DOI QR코드

DOI QR Code

F-18 Fluoride Positron Emission Tomography-Computed Tomography for Detecting Atherosclerotic Plaques

  • Kang, Won Jun (Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine)
  • Received : 2015.04.04
  • Accepted : 2015.08.05
  • Published : 2015.11.01

Abstract

A large number of major cardiovascular events occur in patients due to minimal or some lumen narrowing of the coronary artery. Recent biological studies have shown that the biological composition or vulnerability of the plaque is more critical for plaque rupture compared to the degree of stenosis. To overcome the limitations of anatomical images, molecular imaging techniques have been suggested as promising imaging tools in various fields. F-18 fluorodeoxyglucose (FDG), which is widely used in the field of oncology, is an example of molecular probes used in atherosclerotic plaque evaluation. FDG is a marker of plaque macrophage glucose utilization and inflammation, which is a prominent characteristic of vulnerable plaque. Recently, F-18 fluoride has been used to visualize vulnerable plaque in clinical studies. F-18 fluoride accumulates in regions of active microcalcification, which is normally observed during the early stages of plaque formation. More studies are warranted on the accumulation of F-18 fluoride and plaque formation/vulnerability; however, due to high specific accumulation, low background activity, and easy accessibility, F-18 fluoride is emerging as a promising non-invasive imaging probe to detect vulnerable plaque.

Keywords

References

  1. Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part I. Circulation 2003;108:1664-1672 https://doi.org/10.1161/01.CIR.0000087480.94275.97
  2. Rogers IS, Nasir K, Figueroa AL, Cury RC, Hoffmann U, Vermylen DA, et al. Feasibility of FDG imaging of the coronary arteries: comparison between acute coronary syndrome and stable angina. JACC Cardiovasc Imaging 2010;3:388-397 https://doi.org/10.1016/j.jcmg.2010.01.004
  3. Calvert PA, Obaid DR, O’Sullivan M, Shapiro LM, McNab D, Densem CG, et al. Association between IVUS findings and adverse outcomes in patients with coronary artery disease: the VIVA (VH-IVUS in Vulnerable Atherosclerosis) Study. JACC Cardiovasc Imaging 2011;4:894-901 https://doi.org/10.1016/j.jcmg.2011.05.005
  4. Virmani R, Burke AP, Farb A, Kolodgie FD. Pathology of the vulnerable plaque. J Am Coll Cardiol 2006;47(8 Suppl):C13-C18 https://doi.org/10.1016/j.jacc.2005.10.065
  5. Falk E, Nakano M, Bentzon JF, Finn AV, Virmani R. Update on acute coronary syndromes: the pathologists' view. Eur Heart J 2013;34:719-728 https://doi.org/10.1093/eurheartj/ehs411
  6. Finn AV, Nakano M, Narula J, Kolodgie FD, Virmani R. Concept of vulnerable/unstable plaque. Arterioscler Thromb Vasc Biol 2010;30:1282-1292 https://doi.org/10.1161/ATVBAHA.108.179739
  7. Huang H, Virmani R, Younis H, Burke AP, Kamm RD, Lee RT. The impact of calcification on the biomechanical stability of atherosclerotic plaques. Circulation 2001;103:1051-1056 https://doi.org/10.1161/01.CIR.103.8.1051
  8. Vengrenyuk Y, Cardoso L, Weinbaum S. Micro-CT based analysis of a new paradigm for vulnerable plaque rupture: cellular microcalcifications in fibrous caps. Mol Cell Biomech 2008;5:37-47
  9. Joshi NV, Vesey A, Newby DE, Dweck MR. Will 18F-sodium fluoride PET-CT imaging be the magic bullet for identifying vulnerable coronary atherosclerotic plaques? Curr Cardiol Rep 2014;16:521 https://doi.org/10.1007/s11886-014-0521-4
  10. Otsuka F, Finn AV, Virmani R. Do vulnerable and ruptured plaques hide in heavily calcified arteries? Atherosclerosis 2013;229:34-37 https://doi.org/10.1016/j.atherosclerosis.2012.12.032
  11. O’Brien KD, Kuusisto J, Reichenbach DD, Ferguson M, Giachelli C, Alpers CE, et al. Osteopontin is expressed in human aortic valvular lesions. Circulation 1995;92:2163-2168 https://doi.org/10.1161/01.CIR.92.8.2163
  12. New SE, Aikawa E. Molecular imaging insights into early inflammatory stages of arterial and aortic valve calcification. Circ Res 2011;108:1381-1391 https://doi.org/10.1161/CIRCRESAHA.110.234146
  13. Aikawa E, Nahrendorf M, Figueiredo JL, Swirski FK, Shtatland T, Kohler RH, et al. Osteogenesis associates with inflammation in early-stage atherosclerosis evaluated by molecular imaging in vivo. Circulation 2007;116:2841-2850 https://doi.org/10.1161/CIRCULATIONAHA.107.732867
  14. Boström K. Proinflammatory vascular calcification. Circ Res 2005;96:1219-1220 https://doi.org/10.1161/01.RES.0000172407.20974.e5
  15. Dilsizian V, Narula J. Putting the face to a name: concurrent assessment of vascular morphology and biology. JACC Cardiovasc Imaging 2009;2:1243-1244 https://doi.org/10.1016/j.jcmg.2009.08.005
  16. Chen W, Dilsizian V. (18)F-fluorodeoxyglucose PET imaging of coronary atherosclerosis and plaque inflammation. Curr Cardiol Rep 2010;12:179-184 https://doi.org/10.1007/s11886-010-0095-8
  17. Blau M, Nagler W, Bender MA. Fluorine-18: a new isotope for bone scanning. J Nucl Med 1962;3:332-334
  18. Grant FD, Fahey FH, Packard AB, Davis RT, Alavi A, Treves ST. Skeletal PET with 18F-fluoride: applying new technology to an old tracer. J Nucl Med 2008;49:68-78
  19. Hawkins RA, Choi Y, Huang SC, Hoh CK, Dahlbom M, Schiepers C, et al. Evaluation of the skeletal kinetics of fluorine-18-fluoride ion with PET. J Nucl Med 1992;33:633-642
  20. Derlin T, Richter U, Bannas P, Begemann P, Buchert R, Mester J, et al. Feasibility of 18F-sodium fluoride PET/CT for imaging of atherosclerotic plaque. J Nucl Med 2010;51:862-865 https://doi.org/10.2967/jnumed.110.076471
  21. Derlin T, Tóth Z, Papp L, Wisotzki C, Apostolova I, Habermann CR, et al. Correlation of inflammation assessed by 18F-FDG PET, active mineral deposition assessed by 18F-fluoride PET, and vascular calcification in atherosclerotic plaque: a dualtracer PET/CT study. J Nucl Med 2011;52:1020-1027 https://doi.org/10.2967/jnumed.111.087452
  22. Derlin T, Wisotzki C, Richter U, Apostolova I, Bannas P, Weber C, et al. In vivo imaging of mineral deposition in carotid plaque using 18F-sodium fluoride PET/CT: correlation with atherogenic risk factors. J Nucl Med 2011;52:362-368 https://doi.org/10.2967/jnumed.110.081208
  23. Dweck MR, Chow MW, Joshi NV, Williams MC, Jones C, Fletcher AM, et al. Coronary arterial 18F-sodium fluoride uptake: a novel marker of plaque biology. J Am Coll Cardiol 2012;59:1539-1548 https://doi.org/10.1016/j.jacc.2011.12.037
  24. Joshi NV, Vesey AT, Williams MC, Shah AS, Calvert PA, Craighead FH, et al. 18F-fluoride positron emission tomography for identification of ruptured and high-risk coronary atherosclerotic plaques: a prospective clinical trial. Lancet 2014;383:705-713 https://doi.org/10.1016/S0140-6736(13)61754-7

Cited by

  1. Characterization and Predictive Value of Near Infrared 2-Deoxyglucose Optical Imaging in Severe Acute Pancreatitis vol.11, pp.2, 2016, https://doi.org/10.1371/journal.pone.0149073