TY - JOUR
T1 - Carotid artery molecular calcification assessed by [18F]fluoride PET/CT
T2 - correlation with cardiovascular and thromboembolic risk factors
AU - Castro, Simon A.
AU - Muser, Daniele
AU - Lee, Hwan
AU - Hancin, Emily C.
AU - Borja, Austin J.
AU - Acosta, Oswaldo
AU - Werner, Thomas J.
AU - Thomassen, Anders
AU - Constantinescu, Caius
AU - Høilund-Carlsen, Poul Flemming
AU - Alavi, Abass
N1 - Funding Information:
This study has received funding from the Jørgen and Gisela Thrane’s Philanthropic Research Foundation, Broager, Denmark.
PY - 2021/10
Y1 - 2021/10
N2 - Objectives: There is growing evidence that sodium fluoride ([18F]fluoride) PET/CT can detect active arterial calcifications at the molecular stage. We investigated the relationship between arterial mineralization in the left common carotid artery (LCC) assessed by [18F]fluoride PET/CT and cardiovascular/thromboembolic risk. Methods: In total, 128 subjects (mean age 48 ± 14 years, 51% males) were included. [18F]fluoride uptake in the LCC was quantitatively assessed by measuring the blood-pool-corrected maximum standardized uptake value (SUVmax) on each axial slice. Average SUVmax (aSUVmax) was calculated over all slices and correlated with 10-year risk of cardiovascular events estimated by the Framingham model, CHA2DS2-VASc score, and level of physical activity (LPA). Results: The aSUVmax was significantly higher in patients with increased risk of cardiovascular (one-way ANOVA, p < 0.01) and thromboembolic (one-way ANOVA, p < 0.01) events, and it was significantly lower in patients with greater LPA (one-way ANOVA, p = 0.02). On multivariable linear regression analysis, age (= 0.07, 95% CI 0.05 – 0.10, p < 0.01), body mass index (= 0.02, 95% CI 0.01 – 0.03, p < 0.01), arterial hypertension (= 0.15, 95% CI 0.08 – 0.23, p < 0.01), and LPA (= −0.10, 95% CI −0.19 to −0.02, p=0.02) were independent associations of aSUVmax. Conclusions: Carotid [18F]fluoride uptake is significantly increased in patients with unfavorable cardiovascular and thromboembolic risk profiles. [18F]fluoride PET/CT could become a valuable tool to estimate subjects’ risk of future cardiovascular events although still major trials are needed to further evaluate the associations found in this study and their potential clinical usefulness. Key Points: • Sodium fluoride ([18F]fluoride) PET/CT imaging identifies patients with early-stage atherosclerosis. • Carotid [18F]fluoride uptake is significantly higher in patients with increased risk of cardiovascular and thromboembolic events and inversely correlated with the level of physical activity. • Early detection of arterial mineralization at a molecular level could help guide clinical decisions in the context of cardiovascular risk assessment.
AB - Objectives: There is growing evidence that sodium fluoride ([18F]fluoride) PET/CT can detect active arterial calcifications at the molecular stage. We investigated the relationship between arterial mineralization in the left common carotid artery (LCC) assessed by [18F]fluoride PET/CT and cardiovascular/thromboembolic risk. Methods: In total, 128 subjects (mean age 48 ± 14 years, 51% males) were included. [18F]fluoride uptake in the LCC was quantitatively assessed by measuring the blood-pool-corrected maximum standardized uptake value (SUVmax) on each axial slice. Average SUVmax (aSUVmax) was calculated over all slices and correlated with 10-year risk of cardiovascular events estimated by the Framingham model, CHA2DS2-VASc score, and level of physical activity (LPA). Results: The aSUVmax was significantly higher in patients with increased risk of cardiovascular (one-way ANOVA, p < 0.01) and thromboembolic (one-way ANOVA, p < 0.01) events, and it was significantly lower in patients with greater LPA (one-way ANOVA, p = 0.02). On multivariable linear regression analysis, age (= 0.07, 95% CI 0.05 – 0.10, p < 0.01), body mass index (= 0.02, 95% CI 0.01 – 0.03, p < 0.01), arterial hypertension (= 0.15, 95% CI 0.08 – 0.23, p < 0.01), and LPA (= −0.10, 95% CI −0.19 to −0.02, p=0.02) were independent associations of aSUVmax. Conclusions: Carotid [18F]fluoride uptake is significantly increased in patients with unfavorable cardiovascular and thromboembolic risk profiles. [18F]fluoride PET/CT could become a valuable tool to estimate subjects’ risk of future cardiovascular events although still major trials are needed to further evaluate the associations found in this study and their potential clinical usefulness. Key Points: • Sodium fluoride ([18F]fluoride) PET/CT imaging identifies patients with early-stage atherosclerosis. • Carotid [18F]fluoride uptake is significantly higher in patients with increased risk of cardiovascular and thromboembolic events and inversely correlated with the level of physical activity. • Early detection of arterial mineralization at a molecular level could help guide clinical decisions in the context of cardiovascular risk assessment.
KW - Atherosclerosis
KW - Cardiovascular diseases
KW - Common carotid artery
KW - Positron emission tomography
KW - Sodium fluoride
KW - Humans
KW - Middle Aged
KW - Risk Factors
KW - Male
KW - Positron-Emission Tomography
KW - Fluorides
KW - Carotid Arteries/diagnostic imaging
KW - Positron Emission Tomography Computed Tomography
KW - Adult
KW - Female
KW - Fluorine Radioisotopes
KW - Radiopharmaceuticals
U2 - 10.1007/s00330-021-07917-7
DO - 10.1007/s00330-021-07917-7
M3 - Journal article
C2 - 33866386
AN - SCOPUS:85104392041
SN - 0938-7994
VL - 31
SP - 8050
EP - 8059
JO - European Radiology
JF - European Radiology
IS - 10
ER -