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Published in: Annals of Nuclear Medicine 10/2021

01-10-2021 | Acute Coronary Syndrome | Original Article

Coronary plaque instability assessed by positron emission tomography and optical coherence tomography

Authors: L. Galiuto, L. Leccisotti, G. Locorotondo, I. Porto, F. Burzotta, C. Trani, G. Niccoli, A. M. Leone, M. L. Danza, V. Melita, E. Fedele, A. Stefanelli, A. Giordano, F. Crea

Published in: Annals of Nuclear Medicine | Issue 10/2021

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Abstract

Background

Non-ST-elevation myocardial infarction (NSTEMI) and unstable angina (UA) are caused often by destabilization of non-flow limiting inflamed coronary artery plaques. 18F-fluorodeoxyglucose (FDG) uptake with positron emission tomography/computed tomography (PET/CT) reveals plaque inflammation, while intracoronary optical coherence tomography (OCT) reliably identifies morphological features of coronary instability, such as plaque rupture or erosion. We aimed to prospectively compare these two innovative biotechnologies in the characterization of coronary artery inflammation, which has never been attempted before.

Methods

OCT and FDG PET/CT were performed in 18 patients with single vessel coronary artery disease, treated by percutaneous coronary intervention (PCI) with stent implantation, divided into 2 groups: NSTEMI/UA (n = 10) and stable angina (n = 8) patients.

Results

Plaque rupture/erosion recurred more frequently [100% vs 25%, p = 0.001] and FDG uptake was greater [TBR median 1.50 vs 0.87, p = 0.004] in NSTEMI/UA than stable angina patients. FDG uptake resulted greater in patients with than without plaque rupture/erosion [1.2 (0.86–1.96) vs 0.87 (0.66–1.07), p = 0.013]. Among NSTEMI/UA patients, no significant difference in FDG uptake was found between ruptured and eroded plaques. The highest FDG uptake values were found in ruptured plaques, belonging to patients with NSTEMI/UA. OCT and PET/CT agreed in 72% of patients [p = 0.018]: 100% of patients with plaque rupture/erosion and increased FDG uptake had NSTEMI/UA.

Conclusion

For the first time, we demonstrated that the correspondence between increased FDG uptake with PET/CT and morphology of coronary plaque instability at OCT is high.
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Metadata
Title
Coronary plaque instability assessed by positron emission tomography and optical coherence tomography
Authors
L. Galiuto
L. Leccisotti
G. Locorotondo
I. Porto
F. Burzotta
C. Trani
G. Niccoli
A. M. Leone
M. L. Danza
V. Melita
E. Fedele
A. Stefanelli
A. Giordano
F. Crea
Publication date
01-10-2021
Publisher
Springer Singapore
Published in
Annals of Nuclear Medicine / Issue 10/2021
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-021-01651-2

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