F-18 fluorodeoxyglucose PET angiography of the abdominal arteries: evaluation of image quality and comparison with contrast-enhanced CT.

Abstract

Positron emission tomography (PET) angiography utilizes early dynamic PET acquisitions for depiction of the arterial vasculature. The aim of this study was to assess image quality and to evaluate feasibility of F-18 FDG PET angiography of the abdominal arteries. Twenty-seven patients were included in the study. Standard activities of 250-280 MBq F-18 FDG were administered. Early dynamic PET data were acquired in list mode. Time frames of 6 × 10 s after tracer injection were reconstructed. Images were analyzed in MPR and MIP modes. Image quality was scored according to scale from 1 to 4. PET angiography findings were compared with contrast-enhanced CT imaging. All examinations were completed successfully. In 83 % of cases, best arterial contrast was seen between 10 and 40 s after tracer injection. Good or moderate diagnostic image quality of the aorta was noted in all the cases, with a 100 % negative predictive value of a normal finding. Celiac trunks, renal and superior mesenteric arteries could be visualized with limited image quality, good to excellent negative predictive values of 90-100 %, and low positive predictive values of 3-13 % due to overestimation of arterial occlusive disease and false-positive findings. F-18 FDG PET angiography is technically feasible and can exclude relevant abdominal aortic occlusive disease. Clinical use in the evaluation of smaller arteries of the upper abdomen is limited. The main advantages of PET angiography are the absence of acute risks to the patient and the possibility to acquire the data as part of routine PET/CT studies.