Abstract
BackgroundMicrocalcifications cannot be identified with the present resolution of CT; however, 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) imaging has been proposed for non-invasive identification of microcalcification. The primary objective of this study was to assess whether 18F-NaF activity can assess the presence and predict the progression of CT detectable vascular calcification. Methods and ResultsThe data of two longitudinal studies in which patients received a 18F-NaF PET-CT at baseline and after 6 months or 1-year follow-up were used. The target to background ratio (TBR) was measured on PET at baseline and CT calcification was quantified in the femoral arteries at baseline and follow-up. 128 patients were included. A higher TBR at baseline was associated with higher calcification mass at baseline and calcification progression (β = 1.006 [1.005-1.007] and β = 1.002 [1.002-1.003] in the studies with 6 months and 1-year follow-up, respectively). In areas without calcification at baseline and where calcification developed at follow-up, the TBR was .11–.13 (P < .001) higher compared to areas where no calcification developed. ConclusionThe activity of 18F-NaF is related to the amount of calcification and calcification progression. In areas where calcification formation occurred, the TBR was slightly but significantly higher.
Highlights
Atherosclerosis is a major cause of disability and death worldwide.[1]
Microcalcifications cannot be identified with the present resolution of Computed tomography (CT); 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) imaging has been proposed for non-invasive identification of microcalcification
The target to background ratio (TBR) was measured on PET at baseline and CT calcification was quantified in the femoral arteries at baseline and follow-up. 128 patients were included
Summary
Atherosclerosis is a major cause of disability and death worldwide.[1]. The amount of arterial calcification is a surrogate imaging marker of the burden of atherosclerotic disease. Extensive macrocalcifications develop which are thought to stabilize the plaque.[2,3] Computed tomography (CT)based quantification of calcification is commonly performed for the coronary arteries, where it is an established predictor of cardiovascular disease.[4] the present resolution of CT allows identification of macrocalcifications, but not of microcalcifications. 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) imaging has been proposed for non-invasive identification of areas with microcalcification, to bridge the gap between what can be measured with histology and with CT. The availability of data on 18F-NaF PET is limited and validation studies are challenging. Microcalcifications cannot be identified with the present resolution of CT; 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) imaging has been proposed for non-invasive identification of microcalcification. The primary objective of this study was to assess whether 18F-NaF activity can assess the presence and predict the progression of CT detectable vascular calcification
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