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Fiz F, Piccardo A, Morbelli S, Bottoni G, Piana M, Cabria M, Bagnasco M, Sambuceti G. Longitudinal analysis of atherosclerotic plaques evolution: an 18F-NaF PET/CT study. J Nucl Cardiol 2022; 29:1713-1723. [PMID: 33630243 DOI: 10.1007/s12350-021-02556-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE 18F-NaF-PET/CT can detect mineral metabolism within atherosclerotic plaques. To ascertain whether their 18F-NaF uptake purports progression, this index was compared with subsequent morphologic evolution. METHODS 71 patients underwent two consecutive 18F-NaF-PET/CTs (PET1/PET2). In PET1, non-calcified 18F-NaF hot spots were identified in the abdominal aorta. Their mean/max HU was compared with those of a non-calcified control region (CR) and with corresponding areas in PET2. A target-to-background ratio (TBR), mean density (HU), and calcium score (CS) were calculated on calcified atherosclerotic plaques in PET1 and compared with those in PET2. A VOI including the entire abdominal aorta was drawn; mean TBR and total CS were calculated on PET1 and compared with those PET2. RESULTS Hot spots in PET1 (N = 179) had a greater HU than CR (48 ± 8 vs 37 ± 9, P < .01). Mean hot spots HU increased to 59 ± 12 in PET2 (P < .001). New calcifications appeared at the hot spots site in 73 cases (41%). Baseline atherosclerotic plaque's (N = 375) TBR was proportional to percent HU and CS increase (P < .01 for both). Aortic CS increased (P < .001); the whole-aorta TBR in PET1 correlated with the CS increase between the baseline and the second PET/CT (R = .63, P < .01). CONCLUSIONS 18F-NaF-PET/CT depicts the early stages of plaques development and tracks their evolution over time.
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Affiliation(s)
- Francesco Fiz
- Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, Via Manzoni, 56, Rozzano, 20089, Milan, Italy.
| | - Arnoldo Piccardo
- Nuclear Medicine Unit, E. O. Ospedali Galliera, Mura delle Cappuccine, 14, 16128, Genoa, Italy
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Via Antonio Pastore, 1, 16132, Genoa, Italy
| | - Gianluca Bottoni
- Nuclear Medicine Unit, E. O. Ospedali Galliera, Mura delle Cappuccine, 14, 16128, Genoa, Italy
| | - Michele Piana
- Department of Mathematics, University of Genoa, Via Dodecaneso, 35, 16146, Genoa, Italy
| | - Manlio Cabria
- Nuclear Medicine Unit, E. O. Ospedali Galliera, Mura delle Cappuccine, 14, 16128, Genoa, Italy
| | - Marcello Bagnasco
- Department of Internal Medicine and Medical specialties, University of Genoa, Viale Benedetto XV, 10, 16132, Genoa, Italy
| | - Gianmario Sambuceti
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Via Antonio Pastore, 1, 16132, Genoa, Italy
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Abstract
Positron emission tomography (PET) offers an incredible wealth of diverse research applications in vascular disease, providing a depth of molecular, functional, structural, and spatial information. Despite this, vascular PET imaging has not yet assumed the same clinical use as vascular ultrasound, CT, and MR imaging which provides information about late-onset, structural tissue changes. The current clinical utility of PET relies heavily on visual inspection and suboptimal parameters such as SUVmax; emerging applications have begun to harness the tool of whole-body PET to better understand the disease. Even still, without automation, this is a time-consuming and variable process. This review summarizes PET applications in vascular disorders, highlights emerging AI methods, and discusses the unlocked potential of AI in the clinical space.
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Cheng M, Liu Q, Liu W, Yuan F, Feng J, Jin Y, Tu L. Engineering micelles for the treatment and diagnosis of atherosclerosis. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102473] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Moghbel M, Al-Zaghal A, Werner TJ, Constantinescu CM, Høilund-Carlsen PF, Alavi A. The Role of PET in Evaluating Atherosclerosis: A Critical Review. Semin Nucl Med 2018; 48:488-497. [DOI: 10.1053/j.semnuclmed.2018.07.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Al-Zaghal A, Mehdizadeh Seraj S, Werner TJ, Gerke O, Høilund-Carlsen PF, Alavi A. Assessment of Physiological Intracranial Calcification in Healthy Adults Using 18F-NaF PET/CT. J Nucl Med 2018; 60:jnumed.118.213678. [PMID: 30002111 DOI: 10.2967/jnumed.118.213678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/18/2018] [Indexed: 11/16/2022] Open
Abstract
The aim of this research study was to determine the role of 18F-Sodium fluoride (NaF) PET/CT imaging in the assessment of physiologic molecular calcification in the intra-cranial structures. We also examined the association of NaF accumulation with age as well as Hounsfield unit (HU) in certain anatomical sites that are known to calcify with normal aging. Methods: A total of 78 healthy subjects from the Cardiovascular Molecular Calcification Assessed by 18F-NaF PET/CT (CAMONA) clinical trial (38 females and 40 males) were included in this retrospective study. The mean age was 45.28 ±14.15 years (21-75). Mean standardized uptake values (SUVmean) was used to measure NaF accumulation in the choroid plexus and epithalamus (pineal gland and habenula). Maximum HU was also measured for each ROI. Correlation analysis was conducted to assess the association between parameters. Results: Mean SUVmean was 0.42 ± 0.26 in the right choroid plexus, 0.39 ±25 in the left choroid plexus, and 0.23±0.08 in the epithalamus. Significant positive correlations were present between NaF uptake and age in the right choroid plexus (r=0.61, P < 0.0001), left choroid plexus (r=0.63, p<0.0001), and epithalamus (r=0.36, P = 0.001). NaF uptake significantly correlated with HU in the right choroid plexus (r=0.52, P < 0.0001), left choroid plexus (r=0.57, p<0.0001), and epithalamus (r=0.25, P = 0.03). Conclusion: NaF could be used in the assessment of physiological calcification in several intracranial structures. We report significant associations between NaF uptake and aging as well as HU in the calcified choroid plexus and epithalamus. Our findings further support the growing interest to utilize NaF for detecting extra-osseous, molecular calcification, and this powerful probe has potential applications in the evaluation of various age-related, neurodegenerative brain processes.
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Affiliation(s)
| | | | | | | | | | - Abass Alavi
- Hospital of the University of Pennsylvania, United States
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Basu S, Beheshti M, Alavi A. Value of 18F NaF PET/CT in the Detection and Global Quantification of Cardiovascular Molecular Calcification as Part of the Atherosclerotic Process. PET Clin 2012; 7:329-39. [DOI: 10.1016/j.cpet.2012.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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