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Mikail N, Meseguer E, Lavallée P, Klein I, Hobeanu C, Guidoux C, Cabrejo L, Lesèche G, Amarenco P, Hyafil F. Evaluation of non-stenotic carotid atherosclerotic plaques with combined FDG-PET imaging and CT angiography in patients with ischemic stroke of unknown origin. J Nucl Cardiol 2022; 29:1329-1336. [PMID: 33462787 DOI: 10.1007/s12350-020-02511-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Non-stenotic plaques are an underestimated cause of ischemic stroke. Imaging aspects of high-risk carotid plaques can be identified on CT angiography (CTA) and 18F-fluoro-deoxyglucose positron emission tomography (FDG-PET) imaging. We evaluated in patients with cryptogenic ischemic stroke the usefulness of FDG-PET-CTA. METHODS 44 patients imaged with CTA and FDG-PET were identified retrospectively. Morphological features were identified on CTA. Intensity of FDG uptake in carotid arteries was quantified on PET. RESULTS Patients were imaged 7 ± 8 days after stroke. 44 non-stenotic plaques with increased 18F-FDG uptake were identified in the carotid artery ipsilateral to stroke and 7 contralateral. Most-diseased-segment TBR on FDG-PET was higher in artery ipsilateral vs. contralateral to stroke (2.24 ± 0.80 vs. 1.84 ± 0.50; p < .05). In the carotid region with high FDG uptake, prevalence of hypodense plaques and extent of hypodensity on CTA were higher in artery ipsilateral vs. contralateral to stroke (41% vs. 11%; 0.72 ± 1.2 mm2 vs. 0.13 ± 0.43 mm2; p < .05). CONCLUSIONS In patients with ischemic stroke of unknown origin and non-stenotic plaques, we found an increased prevalence of high-risk plaques features ipsilateral vs. contralateral to stroke on FDG-PET-CTA imaging suggesting a causal role for these plaques.
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Affiliation(s)
- Nidaa Mikail
- Department of Nuclear Medicine, Bichat University Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Elena Meseguer
- Department of Neurology, Bichat University Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Philippa Lavallée
- Department of Neurology, Bichat University Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Isabelle Klein
- Department of Neurology, Bichat University Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Cristina Hobeanu
- Department of Neurology, Bichat University Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Céline Guidoux
- Department of Neurology, Bichat University Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Lucie Cabrejo
- Department of Neurology, Bichat University Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Guy Lesèche
- Department of Vascular Surgery, Bichat University Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Pierre Amarenco
- Department of Neurology, Bichat University Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Fabien Hyafil
- Department of Nuclear Medicine, Georges-Pompidou European Hospital, DMU IMAGINA, Assistance Publique-Hôpitaux de Paris, University of Paris, 20 rue Leblanc, 75015, Paris, France.
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Kiani A, Esquevin A, Lepareur N, Bourguet P, Le Jeune F, Gauvrit J. Main applications of hybrid PET-MRI contrast agents: a review. CONTRAST MEDIA & MOLECULAR IMAGING 2015; 11:92-8. [PMID: 26632007 DOI: 10.1002/cmmi.1674] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Revised: 09/17/2015] [Accepted: 10/19/2015] [Indexed: 12/29/2022]
Abstract
In medical imaging, the continuous quest to improve diagnostic performance and optimize treatment strategies has led to the use of combined imaging modalities. Positron emission tomography (PET) and computed tomography (CT) is a hybrid imaging existing already for many years. The high spatial and contrast resolution of magnetic resonance imaging (MRI) and the high sensitivity and molecular information from PET imaging are leading to the development of this new hybrid imaging along with hybrid contrast agents. To create a hybrid contrast agent for PET-MRI device, a PET radiotracer needs to be combined with an MRI contrast agent. The most common approach is to add a radioactive isotope to the surface of a small superparamagnetic iron oxide (SPIO) particle. The resulting agents offer a wide range of applications, such as pH variation monitoring, non-invasive angiography and early imaging diagnosis of atherosclerosis. Oncology is the most promising field with the detection of sentinel lymph nodes and the targeting of tumor neoangiogenesis. Oncology and cardiovascular imaging are thus major areas of development for hybrid PET-MRI imaging systems and hybrid contrast agents. The aim is to combine high spatial resolution, high sensitivity, morphological and functional information. Future prospects include the use of specific antibodies and hybrid multimodal PET-MRI-ultrasound-fluorescence imaging with the potential to provide overall pre-, intra- and postoperative patient care.
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Affiliation(s)
- A Kiani
- Neurofacial Imaging Unit, Department of Radiology, Rennes University Hospital, 2 rue H. Le Guilloux, 35033, Rennes, France
| | - A Esquevin
- Neurofacial Imaging Unit, Department of Radiology, Rennes University Hospital, 2 rue H. Le Guilloux, 35033, Rennes, France.,VisAGeS U746 Unit/Project, INSERM/INRIA, IRISA, UMR CNRS 6074, University of Rennes 1, Beaulieu Campus, 35042, Rennes, France
| | - N Lepareur
- Department of Nuclear Medicine, Eugène Marquis Center, avenue Bataille Flandres Dunkerque, 35042, Rennes, France.,INSERM UMR-S 991 Unit "Liver, Metabolisms and Cancer", University of Rennes 1, 2 rue H. Le Guilloux, 35033, Rennes, France
| | - P Bourguet
- Department of Nuclear Medicine, Eugène Marquis Center, avenue Bataille Flandres Dunkerque, 35042, Rennes, France
| | - F Le Jeune
- Department of Nuclear Medicine, Eugène Marquis Center, avenue Bataille Flandres Dunkerque, 35042, Rennes, France.,EA 4712, "Behavior and Basal Ganglia", University of Rennes 1, 2 rue H. Le Guilloux, 35033, Rennes, France
| | - Jy Gauvrit
- Neurofacial Imaging Unit, Department of Radiology, Rennes University Hospital, 2 rue H. Le Guilloux, 35033, Rennes, France.,VisAGeS U746 Unit/Project, INSERM/INRIA, IRISA, UMR CNRS 6074, University of Rennes 1, Beaulieu Campus, 35042, Rennes, France
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