1
|
Proaño-Bernal L, Gilabert-García A, Sharma-Sharma S, Mora-Barrera CM, Singer-De-la-Garza J, Beristain-de-la-Rosa PY, Basile-Alvarez MR, Guerra EC, Bermudez-Gonzalez JL, Luna-Alcala S, Espinola-Zavaleta N, Alexanderson-Rosas E. Positron emission tomography and its role in the assessment of vulnerable plaques in comparison to other imaging modalities. Front Med (Lausanne) 2024; 10:1293848. [PMID: 38425695 PMCID: PMC10902136 DOI: 10.3389/fmed.2023.1293848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/04/2023] [Indexed: 03/02/2024] Open
Abstract
The diagnosis and management of vulnerable plaques are topics of high interest in the cardiovascular field. Although imaging techniques like computed tomography angiography (MCTA) and ultrasonography (USG) can structurally evaluate atherosclerotic plaques, they are limited in examining internal cellular processes. Positron emission tomography (PET) molecular imaging, on the other hand, can highlight these cellular processes, including inflammation, angiogenesis, and lipid oxidation. Magnetic resonance imaging (MRI) is also a valuable non-invasive imaging technique that can provide detailed anatomical and functional information on the cardiovascular system. In this review, we compare the advantages and drawbacks of MCTA, USG and MRI imaging techniques with PET molecular imaging in evaluating vulnerable plaques. PET imaging allows physicians to measure different pathophysiological events within the plaque using intravenous radiotracers, of which 18F-fluorodeoxyglucose (18F-FDG) is the most validated one. By using 18F-FDG, physicians can understand the formation of the plaque, assess the accumulation of macrophages, and predict major cardiovascular events. However, some limitations exist in using 18F-FDG, including myocardial uptake and low sensitivity in imaging coronary arteries. We also mention other radiotracers that can help in evaluating vulnerable plaques, including 18F-NaF. Although PET imaging is still challenging, it has shown promise in evaluating vulnerable plaques and could be used to intervene in high-risk patients before major cardiovascular events occur.
Collapse
Affiliation(s)
- Leonardo Proaño-Bernal
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Ana Gilabert-García
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | | | | | | | | | | | - Enrique C. Guerra
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Jorge Luis Bermudez-Gonzalez
- Department of Internal Medicine, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Santiago Luna-Alcala
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Nilda Espinola-Zavaleta
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Erick Alexanderson-Rosas
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| |
Collapse
|
2
|
Minamimoto R. Series of myocardial FDG uptake requiring considerations of myocardial abnormalities in FDG-PET/CT. Jpn J Radiol 2021; 39:540-557. [PMID: 33517516 PMCID: PMC8175248 DOI: 10.1007/s11604-021-01097-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/16/2021] [Indexed: 12/18/2022]
Abstract
Distinct from cardiac PET performed with preparation to control physiological FDG uptake in the myocardium, standard FDG-PET/CT performed with 4-6 h of fasting will show variation in myocardial FDG uptake. For this reason, important signs of myocardial and pericardial abnormality revealed by myocardial FDG uptake tend to be overlooked. However, recognition of possible underlying disease will support further patient management to avoid complications due to the disease. This review demonstrates the mechanism of FDG uptake in the myocardium, discusses the factors affecting uptake, and provides notable image findings that may suggest underlying disease.
Collapse
Affiliation(s)
- Ryogo Minamimoto
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan.
| |
Collapse
|
3
|
Nakata T. A multifunctional CT technology: Reality or illusion for patient risk assessment? J Nucl Cardiol 2017; 24:1263-1266. [PMID: 27021384 DOI: 10.1007/s12350-016-0439-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 10/22/2022]
Abstract
A high-speed, multi-slice coronary computed tomography (CT) imaging has emerged as a promising or clinically available multifunctional technique for the assessment of myocardial ischemia, viability, ischemia-induced cardiac dysfunction, and coronary atherosclerotic alterations in patients with suspected or known coronary artery disease. Despite several technical issues remain to be resolved, cardiac CT imaging will have a reality as a multifunctional modality for guiding physicians in better decision-making for favorable clinical outcomes in patients with suspected coronary artery disease, provided that this imaging technology can contribute to characterization and localization of high-risk coronary atherosclerosis in combination with the quantitative evaluation of functional myocardial ischemia.
Collapse
Affiliation(s)
- Tomoaki Nakata
- Department of Cardiology, Hakodate Goryoukaku Hospital, Hakodate, 040-8611, Japan.
- Sapporo Medical University School of Medicine, Sapporo, 060-8543, Japan.
| |
Collapse
|
4
|
Mamdani N, Tung B, Wang Y, Jaffer FA, Tawakol A. Imaging the Coronary Artery Plaque: Approaches, Advances, and Challenges. CURRENT CARDIOVASCULAR IMAGING REPORTS 2017. [DOI: 10.1007/s12410-017-9419-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
5
|
Starosolski Z, Villamizar CA, Rendon D, Paldino MJ, Milewicz DM, Ghaghada KB, Annapragada AV. Ultra High-Resolution In vivo Computed Tomography Imaging of Mouse Cerebrovasculature Using a Long Circulating Blood Pool Contrast Agent. Sci Rep 2015; 5:10178. [PMID: 25985192 PMCID: PMC4650815 DOI: 10.1038/srep10178] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 04/01/2015] [Indexed: 12/21/2022] Open
Abstract
Abnormalities in the cerebrovascular system play a central role in many neurologic diseases. The on-going expansion of rodent models of human cerebrovascular diseases and the need to use these models to understand disease progression and treatment has amplified the need for reproducible non-invasive imaging methods for high-resolution visualization of the complete cerebral vasculature. In this study, we present methods for in vivo high-resolution (19 μm isotropic) computed tomography imaging of complete mouse brain vasculature. This technique enabled 3D visualization of large cerebrovascular networks, including the Circle of Willis. Blood vessels as small as 40 μm were clearly delineated. ACTA2 mutations in humans cause cerebrovascular defects, including abnormally straightened arteries and a moyamoya-like arteriopathy characterized by bilateral narrowing of the internal carotid artery and stenosis of many large arteries. In vivo imaging studies performed in a mouse model of Acta2 mutations demonstrated the utility of this method for studying vascular morphometric changes that are practically impossible to identify using current histological methods. Specifically, the technique demonstrated changes in the width of the Circle of Willis, straightening of cerebral arteries and arterial stenoses. We believe the use of imaging methods described here will contribute substantially to the study of rodent cerebrovasculature.
Collapse
Affiliation(s)
- Zbigniew Starosolski
- 1] Edward B. Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston TX [2] Department of Radiology, Baylor College of Medicine, Houston, TX
| | - Carlos A Villamizar
- Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX
| | - David Rendon
- Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Michael J Paldino
- 1] Edward B. Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston TX [2] Department of Radiology, Baylor College of Medicine, Houston, TX
| | - Dianna M Milewicz
- Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX
| | - Ketan B Ghaghada
- 1] Edward B. Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston TX [2] Department of Radiology, Baylor College of Medicine, Houston, TX
| | - Ananth V Annapragada
- 1] Edward B. Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston TX [2] Department of Radiology, Baylor College of Medicine, Houston, TX
| |
Collapse
|
6
|
Korean red ginseng extract alleviates atherosclerotic lesions in apolipoprotein E knockout mice. Food Sci Biotechnol 2014. [DOI: 10.1007/s10068-014-0174-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
7
|
Sannino A, Brevetti L, Giugliano G, Scudiero F, Toscano E, Mainolfi C, Cuocolo A, Perrino C, Stabile E, Trimarco B, Esposito G. Non-invasive vulnerable plaque imaging: how do we know that treatment works? Eur Heart J Cardiovasc Imaging 2014; 15:1194-202. [PMID: 24876097 DOI: 10.1093/ehjci/jeu097] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Atherosclerosis is an inflammatory disorder that can evolve into an acute clinical event by plaque development, rupture, and thrombosis. Plaque vulnerability represents the susceptibility of a plaque to rupture and to result in an acute cardiovascular event. Nevertheless, plaque vulnerability is not an established medical diagnosis, but rather an evolving concept that has gained attention to improve risk prediction. The availability of high-resolution imaging modalities has significantly facilitated the possibility of performing in vivo regression studies and documenting serial changes in plaque stability. This review summarizes the currently available non-invasive methods to identify vulnerable plaques and to evaluate the effects of the current cardiovascular treatments on plaque evolution.
Collapse
Affiliation(s)
- Anna Sannino
- Cardiology, Department of Advanced Biomedical Sciences, University of Naples 'Federico II', Via Pansini, 5, 80131 Naples, Italy
| | - Linda Brevetti
- Cardiology, Department of Advanced Biomedical Sciences, University of Naples 'Federico II', Via Pansini, 5, 80131 Naples, Italy
| | - Giuseppe Giugliano
- Cardiology, Department of Advanced Biomedical Sciences, University of Naples 'Federico II', Via Pansini, 5, 80131 Naples, Italy
| | - Fernando Scudiero
- Cardiology, Department of Advanced Biomedical Sciences, University of Naples 'Federico II', Via Pansini, 5, 80131 Naples, Italy
| | - Evelina Toscano
- Cardiology, Department of Advanced Biomedical Sciences, University of Naples 'Federico II', Via Pansini, 5, 80131 Naples, Italy
| | - Ciro Mainolfi
- Nuclear Medicine, Department of Advanced Biomedical Sciences, University of Naples 'Federico II', Via Pansini, 5, 80131 Naples, Italy
| | - Alberto Cuocolo
- Nuclear Medicine, Department of Advanced Biomedical Sciences, University of Naples 'Federico II', Via Pansini, 5, 80131 Naples, Italy
| | - Cinzia Perrino
- Cardiology, Department of Advanced Biomedical Sciences, University of Naples 'Federico II', Via Pansini, 5, 80131 Naples, Italy
| | - Eugenio Stabile
- Cardiology, Department of Advanced Biomedical Sciences, University of Naples 'Federico II', Via Pansini, 5, 80131 Naples, Italy
| | - Bruno Trimarco
- Cardiology, Department of Advanced Biomedical Sciences, University of Naples 'Federico II', Via Pansini, 5, 80131 Naples, Italy
| | - Giovanni Esposito
- Cardiology, Department of Advanced Biomedical Sciences, University of Naples 'Federico II', Via Pansini, 5, 80131 Naples, Italy
| |
Collapse
|
8
|
Millar BC, Prendergast BD, Alavi A, Moore JE. 18FDG-positron emission tomography (PET) has a role to play in the diagnosis and therapy of infective endocarditis and cardiac device infection. Int J Cardiol 2013; 167:1724-36. [DOI: 10.1016/j.ijcard.2012.12.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 11/19/2012] [Accepted: 12/01/2012] [Indexed: 12/15/2022]
|
9
|
Meyer T, Chemnitz M, Baumgartl M, Gottschall T, Pascher T, Matthäus C, Romeike BFM, Brehm BR, Limpert J, Tünnermann A, Schmitt M, Dietzek B, Popp J. Expanding Multimodal Microscopy by High Spectral Resolution Coherent Anti-Stokes Raman Scattering Imaging for Clinical Disease Diagnostics. Anal Chem 2013; 85:6703-15. [DOI: 10.1021/ac400570w] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Tobias Meyer
- Institute of Photonic Technology Jena, Albert-Einstein-Strasse 9, 07745 Jena,
Germany
| | - Mario Chemnitz
- Institute of Applied
Physics
and Abbe Center of Photonics, Friedrich-Schiller-University Jena, Albert-Einstein-Strasse 15, 07745 Jena, Germany
| | - Martin Baumgartl
- Institute of Applied
Physics
and Abbe Center of Photonics, Friedrich-Schiller-University Jena, Albert-Einstein-Strasse 15, 07745 Jena, Germany
| | - Thomas Gottschall
- Institute of Applied
Physics
and Abbe Center of Photonics, Friedrich-Schiller-University Jena, Albert-Einstein-Strasse 15, 07745 Jena, Germany
| | - Torbjörn Pascher
- Pascher Instruments, Stora Rabybyaväg 24, 22478 Lund, Sweden
- Department of Chemical Physics, Lund University, Kemicentrum, Getingevägen 60,
22241 Lund, Sweden
| | - Christian Matthäus
- Institute of Photonic Technology Jena, Albert-Einstein-Strasse 9, 07745 Jena,
Germany
| | - Bernd F. M. Romeike
- Institute
of Pathology, Department
of Neuropathology, Jena University Hospital, Friedrich-Schiller-University, Erlanger Allee 101, 07740 Jena, Germany
| | - Bernhard R. Brehm
- Internal Medicine and Cardiology, Catholic Clinic Koblenz, Rudolf Virchow Strasse 9,
56073 Koblenz, Germany
| | - Jens Limpert
- Institute of Applied
Physics
and Abbe Center of Photonics, Friedrich-Schiller-University Jena, Albert-Einstein-Strasse 15, 07745 Jena, Germany
| | - Andreas Tünnermann
- Institute of Applied
Physics
and Abbe Center of Photonics, Friedrich-Schiller-University Jena, Albert-Einstein-Strasse 15, 07745 Jena, Germany
- Fraunhofer Institute for Applied Optics and Precision Engineering, Albert-Einstein-Strasse
7, 07745 Jena, Germany
| | - Michael Schmitt
- Institute of Physical Chemistry
and Abbe Center of Photonics, Friedrich-Schiller-University Jena, Helmholtzweg 4, 07743 Jena, Germany
| | - Benjamin Dietzek
- Institute of Photonic Technology Jena, Albert-Einstein-Strasse 9, 07745 Jena,
Germany
- Institute of Physical Chemistry
and Abbe Center of Photonics, Friedrich-Schiller-University Jena, Helmholtzweg 4, 07743 Jena, Germany
| | - Jürgen Popp
- Institute of Photonic Technology Jena, Albert-Einstein-Strasse 9, 07745 Jena,
Germany
- Institute of Physical Chemistry
and Abbe Center of Photonics, Friedrich-Schiller-University Jena, Helmholtzweg 4, 07743 Jena, Germany
| |
Collapse
|
10
|
Morsbach F, Berger N, Desbiolles L, Poropat T, Leschka S, Alkadhi H, Stolzmann P. Systematic analysis on the relationship between luminal enhancement, convolution kernel, plaque density, and luminal diameter of coronary artery stenosis: a CT phantom study. Int J Cardiovasc Imaging 2013; 29:1129-35. [PMID: 23329389 DOI: 10.1007/s10554-012-0173-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Accepted: 12/21/2012] [Indexed: 11/29/2022]
Abstract
To systematically investigate into the relationships between luminal enhancement, convolution kernel, plaque density, and stenosis severity in coronary computed tomography (CT) angiography. A coronary phantom including 63 stenoses (stenosis severity, 10-90%; plaque densities, -100 to 1,000 HU) was loaded with increasing solutions of contrast material (luminal enhancement, 0-700 HU) and scanned in an anthropomorphic chest. CT data was acquired with prospective triggering using 64-section dual-source CT; reconstructions were performed with soft-tissue (B26f) and sharp convolution kernels (B46f). Two blinded and independent readers quantitatively assessed luminal diameter and CT number of plaque using electronic calipers. Measurement bias between phantom dimensions and CT measurements were calculated. Multivariate linear regression models identified predictors of bias. Inter- and intra-reader agreements of luminal diameter and CT number measurements were excellent (ICCs > 0.91, p < 0.01, each). Measurement bias of luminal diameter and plaque density was significantly (p < 0.01, each) lower (-12% and 58 HU, respectively) with B46f as opposed to B26f, especially in plaque densities >200 HU. Measurement bias was significantly (p < 0.01, each) correlated (ρ = 0.37-55 and ρ = -0.70-85) with the differences between luminal enhancement and plaque density. In multivariate models, bias of luminal diameter assessment with CT was correlated with plaque density (β = 0.09, p < 0.05). Convolution kernel (β = -0.29 and -0.38), stenosis severity (β = -0.45 and -0.38), and luminal enhancement (β = -0.11 and -0.29) represented independent (p < 0.05,each) predictors of measurement bias of luminal diameter and plaque number, respectively. Significant independent relationships exist between luminal enhancement, convolution kernel, plaque density, and luminal diameter, which have to be taken into account when performing, evaluating, and interpreting coronary CT angiography.
Collapse
Affiliation(s)
- Fabian Morsbach
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 8091 Zurich, Switzerland
| | | | | | | | | | | | | |
Collapse
|
11
|
Piga M, Ruffini L, Salvarani C, Mathieu A. Myocardial positron emission tomography/computed tomography scan revealing right coronary artery involvement in large vessel vasculitis. J Rheumatol 2012; 39:1761-1763. [PMID: 22859537 DOI: 10.3899/jrheum.120353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
12
|
Schlett CL, Ferencik M, Kriegel MF, Bamberg F, Ghoshhajra BB, Joshi SB, Nagurney JT, Fox CS, Truong QA, Hoffmann U. Association of pericardial fat and coronary high-risk lesions as determined by cardiac CT. Atherosclerosis 2012; 222:129-34. [PMID: 22417843 DOI: 10.1016/j.atherosclerosis.2012.02.029] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 02/15/2012] [Accepted: 02/16/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Pericardial adipose tissue (PAT) is a pathogenic fat depot associated with coronary atherosclerosis and cardiovascular events. We hypothesized that higher PAT is associated with coronary high-risk lesions as determined by cardiac CT. METHODS We included 358 patients (38% female; median age 51 years) who were admitted to the ED with acute chest pain and underwent 64-slice CT angiography. The cardiac CT data sets were assessed for presence and morphology of CAD and PAT. Coronary high-risk lesions were defined as >50% luminal narrowing and at least two of the following characteristics: positive remodeling, low-density plaque, and spotty calcification. PAT was defined as any pixel with CT attenuation of -190 to -30 HU within the pericardial sac. RESULTS Based on cardiac CT, 50% of the patients (n=180) had no CAD, 46% (n=165) had CAD without high-risk lesions, and 13 patients had CAD with high-risk lesions. The median PAT in patients with high-risk lesions was significantly higher compared to patients without high-risk lesions and without any CAD (151.9 [109.0-179.4]cm(3) vs. 110.0 [81.5-137.4]cm(3), vs. 74.8 [58.2-111.7]cm(3), respectively p=0.04 and p<0.0001). These differences remained significant after adjusting for traditional risk factors including BMI (all p<0.05). The area under the ROC curve for the identification of high-risk lesions was 0.756 in a logistic regression model with PAT as a continuous predictor. CONCLUSION PAT volume is nearly twice as high in patients with high-risk coronary lesions as compared to those without CAD. PAT volume is significantly associated with high risk coronary lesion morphology independent of clinical characteristics and general obesity.
Collapse
Affiliation(s)
- Christopher L Schlett
- Cardiac MR, PET, CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02214, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Steiner RM. Why Should We Be Interested in Cardiac PET/CT Imaging? Radiographics 2011; 31:1237-8. [DOI: 10.1148/rg.315115145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|