Skip to main content
Top
Published in: European Journal of Nuclear Medicine and Molecular Imaging 12/2019

01-11-2019 | Magnetic Resonance Imaging | Original Article

Association of aortic vascular uptake of 18FDG by PET/CT and aortic wall thickness by MRI in psoriasis: a prospective observational study

Authors: Jacob W. Groenendyk, Parag Shukla, Amit K. Dey, Youssef A. Elnabawi, Milena Aksentijevich, Harry Choi, Leonard D. Genovese, Charlotte L. Harrington, Balaji Natarajan, Aditya Goyal, Aarthi S. Reddy, Justin Rodante, Mohammad Tarek Kabbany, Ahmed Sadek, Mina Al Najafi, Martin P. Playford, Aditya A. Joshi, Mark A. Ahlman, Joel M. Gelfand, David A. Bluemke, Nehal N. Mehta

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 12/2019

Login to get access

Abstract

Background

The contribution of inflammation to the incidence of cardiovascular disease (CVD) has been increasingly recognized in recent years. We investigated the relationship of aortic vascular uptake of 18F-FDG by PET/CT and aortic wall thickness (AWT) by MRI in psoriasis, a chronic inflammatory disease with increased incidence of CVD. One hundred sixty-five patients with plaque psoriasis participated in an ongoing longitudinal cohort study. Subclinical atherosclerosis was assessed as aortic uptake of 18F-FDG by PET/CT reported as target-to-background ratio (TBR) and AWT by MRI reported as maximal thickness.

Results

Patients with psoriasis were middle aged, predominantly male, and had mild CV risk by traditional risk factors. Psoriasis severity as measured by PASI score was a notable determinant of AWT (ρ = 0.20, p = 0.01). Moreover, aortic vascular uptake of 18F-FDG associated with AWT by MRI at baseline in unadjusted analysis (β = 0.27 p = 0.001) and following adjustment for traditional cardiovascular risk factors, waist-to-hip ratio, and statin use (β = 0.21 p = 0.01). Finally, following 1 year of psoriasis treatment, a decrease in aortic vascular uptake of 18F-FDG was associated with a reduction in AWT in fully adjusted models (β = 0.33, p = 0.02).

Conclusion

In conclusion, we demonstrate that psoriasis severity and aortic vascular uptake of 18F-FDG in the aorta were associated with AWT. Following treatment of psoriasis, a decrease in aortic vascular uptake of 18F-FDG was associated with a reduction in AWT at 1 year. These findings suggest that aortic vascular uptake of 18F-FDG is associated with early evidence of vascular disease assessed by aortic wall thickness. Prospective studies in larger populations including other inflammatory diseases are warranted.
Appendix
Available only for authorised users
Literature
1.
go back to reference Ridker PM, Danielson E, Fonseca FAH, Genest J, Gotto AMJ, Kastelein JJP, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359(21):2195–207.CrossRef Ridker PM, Danielson E, Fonseca FAH, Genest J, Gotto AMJ, Kastelein JJP, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359(21):2195–207.CrossRef
2.
go back to reference Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017;377(12):1119–31.CrossRef Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017;377(12):1119–31.CrossRef
3.
go back to reference Ridker PM, Rifai N, Rose L, Buring JE, Cook NR. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med. 2002;347(20):1557–65.CrossRef Ridker PM, Rifai N, Rose L, Buring JE, Cook NR. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med. 2002;347(20):1557–65.CrossRef
4.
go back to reference Harrington RA. Targeting inflammation in coronary artery disease. N Engl J Med. 2017;377(12):1197–8.CrossRef Harrington RA. Targeting inflammation in coronary artery disease. N Engl J Med. 2017;377(12):1197–8.CrossRef
5.
go back to reference Teague HL, Ahlman MA, Alavi A, Wagner DD, Lichtman AH, Nahrendorf M, et al. Unraveling vascular inflammation: from immunology to imaging. J Am Coll Cardiol. 2017;70(11):1403–12.CrossRef Teague HL, Ahlman MA, Alavi A, Wagner DD, Lichtman AH, Nahrendorf M, et al. Unraveling vascular inflammation: from immunology to imaging. J Am Coll Cardiol. 2017;70(11):1403–12.CrossRef
6.
go back to reference Figueroa AL, Abdelbaky A, Truong QA, Corsini E, MacNabb MH, Lavender ZR, et al. Measurement of arterial activity on routine FDG PET/CT images improves prediction of risk of future CV events. JACC Cardiovasc Imaging. 2013;6(12):1250–9.CrossRef Figueroa AL, Abdelbaky A, Truong QA, Corsini E, MacNabb MH, Lavender ZR, et al. Measurement of arterial activity on routine FDG PET/CT images improves prediction of risk of future CV events. JACC Cardiovasc Imaging. 2013;6(12):1250–9.CrossRef
7.
go back to reference Figueroa AL, Takx RAP, MacNabb MH, Abdelbaky A, Lavender ZR, Kaplan RS, et al. Relationship between measures of adiposity, arterial inflammation, and subsequent cardiovascular events. Circ: Cardiovasc Imaging. 2016;9(4). Figueroa AL, Takx RAP, MacNabb MH, Abdelbaky A, Lavender ZR, Kaplan RS, et al. Relationship between measures of adiposity, arterial inflammation, and subsequent cardiovascular events. Circ: Cardiovasc Imaging. 2016;9(4).
8.
go back to reference Vaidya K, Arnott C, Martínez GJ, Ng B, McCormack S, Sullivan DR, et al. Colchicine therapy and plaque stabilization in patients with acute coronary syndrome: a CT coronary angiography study. JACC Cardiovasc Imaging. 2018;11(2, Part 2):305–16.CrossRef Vaidya K, Arnott C, Martínez GJ, Ng B, McCormack S, Sullivan DR, et al. Colchicine therapy and plaque stabilization in patients with acute coronary syndrome: a CT coronary angiography study. JACC Cardiovasc Imaging. 2018;11(2, Part 2):305–16.CrossRef
9.
go back to reference Joshi AA, Lerman JB, Dey AK, Sajja AP, Belur AD, Elnabawi YA, et al. Association between aortic vascular inflammation and coronary artery plaque characteristics in Psoriasis. JAMA Cardiol. 2018;3(10):949–56.CrossRef Joshi AA, Lerman JB, Dey AK, Sajja AP, Belur AD, Elnabawi YA, et al. Association between aortic vascular inflammation and coronary artery plaque characteristics in Psoriasis. JAMA Cardiol. 2018;3(10):949–56.CrossRef
10.
go back to reference Dey AK, Joshi AA, Chaturvedi A, et al. Association between skin and aortic vascular inflammation in patients with psoriasis: a case-cohort study using positron emission tomography/computed tomography. JAMA Cardiol. 2017;2(9):1013–8.CrossRef Dey AK, Joshi AA, Chaturvedi A, et al. Association between skin and aortic vascular inflammation in patients with psoriasis: a case-cohort study using positron emission tomography/computed tomography. JAMA Cardiol. 2017;2(9):1013–8.CrossRef
11.
go back to reference Tawakol A, Fayad ZA, Mogg R, Alon A, Klimas MT, Dansky H, et al. Intensification of statin therapy results in a rapid reduction in atherosclerotic inflammation: results of a multicenter fluorodeoxyglucose-positron emission tomography/computed tomography feasibility study. J Am Coll Cardiol. 2013;62(10):909–17.CrossRef Tawakol A, Fayad ZA, Mogg R, Alon A, Klimas MT, Dansky H, et al. Intensification of statin therapy results in a rapid reduction in atherosclerotic inflammation: results of a multicenter fluorodeoxyglucose-positron emission tomography/computed tomography feasibility study. J Am Coll Cardiol. 2013;62(10):909–17.CrossRef
12.
go back to reference Mehta NN, Torigian DA, Gelfand JM, Saboury B, Alavi A. Quantification of atherosclerotic plaque activity and vascular inflammation using [18-f] fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT). J Vis Exp: JoVE. 2012;63:e3777-e. Mehta NN, Torigian DA, Gelfand JM, Saboury B, Alavi A. Quantification of atherosclerotic plaque activity and vascular inflammation using [18-f] fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT). J Vis Exp: JoVE. 2012;63:e3777-e.
13.
go back to reference Naredo E, Möller I, Corrales A, Bong DA, Cobo-Ibáñez T, Corominas H, et al. Automated radiofrequency-based US measurement of common carotid intima–media thickness in RA patients treated with synthetic vs synthetic and biologic DMARDs. Rheumatology. 2013;52(2):376–81.CrossRef Naredo E, Möller I, Corrales A, Bong DA, Cobo-Ibáñez T, Corominas H, et al. Automated radiofrequency-based US measurement of common carotid intima–media thickness in RA patients treated with synthetic vs synthetic and biologic DMARDs. Rheumatology. 2013;52(2):376–81.CrossRef
14.
go back to reference Kisiel B, Kruszewski R, Juszkiewicz A, Raczkiewicz A, Bachta A, Tlustochowicz M, et al. Methotrexate, cyclosporine a, and biologics protect against atherosclerosis in rheumatoid arthritis. J Immunol Res. 2015;2015:8.CrossRef Kisiel B, Kruszewski R, Juszkiewicz A, Raczkiewicz A, Bachta A, Tlustochowicz M, et al. Methotrexate, cyclosporine a, and biologics protect against atherosclerosis in rheumatoid arthritis. J Immunol Res. 2015;2015:8.CrossRef
15.
go back to reference Abolmaali N, Langenfeld M, Krahforst R, Schick C, Thalhammer A, Schmitt J, et al. Vessel wall MRI of the thoracic aorta: correlation to histology and transesophageal ultrasound. Preliminary results. Rofo. 2002;174(5):568–72.CrossRef Abolmaali N, Langenfeld M, Krahforst R, Schick C, Thalhammer A, Schmitt J, et al. Vessel wall MRI of the thoracic aorta: correlation to histology and transesophageal ultrasound. Preliminary results. Rofo. 2002;174(5):568–72.CrossRef
16.
go back to reference Maroules CD, Rosero E, Ayers C, Peshock RM, Khera A. Abdominal aortic atherosclerosis at MR imaging is associated with cardiovascular events: the Dallas heart study. Radiology. 2013;269(1):84–91.CrossRef Maroules CD, Rosero E, Ayers C, Peshock RM, Khera A. Abdominal aortic atherosclerosis at MR imaging is associated with cardiovascular events: the Dallas heart study. Radiology. 2013;269(1):84–91.CrossRef
17.
go back to reference Malayeri AA, Natori S, Bahrami H, Bertoni AG, Kronmal R, Lima JAC, et al. Relation of aortic wall thickness and distensibility to cardiovascular risk factors (from the multi-ethnic study of atherosclerosis [MESA]). Am J Cardiol. 2008;102(4):491–6.CrossRef Malayeri AA, Natori S, Bahrami H, Bertoni AG, Kronmal R, Lima JAC, et al. Relation of aortic wall thickness and distensibility to cardiovascular risk factors (from the multi-ethnic study of atherosclerosis [MESA]). Am J Cardiol. 2008;102(4):491–6.CrossRef
18.
go back to reference Rosero EB, Peshock RM, Khera A, Clagett P, Lo H, Timaran CH. Sex, race, and age distributions of mean aortic wall thickness in a multiethnic population-based sample. J Vasc Surg. 2011;53(4):950–7.CrossRef Rosero EB, Peshock RM, Khera A, Clagett P, Lo H, Timaran CH. Sex, race, and age distributions of mean aortic wall thickness in a multiethnic population-based sample. J Vasc Surg. 2011;53(4):950–7.CrossRef
19.
go back to reference Gupta S, Berry JD, Ayers CR, Peshock RM, Khera A, de Lemos JA, et al. Left ventricular hypertrophy, aortic wall thickness, and lifetime predicted risk of cardiovascular disease: the Dallas heart study. JACC Cardiovasc Imaging. 2010;3(6):605–13.CrossRef Gupta S, Berry JD, Ayers CR, Peshock RM, Khera A, de Lemos JA, et al. Left ventricular hypertrophy, aortic wall thickness, and lifetime predicted risk of cardiovascular disease: the Dallas heart study. JACC Cardiovasc Imaging. 2010;3(6):605–13.CrossRef
20.
go back to reference Liu C-Y, Chen D, Bluemke DA, Wu CO, Teixido-Tura G, Chugh A, et al. Evolution of aortic wall thickness and stiffness with atherosclerosis: long-term follow up from the multi-ethnic study of atherosclerosis (MESA). Hypertension. 2015;65(5):1015–9.CrossRef Liu C-Y, Chen D, Bluemke DA, Wu CO, Teixido-Tura G, Chugh A, et al. Evolution of aortic wall thickness and stiffness with atherosclerosis: long-term follow up from the multi-ethnic study of atherosclerosis (MESA). Hypertension. 2015;65(5):1015–9.CrossRef
21.
go back to reference Li AE, Kamel I, Rando F, Anderson M, Kumbasar B, Lima JAC, et al. Using MRI to assess aortic wall thickness in the multiethnic study of atherosclerosis: distribution by race, sex, and age. Am J Roentgenol. 2004;182(3):593–7.CrossRef Li AE, Kamel I, Rando F, Anderson M, Kumbasar B, Lima JAC, et al. Using MRI to assess aortic wall thickness in the multiethnic study of atherosclerosis: distribution by race, sex, and age. Am J Roentgenol. 2004;182(3):593–7.CrossRef
22.
go back to reference Abuabara K, Azfar RS, Shin DB, Neimann AL, Troxel AB, Gelfand JM. Cause-specific mortality in patients with severe psoriasis: a population-based cohort study in the United Kingdom. Br J Dermatol. 2010;163(3):586–92.CrossRef Abuabara K, Azfar RS, Shin DB, Neimann AL, Troxel AB, Gelfand JM. Cause-specific mortality in patients with severe psoriasis: a population-based cohort study in the United Kingdom. Br J Dermatol. 2010;163(3):586–92.CrossRef
23.
go back to reference Mehta NN, Azfar RS, Shin DB, Neimann AL, Troxel AB, Gelfand JM. Patients with severe psoriasis are at increased risk of cardiovascular mortality: cohort study using the general practice research database. Eur Heart J. 2010;31(8):1000–6.CrossRef Mehta NN, Azfar RS, Shin DB, Neimann AL, Troxel AB, Gelfand JM. Patients with severe psoriasis are at increased risk of cardiovascular mortality: cohort study using the general practice research database. Eur Heart J. 2010;31(8):1000–6.CrossRef
24.
go back to reference Naik Haley B, Natarajan B, Stansky E, Ahlman Mark A, Teague H, Salahuddin T, et al. Severity of psoriasis associates with aortic vascular inflammation detected by FDG PET/CT and neutrophil activation in a prospective observational study. Arterioscler Thromb Vasc Biol. 2015;35(12):2667–76.CrossRef Naik Haley B, Natarajan B, Stansky E, Ahlman Mark A, Teague H, Salahuddin T, et al. Severity of psoriasis associates with aortic vascular inflammation detected by FDG PET/CT and neutrophil activation in a prospective observational study. Arterioscler Thromb Vasc Biol. 2015;35(12):2667–76.CrossRef
25.
go back to reference Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007;335(7624):806–8.CrossRef Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007;335(7624):806–8.CrossRef
26.
27.
go back to reference Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002;105(9):1135–43.CrossRef Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002;105(9):1135–43.CrossRef
28.
go back to reference Crowson CS, Liao KP, Davis JM 3rd, Solomon DH, Matteson EL, Knutson KL, et al. Rheumatoid arthritis and cardiovascular disease. Am Heart J. 2013;166(4):622–8 e1.CrossRef Crowson CS, Liao KP, Davis JM 3rd, Solomon DH, Matteson EL, Knutson KL, et al. Rheumatoid arthritis and cardiovascular disease. Am Heart J. 2013;166(4):622–8 e1.CrossRef
29.
go back to reference Rudd JH, Warburton EA, Fryer TD, Jones HA, Clark JC, Antoun N, et al. Imaging atherosclerotic plaque inflammation with [18F]-fluorodeoxyglucose positron emission tomography. Circulation. 2002;105(23):2708–11.CrossRef Rudd JH, Warburton EA, Fryer TD, Jones HA, Clark JC, Antoun N, et al. Imaging atherosclerotic plaque inflammation with [18F]-fluorodeoxyglucose positron emission tomography. Circulation. 2002;105(23):2708–11.CrossRef
30.
go back to reference Yu Y, Sheth N, Krishnamoorthy P, Saboury B, Raper A, Baer A, et al. Aortic vascular inflammation in psoriasis is associated with HDL particle size and concentration: a pilot study. Am J Cardiovasc Dis. 2012;2(4):285–92.PubMedPubMedCentral Yu Y, Sheth N, Krishnamoorthy P, Saboury B, Raper A, Baer A, et al. Aortic vascular inflammation in psoriasis is associated with HDL particle size and concentration: a pilot study. Am J Cardiovasc Dis. 2012;2(4):285–92.PubMedPubMedCentral
31.
go back to reference Hayashida T, Sueyoshi E, Sakamoto I, Uetani M, Chiba K. PET features of aortic diseases. Am J Roentgenol. 2010;195(1):229–33.CrossRef Hayashida T, Sueyoshi E, Sakamoto I, Uetani M, Chiba K. PET features of aortic diseases. Am J Roentgenol. 2010;195(1):229–33.CrossRef
32.
go back to reference Joly L, Djaballah W, Koehl G, Mandry D, Dolivet G, Marie PY, et al. Aortic inflammation, as assessed by hybrid FDG-PET/CT imaging, is associated with enhanced aortic stiffness in addition to concurrent calcification. Eur J Nucl Med Mol Imaging. 2009;36(6):979–85.CrossRef Joly L, Djaballah W, Koehl G, Mandry D, Dolivet G, Marie PY, et al. Aortic inflammation, as assessed by hybrid FDG-PET/CT imaging, is associated with enhanced aortic stiffness in addition to concurrent calcification. Eur J Nucl Med Mol Imaging. 2009;36(6):979–85.CrossRef
33.
go back to reference Huet P, Burg S, Le Guludec D, Hyafil F, Buvat I. Variability and uncertainty of 18F-FDG PET imaging protocols for assessing inflammation in atherosclerosis: suggestions for improvement. J Nucl Med. 2015;56(4):552–9.CrossRef Huet P, Burg S, Le Guludec D, Hyafil F, Buvat I. Variability and uncertainty of 18F-FDG PET imaging protocols for assessing inflammation in atherosclerosis: suggestions for improvement. J Nucl Med. 2015;56(4):552–9.CrossRef
Metadata
Title
Association of aortic vascular uptake of 18FDG by PET/CT and aortic wall thickness by MRI in psoriasis: a prospective observational study
Authors
Jacob W. Groenendyk
Parag Shukla
Amit K. Dey
Youssef A. Elnabawi
Milena Aksentijevich
Harry Choi
Leonard D. Genovese
Charlotte L. Harrington
Balaji Natarajan
Aditya Goyal
Aarthi S. Reddy
Justin Rodante
Mohammad Tarek Kabbany
Ahmed Sadek
Mina Al Najafi
Martin P. Playford
Aditya A. Joshi
Mark A. Ahlman
Joel M. Gelfand
David A. Bluemke
Nehal N. Mehta
Publication date
01-11-2019
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 12/2019
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-019-04454-w

Other articles of this Issue 12/2019

European Journal of Nuclear Medicine and Molecular Imaging 12/2019 Go to the issue