Systemic atherosclerotic plaque vulnerability in patients with Coronary Artery Disease with a single Whole Body FDGPET-CT scan.

Sanchez Roa, Patricia and Rees, John and Bartley, Lee and Marshall, Christopher (2020) Systemic atherosclerotic plaque vulnerability in patients with Coronary Artery Disease with a single Whole Body FDGPET-CT scan. Asia Oceania Journal of Nuclear Medicine and Biology, 8 (1). pp. 18-26.

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Objective(s): Cardiovascular disease is a leading cause of morbimortality with over half cardiovascular events occurring in the asymptomatic population by traditional risk stratification. This preliminary study aimed to evaluate systemic plaque vulnerability in patients with prior Coronary Artery Disease (CAD) with a single Whole Body FDG PET-CT scan in terms of plaque inflammation and calcifications. Methods: Twenty-two patients referred for oncological evaluation and with prior history of advanced CAD or age and gender matched controls without cardiovascular disease, underwent a Whole Body PET-CT scan 90 min after injection of 18F-FDG. A total of 975 transaxial PET images were retrospectively analysed to assess plaque inflammation using a standardized method of analysis with averaged Target-to-Background Ratios (TBRs) at different levels, in the thoracic and abdominal aorta, carotids, LAD, common iliac and femoral arteries, and were correlated with calcium scores from the CT images. Results: TBRs from the thoracic aorta were higher in male patients than controls (1.49±0.11, p<0.05) and a gradient was observed (ascending > descending > aortic arch), and were also higher in the carotids in female patients (1.43±0.07) versus controls (p<0.05). A tendency for higher levels of plaque inflammation in the abdominal aorta was noted in all groups, but no significant FDG uptake was found either in the iliac or femoral arteries in any group. Plaque inflammation was also higher in the LAD in males but with large variations. Higher levels of calcifications were noted in the LAD, infra-renal abdominal aorta and common iliac arteries, but without significant correlation with plaque inflammation except sporadic overlapping. Conclusion: Patients with advanced CAD are at risk for vulnerable inflamed atheromas in other territories such as the thoracic aorta and carotid arteries, underpinning the systemic nature of the atherosclerotic disease. Coexistence with calcifications is rare, suggesting a different functional status of the plaques and different stages of the disease. Evaluation of subclinical systemic plaque vulnerability in CAD with a Whole Body FDG PET-CT scan is feasible and a potentially useful biomarker to assess subclinical vascular risk for risk stratification and treatment optimization, but further studies are needed.

Item Type: Article
Uncontrolled Keywords: PET,plaque inflammation,plaque calcifications,Atherosclerosis,Coronary Artery Disease
Subjects: WN Radiology . Diagnostic Imaging
Divisions: Journals > Asia Oceania J Nuclear Medicine & Biology
Depositing User: AOJNMB AOJNMB
Date Deposited: 19 Jan 2020 07:03
Last Modified: 19 Jan 2020 07:03

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