Abstract
The evidence on atherosclerosis imaging with 18F-sodium-fluoride (NaF) positron emission tomography (PET) is hotly debated because of the different patient characteristics, methodology, vascular beds, etc. in reported studies. This review is a continuation of a previous review on this topic, which covered the period 2010–2018. The purpose was to examine whether some of the most important questions that the previous review had left open had been elucidated by the most recent literature. Using principles of a systematic review, we ended analyzing 25 articles dealing with the carotids, coronary arteries, aorta, femoral, intracranial, renal, and penile arteries. The knowledge thus far can be summarized as follows: by targeting active arterial microcalcification, NaF uptake is considered a marker of early stage atherosclerosis, is age-dependent, and consistently associated with cardiovascular risk. Longitudinal studies on NaF uptake, conducted in the abdominal aorta only, showed unchanged uptake in postmenopausal women for nearly four years and varying uptake in prostate cancer patients over 1.5 years, despite constant or increasing calcium volume detected by computed tomography (CT). Thus, uncertainty remains about the transition from active arterial wall calcification marked by increased NaF uptake to less active or consolidated calcification detected by CT. The question of whether early-phase atherosclerosis and calcification can be modified remains also unanswered due to lack of intervention studies.
Highlights
A previous review of the literature on atherosclerosis imaging with 18 F-sodium-fluoride (NaF)positron emission tomography (PET) published 2010–2018 left us with some major questions unanswered: (1) to what extent and with what consistency is arterial wall NaF uptake followed by or translated into computed tomography (CT)-detectable calcification, (2) in which compartment of the arterial wall does theNaF-detectable microcalcification first occur, and (3) can NaF-avid microcalcification be diminished or abolished by medical therapy or other types of intervention [1]
Using the same principles as previously described [1] including the Patient, Intervention, Comparison, Outcome Study (PICOS) approach [2], we searched PubMed/MEDLINE, Embase, and the Cochrane Library to extract relevant peer-reviewed articles on NaF-PET imaging in atherosclerosis published in English from 1 January 2019 and until 31 March 2020
We focused on (a) patients with any disease and (b) diagnostic performance, lesion detection, qualitative evaluation, and feasibility in (c) studies on evaluation of atherosclerosis
Summary
A previous review of the literature on atherosclerosis imaging with 18 F-sodium-fluoride (NaF)positron emission tomography (PET) published 2010–2018 left us with some major questions unanswered: (1) to what extent and with what consistency is arterial wall NaF uptake followed by or translated into CT-detectable calcification, (2) in which compartment of the arterial wall does theNaF-detectable microcalcification first occur, and (3) can NaF-avid microcalcification be diminished or abolished by medical therapy or other types of intervention [1]. A previous review of the literature on atherosclerosis imaging with 18 F-sodium-fluoride (NaF). Positron emission tomography (PET) published 2010–2018 left us with some major questions unanswered: (1) to what extent and with what consistency is arterial wall NaF uptake followed by or translated into CT-detectable calcification, (2) in which compartment of the arterial wall does the. NaF-detectable microcalcification first occur, and (3) can NaF-avid microcalcification be diminished or abolished by medical therapy or other types of intervention [1]. To present the current state of Diagnostics 2020, 10, 852; doi:10.3390/diagnostics10100852 www.mdpi.com/journal/diagnostics. Diagnostics 2020, 10, 852 the art, we have surveyed the most recent literature to examine if these important questions have been elucidated
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