with positron emission tomography

Joshi

Rosenbaum

Bordes

et al. 2011

Journal of Internal Medicine

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Atherosclerosis is an inflammatory disease that causes most myocardial infarctions, strokes and acute coronary syndromes. Despite the identification of multiple risk factors and widespread use of drug therapies, it still remains a global health concern with associated costs. Although angiography is established as the gold standard means of detecting coronary artery stenosis, it does not image the vessel wall itself, reporting only on its consequences such as luminal narrowing and obstruction. MRI and computed tomography provide more information about the plaque structure, but recently positron emission tomography (PET) imaging using [ 18 F]-fluorodeoxyglucose (FDG) has been advocated as a means of measuring arterial inflammation. This results from the ability of FDG-PET to highlight areas of high glucose metabolism, a feature of macrophages within atherosclerosis, particularly in high-risk plaques. It is suggested that the degree of FDG accumulation in the vessel wall reflects underlying inflammation levels and that tracking any changes in FDG uptake over time or with drug therapy might be a way of getting an early efficacy readout for novel anti-atherosclerotic drugs. Early reports also demonstrate that FDG uptake is correlated with the number of cardiovascular risk factors and possibly even the risk of future cardiovascular events. This review will outline the evidence base, shortcomings and emerging applications for FDG-PET in vascular imaging. Alternative PET tracers and other candidate imaging modalities for measuring vascular inflammation will also be discussed.

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“…32,33 Furthermore, TBR calculated as arterial standardized uptake value (SUV) score divided by venous blood SUV is generally used as an index of a quantitative parameter of vascular inflammation. 23,[32][33][34][35][36] Indeed, Tawakol et al 23 reported that TBR values in the carotid arteries were closely correlated with accumulation of CD68-positive macrophages in the corresponding histological sections of patients with severe carotid stenoses (r=0.85; P<0.001). Carotid TBR values were higher in patients with high-risk morphological features of atherosclerotic plaques, such as echolucent plaques, positive remodeling, luminal irregularity, and low attenuation in computed tomographic, than those without.…”

Section: Methodological Considerationsmentioning

confidence: 99%

“…Carotid TBR values were higher in patients with high-risk morphological features of atherosclerotic plaques, such as echolucent plaques, positive remodeling, luminal irregularity, and low attenuation in computed tomographic, than those without. 34,35 In addition, carotid artery TBR has been shown to strongly predict subsequent cardiovascular disease in patients with no previous history of cardiovascular disease independent of traditional risk factors. 36 Moreover, when we examined which variables including carotid artery SUV, venous blood SUV, and TBR value were independently associated with %FMD, TBR value was the strongest correlate of decreased %FMD (β=−2.506; P=0.002).…”

Section: Methodological Considerationsmentioning

confidence: 99%

Vascular Inflammation Evaluated by [ ¹⁸ F]-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography Is Associated With Endothelial Dysfunction

Honda

Tahara

Nitta

et al. 2016

ATVB

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Objective— Endothelial dysfunction is an initial step in atherosclerotic cardiovascular disease. However, involvement of vascular inflammation in endothelial dysfunction is not fully investigated in humans because of the lack of diagnostic modality to noninvasively evaluate vascular inflammation. We assessed the relationship between endothelial function and vascular inflammation evaluated by [ 18 F]-fluorodeoxyglucose-positron emission tomography/computed tomographic imaging. Approach and Results— We examined endothelial function and vascular inflammation by flow-mediated dilation (FMD) of the brachial artery and [ 18 F]-fluorodeoxyglucose-positron emission tomography/computed tomographic imaging of carotid arteries, respectively, in 145 subjects (95 men and 50 women; mean age, 61.8±9.5 years) who underwent a risk-screening test for cardiovascular disease in Kurume University Hospital. Vascular inflammation was measured by blood-normalized standardized uptake value, known as a target:background ratio (TBR). We investigated whether absolute changes from baseline of %FMD after antihypertensive treatment for 6 months (Δ%FMD) were correlated with those of TBR in 33 drug-naive patients with essential hypertension. Multiple logistic regression analysis revealed that age (odds ratio, 1.767 for 10-year increase), male sex (odds ratio, 0.434), low-density lipoprotein-cholesterol (odds ratio, 1.630 for 26-mg/dL increase), and TBR values (odds ratio, 1.759 for 0.2 increase) were independently associated with %FMD in 145 patients. There was an inverse correlation between Δ%FMD and ΔTBR; ΔTBR was a sole independent associate of Δ%FMD in hypertensive patients ( r =−0.558; P <0.001). Conclusions— The present study showed that vascular inflammation in the carotid arteries evaluated by [ 18 F]-fluorodeoxyglucose-positron emission tomography/computed tomography was one of the independent correlates of decreased %FMD, thus suggesting the association of vascular inflammation with endothelial dysfunction in humans.

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Uptake of F-18 FDG and ultrasound analysis of carotid plaque

Abstract: Our results show that F-18 FDG carotid PET/CT can depict metabolically active atherosclerotic plaques, and suggest that F-18 FDG carotid PET/CT can be used as a noninvasive imaging modality for functional evaluation of atherosclerosis.

Cited by 22 publications

References 16 publications

Relation of Carotid Artery ¹⁸F-FDG Uptake to C-Reactive Protein and Framingham Risk Score in a Large Cohort of Asymptomatic Adults

Relation of Carotid Artery ¹⁸F-FDG Uptake to C-Reactive Protein and Framingham Risk Score in a Large Cohort of Asymptomatic Adults

Vascular imaging with positron emission tomography

Vascular Inflammation Evaluated by [ ¹⁸ F]-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography Is Associated With Endothelial Dysfunction

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Uptake of F-18 FDG and ultrasound analysis of carotid plaque

Abstract: Our results show that F-18 FDG carotid PET/CT can depict metabolically active atherosclerotic plaques, and suggest that F-18 FDG carotid PET/CT can be used as a noninvasive imaging modality for functional evaluation of atherosclerosis.

Cited by 22 publications

References 16 publications

Relation of Carotid Artery 18F-FDG Uptake to C-Reactive Protein and Framingham Risk Score in a Large Cohort of Asymptomatic Adults

Relation of Carotid Artery 18F-FDG Uptake to C-Reactive Protein and Framingham Risk Score in a Large Cohort of Asymptomatic Adults

Vascular imaging with positron emission tomography

Vascular Inflammation Evaluated by [ 18 F]-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography Is Associated With Endothelial Dysfunction

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Relation of Carotid Artery ¹⁸F-FDG Uptake to C-Reactive Protein and Framingham Risk Score in a Large Cohort of Asymptomatic Adults

Relation of Carotid Artery ¹⁸F-FDG Uptake to C-Reactive Protein and Framingham Risk Score in a Large Cohort of Asymptomatic Adults

Vascular Inflammation Evaluated by [ ¹⁸ F]-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography Is Associated With Endothelial Dysfunction