Varying Correlation Between ¹⁸ F-Fluorodeoxyglucose Positron Emission Tomography and Dynamic Contrast-Enhanced MRI in Carotid Atherosclerosis

Abstract

Background and Purpose— 18 F-fluorodeoxyglucose positron emission tomography and dynamic contrast-enhanced MRI have been proposed to quantitatively assess plaque inflammation by probing macrophages and neovessels, respectively. We examined their correlation to study the in vivo relationship between macrophage and neovessel activities in atherogenesis. Methods— Forty-one patients (34 men; aged 65±12 years) with a total of 68 carotid plaques (thickness ≥2 mm on ultrasound; 20 symptomatic) were assessed by both 18 F-fluorodeoxyglucose positron emission tomography/computed tomography and dynamic contrast-enhanced MRI within 2 weeks, measured as target-to-background ratio and transfer constant ( K trans ), respectively. Results— Overall, the correlation between target-to-background ratio and K trans was weak and marginal ( r =0.22; P =0.068). They were correlated in the symptomatic plaques ( r =0.59; P =0.006) but not in the asymptomatic plaques ( r =0.07; P =0.625; P =0.033 for difference in r ). Neither target-to-background ratio nor K trans was significantly higher in the symptomatic plaques, but both showed an inverse relationship with time since last neurological event ( r =−0.94 and −0.69 for target-to-background ratio and K trans , respectively). Conclusions— The correlation between 18 F-fluorodeoxyglucose positron emission tomography and dynamic contrast-enhanced MRI measurements varied with clinical conditions, pointing to a complex interplay between macrophages and neovessels under different pathophysiological conditions. The moderate correlation shown only in symptomatic plaques indicates the presence of acute plaque inflammation with increased metabolic activity and cytokine production by inflammatory cells.

Heart rate lowering treatment leads to a reduction in vulnerable plaque features in atherosclerotic rabbits

“…These results are in line with previous studies [20, 23, 28–30], where a weak to modest correlation between plaque inflammation and microvasculature was reported. The present study supports the concept that there is a complex interplay between macrophages and plaque microvasculature [28].…”

“…Magnetic Resonance Imaging (MRI) has emerged as a promising technique to visualize both plaque size and features of plaque vulnerability in vivo [19]. Dynamic contrast-enhanced MRI (DCE-MRI) has developed into a tool for assessment of the atherosclerotic plaque microvasculature [20–30], which is thought to be a hallmark of plaque vulnerability [31]. It has been shown that both semi-quantitative [20] and quantitative [25–27] DCE-MRI parameters correlate with the amount of microvessels in the plaque.…”

2015 ESC Guidelines for the management of infective endocarditis

“…[300]. W jednym z badań porównywano użyteczność prognostyczną współcześnie stosowanych skal ryzyka pod względem chorobowości i śmiertelności po leczeniu operacyjnym z powodu IZW u 146 osób [301]. W tym badaniu wykazano, że choć skala EuroSCORE II pozwoliła na rozróżnienie śmiertel-ności i chorobowości pooperacyjnej (zwłaszcza występowania udaru), to skala Towarzystwa Chirurgów Klatki Piersiowej dla zapalenia wsierdzia oraz skala De Feo i wsp.…”

Guía ESC 2015 sobre el tratamiento de la endocarditis infecciosa

“…Los sistemas de puntuación de riesgo específicos para la cirugía de la EI se han desarrollado: a) a partir de la base de datos de la Society of Thoracic Surgeons usando datos de 13.617 pacientes 299 , y b) un sistema específico de puntuación de riesgo de EVN desarrollado a partir de un único centro con datos de 440 pacientes de De Feo et al 300 . Un estudio ha comparado la utilidad pronóstica de estos sistemas contemporáneos de puntuación del riesgo de mortalidad y morbilidad después de la cirugía de EI en 146 pacientes 301 . Los resultados indican que aunque el EuroSCORE II discrimina mortalidad y morbilidad posoperatoria (en especial, accidentes cerebrovasculares), el sistema de clasificación de riesgo en la endocarditis de la Society of Thoracic Surgeons y de De Feo et al 300 es superior a la hora de predecir la mortalidad posoperatoria después de la cirugía en la EI activa.…”