Abstract 5814: Increased arterial 18F-FDG-uptake is associated with future Cardio- and Cerebrovascular Events: Initial Results of a PET-CT Study considering Age and Cardiovascular Risk Factors

Abstract

Background Atherosclerosis is a systemic disease which is associated with increased vascular inflammation. The purpose of this study was to correlate glucose-uptake of arterial walls as measured by 18F-FDG PET-CT with the occurrence of cardio- and cerebrovascular events. Methods: 1000 tumor patients were examined by whole-body 18F-FDG PET-CT between 2004 to 2007. Patients’ clinical follow-up information could be obtained in 650 patients by telephone interviews (mean follow-up time 3,1y). In 22/650 patients (3.3%), cardio- or cerebrovascular events were registered, defined as cardiac death, myocardial infarction or revascularization and stroke. 6 out of 22 patients were not evaluable because of ongoing or prior steroid medication. In total, 16 PET-CT’s of patients with cardiovascular events could be evaluated and compared to PET-CT’s of 300 consecutive patients with known cardiovascular risk factors. Maximum standardized uptake values were measured from arterial walls of the ascending, thoracic and abdominal aorta, iliac and carotid arteries and corrected by dividing with the blood pool uptake in the vena cava (target-to-background ratio, TBR). Occurrence of events was correlated with TBR, age, cardiovascular risk factors and presence of calcified plaques using the Spearman’s correlation coefficient R. Multiple linear regression analysis was used to accommodate for differences in risk factors. Statistical significance was considered to be present when p<0.01. Results: Occurrence of events was significantly correlated with coronary heart disease (R=0.33; p<.001), arterial hypertension (R=0.22; p<.001), presence of hard plaques (R=0.15; p=.007) and TBR values (R=0.28; p<.001). No other significant correlations were found. When performing multiple regression analysis the association between the occurrence of events and TBR values/presence of coronary heart disease remained significant (p<.001). Conclusion: The findings of this study suggest that a higher arterial wall glucose uptake in tumor patients is associated with the occurrence of future cardio- and cerebrovascular events. TBR values as measured by 18F-FDG PET-CT could be useful for identifying high-risk patients in need of intensified medical or interventional therapy.