Feasibility of in vivo 18F-florbetaben PET/MR imaging of human carotid amyloid-\u03b2

Jan Bucerius,Felix M Mottaghy,Solveig Tiepolt,Swen Hesse,Joachim E Wildberger,Marianne Patt,Judith C Sluimer,Peter Werner,Erik A L Biessen,Henryk Barthel,Hermann-Josef Gertz,Osama Sabri

doi:10.1007/s00259-017-3651-2

Abstract

PurposeAmyloid-beta (Aβ) peptides are involved in the inflammatory pathology of atherosclerosis. 18F-Florbetaben is a PET tracer for clinical imaging of cerebral Aβ plaques in Alzheimer’s disease (AD). We sought to determine whether specific uptake of 18F-florbetaben in the carotid arteries can be identified using a fully integrated hybrid PET/MRI system and whether this uptake is associated with clinical cardiovascular disease (CVD) risk factors.MethodsCarotid 18F-florbetaben uptake was quantified as the mean of the maximum target-to-background ratio (meanTBRmax) in 40 cognitively impaired subjects (age 68.2 ± 9.5 years) undergoing 18F-florbetaben PET/MRI to diagnose AD. Associations between carotid 18F-florbetaben uptake and several CVD risk factors were assessed by univariate analysis followed by a multivariate linear regression analysis. Furthermore, carotid 18F-florbetaben uptake was compared between patients with and without a positive cerebral Aβ PET scan.Results18F-Florbetaben uptake was clearly visualized in the carotid arteries. Values of meanTBRmax corrected for the blood pool activity of the tracer showed specific 18F-florbetaben uptake in the carotid wall. Male gender was associated with carotid 18F-florbetaben uptake in the univariate analysis, and was found to be an independent predictor of 18F-florbetaben uptake in the multivariate regression analysis (standardized regression coefficient β = 0.407, p = 0.009). Carotid 18F-florbetaben meanTBRmax in patients with a positive cerebral Aβ scan did not differ from that in patients without cerebral Aβ deposits.ConclusionSpecific 18F-florbetaben uptake in human carotid arteries was detected. Male gender was identified as an independent clinical risk factor. Therefore, 18F-florbetaben PET/MRI might provide new insights into the pathophysiological process in atherosclerosis.

Highlights

The development of atherosclerotic plaques is characterized by accumulation of lipids, inflammatory cells and connective tissue within the arterial wall [1,2,3]
Even though atherosclerosis is usually a chronic, progressive process, abrupt rupture of an atherosclerotic – so-called vulnerable – plaque can become acutely life threatening by releasing embolic material that leads to myocardial infarction or stroke
Using a fully integrated hybrid PET/MRI system, we evaluated whether specific 18F-florbetaben uptake in the carotid arteries can be identified and, subsequently, whether the carotid artery PET signal correlates with risk factors for clinical cardiovascular disease (CVD)

Summary

Introduction

The development of atherosclerotic plaques is characterized by accumulation of lipids, inflammatory cells and connective tissue within the arterial wall [1,2,3]. Even though atherosclerosis is usually a chronic, progressive process, abrupt rupture of an atherosclerotic – so-called vulnerable – plaque can become acutely life threatening by releasing embolic material that leads to myocardial infarction or stroke. No biomarker or imaging technique is able to assess and predict the individual risk of plaque rupture and a subsequent acute cardiovascular event beforehand. Arterial wall inflammation plays a key role in atherosclerotic plaque rupture [2]. Specific detection of markers of arterial inflammation within a vulnerable plaque through imaging represents a highly attractive approach to identifying patients at risk of rupture of such an atherosclerotic plaque [5]

Methods

Results

Conclusion