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

H. Hop*, S.A. de Boer, M. Reijrink, P.W. Kamphuisen, M.H. de Borst, R.A. Pol, C.J. Zeebregts, J.L. Hillebrands, R.H.J.A. Slart, H.H. Boersma, J. Doorduin, D.J. Mulder

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

33 Citations (Scopus)
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Abstract

Background: 18F-NaF positron emission tomography (PET) targets microcalcifications. We compared in vitro microPET assessed 18F-NaF uptake between culprit and non-culprit human carotid plaques. Furthermore, we compared 18F-NaF uptake with calcification visualized on microcomputed tomography (microCT).

Methods: Carotid plaques from stroke patients undergoing surgery were incubated in 18F-NaF and scanned using a microPET and a microCT scan. The average PET assessed 18F-NaF uptake was expressed as percentage of the incubation dose per gram (%Inc/g). 18F-NaF PET volume of interest (VOI) was compared with CT calcification VOI.

Results: 23 carotid plaques (17 culprit, 6 non-culprit) were included. The average 18F-NaF uptake in culprit carotid plaques was comparable with the uptake in non-culprit carotid plaques (median 2.32 %Inc/g [IQR 1.98 to 2.81] vs. median 2.35 %Inc/g [IQR 1.77 to 3.00], P = 0.916). Only a median of 10% (IQR 4 to 25) of CT calcification VOI showed increased 18F-NaF uptake, while merely a median of 35% (IQR 6 to 42) of 18F-NaF PET VOI showed calcification on CT.

Conclusions: 18F-NaF PET represents a different stage in the calcification process than CT. We observed a similar PET assessed 18F-NaF uptake and pattern in culprit and non-culprit plaques of high-risk patients, indicating that this method may be of more value in early atherosclerotic stenosis development.

Original languageEnglish
Pages (from-to)1064-1075
Number of pages12
JournalJournal of nuclear cardiology
Volume26
Issue number4
DOIs
Publication statusPublished - 15 Aug 2019

Keywords

  • F-sodium fluoride (F-NaF)
  • Calcification
  • Carotid artery stenosis
  • PET/CT imaging
  • Vulnerable atherosclerotic plaque

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