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The International Journal of Cardiovascular Imaging

Published in:

01-01-2016 | Original Paper

Natural history of atherosclerotic disease progression as assessed by ¹⁸F-FDG PET/CT

Authors: Holger Hetterich, Axel Rominger, Lisa Walter, Maximilian Habs, Sarah Volpers, Marcus Hacker, Maximilian F. Reiser, Peter Bartenstein, Tobias Saam

Published in: The International Journal of Cardiovascular Imaging | Issue 1/2016

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Abstract

The aim of this study was to assess the impact of cardiovascular risk factors and plaque inflammation on the progression of atherosclerosis as assessed by positron emission tomography/computed tomography (PET/CT) imaging with ¹⁸F-radiolabled fluorodeoxyglucose (¹⁸F-FDG). This study was designed as a retrospective cohort study. Patients who received a ¹⁸F-FDG PET/CT scan and follow-up scan 9–24 months later without systemic inflammation or steroid medication were eligible for the study. ¹⁸F-FDG PET/CT included a full diagnostic contrast enhanced CT scan. Cardiovascular risk factors and medication were documented. Calcified plaque volume, lumen area and ¹⁸F-FDG uptake, quantified by the target-to-background ratio (TBR), were measured in the carotid arteries, aorta and iliac arteries. Influence of cardiovascular risk factors and vessel wall inflammation on atherosclerotic disease progression was analyzed. Ninety-four patients underwent baseline and follow-up whole body ¹⁸F-FDG PET/CT (mean follow-up time 14.5 ± 3.5 months). Annualized calcified plaque volume increased by 15.4 % (p < 0.0001), carotid and aortic lumen area decreased by 10.5 % (p < 0.0001) and 1.7 % (p = 0.045). There was no significant difference in ¹⁸F-FDG uptake at baseline and follow-up (mean TBR 1.44 ± 0.18 vs. 1.42 ± 0.19, p = 0.18). Multiple linear regression analysis identified hypertension as an independent predictor for total, aortic and iliac calcified plaque volume progression (all p < 0.04). Carotid lumen reduction was predicted by hypercholesterolemia (p = 0.008) while aortic lumen reduction was associated with BMI and mean ¹⁸F-FDG uptake (p ≤ 0.005). Furthermore we observed a dose response relationship between the number of cardiovascular risk factors and calcified plaque volume progression in the aorta (p = 0.03). Findings from this study provide data on the natural history of atherosclerotic disease burden in multiple vascular beds and emphasize the value of morphological and physiologic information provided by ¹⁸F-FDG PET/CT imaging.

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Title: Natural history of atherosclerotic disease progression as assessed by 18F-FDG PET/CT
Authors: Holger Hetterich
Axel Rominger
Lisa Walter
Maximilian Habs
Sarah Volpers
Marcus Hacker
Maximilian F. Reiser
Peter Bartenstein
Tobias Saam
Publication date: 01-01-2016
Publisher: Springer Netherlands
Published in: The International Journal of Cardiovascular Imaging / Issue 1/2016
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-015-0660-8

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