Juan Wang1, Hongbin Liu2, Jie Sun1, Hao Xue1, Leixing Xie1, Shengyuan Yu1, Changzai Liang1, Xu Han1, Zhiwei Guan1, Liqun Wei1, Chun Yuan1, Xihai Zhao1, Huijun Chen1. 1. From the Departments of Cardiology (J.W., H.L., H.X., L.X., C.L.), Neurology (S.Y.), and Radiology (X.H., Z.G., L.W.), People's Liberation Army General Hospital, Beijing, China; Department of Radiology, University of Washington, Seattle (J.S., C.Y.); and Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China (C.Y., X.Z., H.C.). 2. From the Departments of Cardiology (J.W., H.L., H.X., L.X., C.L.), Neurology (S.Y.), and Radiology (X.H., Z.G., L.W.), People's Liberation Army General Hospital, Beijing, China; Department of Radiology, University of Washington, Seattle (J.S., C.Y.); and Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China (C.Y., X.Z., H.C.). liuhbcad301@163.com.
Abstract
BACKGROUND AND PURPOSE: (18)F-fluorodeoxyglucose positron emission tomography and dynamic contrast-enhanced MRI have been proposed to quantitatively assess plaque inflammation by probing macrophages and neovessels, respectively. We examined their correlation to study the in vivo relationship between macrophage and neovessel activities in atherogenesis. METHODS: Forty-one patients (34 men; aged 65±12 years) with a total of 68 carotid plaques (thickness ≥2 mm on ultrasound; 20 symptomatic) were assessed by both (18)F-fluorodeoxyglucose positron emission tomography/computed tomography and dynamic contrast-enhanced MRI within 2 weeks, measured as target-to-background ratio and transfer constant (K(trans)), respectively. RESULTS: Overall, the correlation between target-to-background ratio and K(trans) was weak and marginal (r=0.22; P=0.068). They were correlated in the symptomatic plaques (r=0.59; P=0.006) but not in the asymptomatic plaques (r=0.07; P=0.625; P=0.033 for difference in r). Neither target-to-background ratio nor K(trans) was significantly higher in the symptomatic plaques, but both showed an inverse relationship with time since last neurological event (r=-0.94 and -0.69 for target-to-background ratio and K(trans), respectively). CONCLUSIONS: The correlation between (18)F-fluorodeoxyglucose positron emission tomography and dynamic contrast-enhanced MRI measurements varied with clinical conditions, pointing to a complex interplay between macrophages and neovessels under different pathophysiological conditions. The moderate correlation shown only in symptomatic plaques indicates the presence of acute plaque inflammation with increased metabolic activity and cytokine production by inflammatory cells.
BACKGROUND AND PURPOSE: (18)F-fluorodeoxyglucose positron emission tomography and dynamic contrast-enhanced MRI have been proposed to quantitatively assess plaque inflammation by probing macrophages and neovessels, respectively. We examined their correlation to study the in vivo relationship between macrophage and neovessel activities in atherogenesis. METHODS: Forty-one patients (34 men; aged 65±12 years) with a total of 68 carotid plaques (thickness ≥2 mm on ultrasound; 20 symptomatic) were assessed by both (18)F-fluorodeoxyglucose positron emission tomography/computed tomography and dynamic contrast-enhanced MRI within 2 weeks, measured as target-to-background ratio and transfer constant (K(trans)), respectively. RESULTS: Overall, the correlation between target-to-background ratio and K(trans) was weak and marginal (r=0.22; P=0.068). They were correlated in the symptomatic plaques (r=0.59; P=0.006) but not in the asymptomatic plaques (r=0.07; P=0.625; P=0.033 for difference in r). Neither target-to-background ratio nor K(trans) was significantly higher in the symptomatic plaques, but both showed an inverse relationship with time since last neurological event (r=-0.94 and -0.69 for target-to-background ratio and K(trans), respectively). CONCLUSIONS: The correlation between (18)F-fluorodeoxyglucose positron emission tomography and dynamic contrast-enhanced MRI measurements varied with clinical conditions, pointing to a complex interplay between macrophages and neovessels under different pathophysiological conditions. The moderate correlation shown only in symptomatic plaques indicates the presence of acute plaque inflammation with increased metabolic activity and cytokine production by inflammatory cells.
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