Vascular uptake on 18F-sodium fluoride positron emission tomography: precursor of vascular calcification?

Annemarie M. den Harder*, Jelmer M. Wolterink, Jonas W. Bartstra, Wilko Spiering, Sabine R. Zwakenberg, Joline W. Beulens, Riemer H.J.A. Slart, Gert Luurtsema, Willem P. Mali, Pim A. de Jong

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: Microcalcifications cannot be identified with the present resolution of CT; however, 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) imaging has been proposed for non-invasive identification of microcalcification. The primary objective of this study was to assess whether 18F-NaF activity can assess the presence and predict the progression of CT detectable vascular calcification.

Methods and Results: The data of two longitudinal studies in which patients received a 18F-NaF PET-CT at baseline and after 6 months or 1-year follow-up were used. The target to background ratio (TBR) was measured on PET at baseline and CT calcification was quantified in the femoral arteries at baseline and follow-up. 128 patients were included. A higher TBR at baseline was associated with higher calcification mass at baseline and calcification progression (β = 1.006 [1.005-1.007] and β = 1.002 [1.002-1.003] in the studies with 6 months and 1-year follow-up, respectively). In areas without calcification at baseline and where calcification developed at follow-up, the TBR was.11–.13 (P < .001) higher compared to areas where no calcification developed.

Conclusion: The activity of 18F-NaF is related to the amount of calcification and calcification progression. In areas where calcification formation occurred, the TBR was slightly but significantly higher.

Original languageEnglish
Number of pages11
JournalJournal of nuclear cardiology
Early online date23 Jan 2020
Publication statusPublished - Oct 2021
Externally publishedYes


  • Atherosclerosis
  • Calcification
  • Computed tomography
  • Cedial artery calcification
  • Cositron emission tomography


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