Joo Myung Lee1, Ji-In Bang1, Bon-Kwon Koo2, Doyeon Hwang1, Jonghanne Park1, Jinlong Zhang1, Tong Yaliang1, Minseok Suh1, Jin Chul Paeng2, Yasutsugu Shiono1, Takashi Kubo1, Takashi Akasaka1. 1. From the Department of Internal Medicine and Cardiovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.M.L.); Department of Nuclear Medicine (J.-I.B., M.S., J.C.P.), Department of Internal Medicine and Cardiovascular Center (B.-K.K., D.H., J.P., J.Z.), and Institute on Aging (B.-K.K.), Seoul National University Hospital, Republic of Korea; Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun (T.Y.); and Department of Cardiovascular Medicine, Wakayama Medical University, Japan (Y.S., T.K., T.A.). 2. From the Department of Internal Medicine and Cardiovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.M.L.); Department of Nuclear Medicine (J.-I.B., M.S., J.C.P.), Department of Internal Medicine and Cardiovascular Center (B.-K.K., D.H., J.P., J.Z.), and Institute on Aging (B.-K.K.), Seoul National University Hospital, Republic of Korea; Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun (T.Y.); and Department of Cardiovascular Medicine, Wakayama Medical University, Japan (Y.S., T.K., T.A.). bkkoo@snu.ac.kr paengjc@snu.ac.kr.
Abstract
BACKGROUND: 18F-sodium fluoride (18F-NaF) positron-emission tomography has been introduced as a potential noninvasive imaging tool to identify plaques with high-risk characteristics in patients with coronary artery disease. We sought to evaluate the clinical relevance of 18F-NaF uptake using optical coherence tomography (OCT), intravascular ultrasound (IVUS), and coronary computed tomography angiography in patients with coronary artery disease. METHODS AND RESULTS: The target population consisted of 51 prospectively enrolled patients (93 stenoses) who underwent 18F-NaF positron-emission tomography before invasive coronary angiography. 18F-NaF uptake was compared with IVUS- and OCT-derived plaque characteristics. In the coronary computed tomography angiography subgroup (46 lesions), qualitative lesion characteristics were compared between 18F-NaF-positive and 18F-NaF-negative plaques using adverse plaque characteristics. The plaques with 18F-NaF uptake showed significantly higher plaque burden, more frequent posterior attenuation and positive remodeling in IVUS, and significantly higher maximum lipid arc and more frequent microvessels in OCT (all P<0.05). There were no differences in minimum lumen area and area of calcium between 18F-NaF-positive and 18F-NaF-negative lesions. Among 51 lesions with 18F-NaF-positive uptake, 48 lesions (94.1%) had at least one of high-risk characteristics. The 18F-NaF tissue-to-background ratio in plaques with high-risk characteristics was significantly higher than in those without (1.09 [95% confidence interval, 0.85-1.34] versus 0.62 [95% confidence interval, 0.42-0.82], P<0.001 for IVUS definition; 0.76 [95% confidence interval, 0.54-0.98] versus 0.42 [95% confidence interval, 0.21-0.62], P=0.014 for OCT definition). Among the 15 lesions that met both IVUS- and OCT-defined criteria for high-risk plaque, 14 (93.3%) showed 18F-NaF-positive uptake. There was no difference in the prevalence of plaques with any adverse plaque characteristics between 18F-NaF-positive and 18F-NaF-negative plaques in the coronary computed tomography angiography subgroup (85.2% versus 78.9%; P=0.583). CONCLUSIONS: This study's results suggest that 18F-NaF positron-emission tomography can be a useful noninvasive diagnostic tool to identify and localize plaque with high-risk characteristics. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02388412.
BACKGROUND:18F-sodium fluoride (18F-NaF) positron-emission tomography has been introduced as a potential noninvasive imaging tool to identify plaques with high-risk characteristics in patients with coronary artery disease. We sought to evaluate the clinical relevance of 18F-NaF uptake using optical coherence tomography (OCT), intravascular ultrasound (IVUS), and coronary computed tomography angiography in patients with coronary artery disease. METHODS AND RESULTS: The target population consisted of 51 prospectively enrolled patients (93 stenoses) who underwent 18F-NaF positron-emission tomography before invasive coronary angiography. 18F-NaF uptake was compared with IVUS- and OCT-derived plaque characteristics. In the coronary computed tomography angiography subgroup (46 lesions), qualitative lesion characteristics were compared between 18F-NaF-positive and 18F-NaF-negative plaques using adverse plaque characteristics. The plaques with 18F-NaF uptake showed significantly higher plaque burden, more frequent posterior attenuation and positive remodeling in IVUS, and significantly higher maximum lipid arc and more frequent microvessels in OCT (all P<0.05). There were no differences in minimum lumen area and area of calcium between 18F-NaF-positive and 18F-NaF-negative lesions. Among 51 lesions with 18F-NaF-positive uptake, 48 lesions (94.1%) had at least one of high-risk characteristics. The 18F-NaF tissue-to-background ratio in plaques with high-risk characteristics was significantly higher than in those without (1.09 [95% confidence interval, 0.85-1.34] versus 0.62 [95% confidence interval, 0.42-0.82], P<0.001 for IVUS definition; 0.76 [95% confidence interval, 0.54-0.98] versus 0.42 [95% confidence interval, 0.21-0.62], P=0.014 for OCT definition). Among the 15 lesions that met both IVUS- and OCT-defined criteria for high-risk plaque, 14 (93.3%) showed 18F-NaF-positive uptake. There was no difference in the prevalence of plaques with any adverse plaque characteristics between 18F-NaF-positive and 18F-NaF-negative plaques in the coronary computed tomography angiography subgroup (85.2% versus 78.9%; P=0.583). CONCLUSIONS: This study's results suggest that 18F-NaF positron-emission tomography can be a useful noninvasive diagnostic tool to identify and localize plaque with high-risk characteristics. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02388412.
Authors: Jacek Kwiecinski; Damini Dey; Sebastien Cadet; Sang-Eun Lee; Balaji Tamarappoo; Yuka Otaki; Phi T Huynh; John D Friedman; Mark R Dweck; David E Newby; Mijin Yun; Hyuk-Jae Chang; Piotr J Slomka; Daniel S Berman Journal: Eur Heart J Cardiovasc Imaging Date: 2020-01-01 Impact factor: 6.875
Authors: Mhairi K Doris; Yuka Otaki; Sandeep K Krishnan; Jacek Kwiecinski; Mathieu Rubeaux; Adam Alessio; Tinsu Pan; Sebastien Cadet; Damini Dey; Marc R Dweck; David E Newby; Daniel S Berman; Piotr J Slomka Journal: J Nucl Cardiol Date: 2018-06-11 Impact factor: 5.952
Authors: Jacek Kwiecinski; Evangelos Tzolos; Philip D Adamson; Sebastien Cadet; Alastair J Moss; Nikhil Joshi; Michelle C Williams; Edwin J R van Beek; Damini Dey; Daniel S Berman; David E Newby; Piotr J Slomka; Marc R Dweck Journal: J Am Coll Cardiol Date: 2020-06-23 Impact factor: 24.094