Xiang Li1, Daniel Heber1, Jacobo Cal-Gonzalez2, Georgios Karanikas1, Marius E Mayerhoefer3, Sazan Rasul1, Dietrich Beitzke4, Xiaoli Zhang5, Hermine Agis6, Markus Mitterhauser1, Wolfgang Wadsak1, Thomas Beyer2, Christian Loewe4, Marcus Hacker7. 1. Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria. 2. Center for Medical Physics and Biomedical Engineering, General Hospital Vienna, Medical University of Vienna, Vienna, Austria. 3. Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria. 4. Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria. 5. Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; and. 6. Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria. 7. Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria Marcus.hacker@meduniwien.ac.at.
Abstract
18F-FDG is the most widely validated PET tracer for the evaluation of atherosclerotic inflammation. Recently, 18F-NaF has also been considered a potential novel biomarker of osteogenesis in atherosclerosis. We aimed to analyze the association between inflammation and osteogenesis at different stages of atherosclerosis, as well as the interrelationship between these 2 processes during disease progression. Methods: Thirty-four myeloma patients underwent 18F-NaF and 18F-FDG PET/CT examinations. Lesions were divided into 3 groups (noncalcified, mildly calcified, and severely calcified lesions) on the basis of calcium density as measured in Hounsfield units by CT. Tissue-to-background ratios were determined from PET for both tracers. The association between inflammation and osteogenesis during atherosclerosis progression was evaluated in 19 patients who had at least 2 examinations with both tracers. Results: There were significant correlations between the maximum tissue-to-background ratios of the 2 tracers (Spearman r = 0.5 [P < 0.01]; Pearson r = 0.4 [P < 0.01]) in the 221 lesions at baseline. The highest uptake of both tracers was observed in noncalcified lesions, but without any correlation between the tracers (Pearson r = 0.06; P = 0.76). Compared with noncalcified plaques, mildly calcified plaques showed concordant significantly lower accumulation, with good correlation between the tracers (Pearson r = 0.7; P < 0.01). In addition, enhanced osteogenesis-derived 18F-NaF uptake and regressive inflammation-derived 18F-FDG uptake were observed in severely calcified lesions (Pearson r = 0.4; P < 0.01). During follow-up, increased calcium density and increased mean 18F-NaF uptake were observed, whereas mean 18F-FDG uptake decreased. Most noncalcified (86%) and mildly calcified (81%) lesions and 47% of severely calcified lesions had concordant development of both vascular inflammation and osteogenesis. Conclusion: The combination of 18F-NaF PET imaging and 18F-FDG PET imaging promotes an understanding of the mechanism of plaque progression, thereby providing new insights into plaque stabilization.
18F-FDG is the most widely validated PET tracer for the evaluation of atherosclerotic inflammation. Recently, 18F-NaF has also been considered a potential novel biomarker of osteogenesis in atherosclerosis. We aimed to analyze the association between inflammation and osteogenesis at different stages of atherosclerosis, as well as the interrelationship between these 2 processes during disease progression. Methods: Thirty-four myelomapatients underwent 18F-NaF and 18F-FDG PET/CT examinations. Lesions were divided into 3 groups (noncalcified, mildly calcified, and severely calcified lesions) on the basis of calcium density as measured in Hounsfield units by CT. Tissue-to-background ratios were determined from PET for both tracers. The association between inflammation and osteogenesis during atherosclerosis progression was evaluated in 19 patients who had at least 2 examinations with both tracers. Results: There were significant correlations between the maximum tissue-to-background ratios of the 2 tracers (Spearman r = 0.5 [P < 0.01]; Pearson r = 0.4 [P < 0.01]) in the 221 lesions at baseline. The highest uptake of both tracers was observed in noncalcified lesions, but without any correlation between the tracers (Pearson r = 0.06; P = 0.76). Compared with noncalcified plaques, mildly calcified plaques showed concordant significantly lower accumulation, with good correlation between the tracers (Pearson r = 0.7; P < 0.01). In addition, enhanced osteogenesis-derived 18F-NaF uptake and regressive inflammation-derived 18F-FDG uptake were observed in severely calcified lesions (Pearson r = 0.4; P < 0.01). During follow-up, increased calcium density and increased mean 18F-NaF uptake were observed, whereas mean 18F-FDG uptake decreased. Most noncalcified (86%) and mildly calcified (81%) lesions and 47% of severely calcified lesions had concordant development of both vascular inflammation and osteogenesis. Conclusion: The combination of 18F-NaF PET imaging and 18F-FDG PET imaging promotes an understanding of the mechanism of plaque progression, thereby providing new insights into plaque stabilization.
Authors: Xiang Li; Daniel Heber; Tatjana Leike; Dietrich Beitzke; Xia Lu; Xiaoli Zhang; Yongxiang Wei; Markus Mitterhauser; Wolfgang Wadsak; Saskia Kropf; Hans J Wester; Christian Loewe; Marcus Hacker; Alexander R Haug Journal: Eur J Nucl Med Mol Imaging Date: 2017-09-21 Impact factor: 9.236
Authors: Nicholas R Evans; Jason M Tarkin; John R Buscombe; Hugh S Markus; James H F Rudd; Elizabeth A Warburton Journal: Nat Rev Neurol Date: 2017-10-06 Impact factor: 42.937