Coronary 18 F-sodium fluoride PET detects high-risk plaque features on optical coherence tomography and CT-angiography in patients with acute coronary syndrome.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: Ireland NLM ID: 0242543 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1484 (Electronic) Linking ISSN: 00219150 NLM ISO Abbreviation: Atherosclerosis Subsets: MEDLINE
    • Publication Information:
      Publication: Limerick : Elsevier
      Original Publication: Amsterdam, Elsevier.
    • Subject Terms:
      Acute Coronary Syndrome*/diagnostic imaging ; Coronary Artery Disease*/diagnostic imaging ; Plaque, Atherosclerotic*; Aged ; Angiography ; Female ; Fluorine Radioisotopes ; Humans ; Male ; Middle Aged ; Positron Emission Tomography Computed Tomography ; Positron-Emission Tomography ; Radiopharmaceuticals ; Sodium Fluoride ; Tomography, Optical Coherence
    • Abstract:
      Background and Aims: 18 F-Sodium Fluoride Positron Emission Tomography ( 18 F-NaF PET) non-invasively detects micro-calcification activity, the earliest stage of atherosclerotic arterial calcification. We studied the association between coronary 18 F-NaF uptake and high-risk plaque features on intra-coronary optical coherence tomography (OCT) and CT-angiography (CTCA) and the potential application to patient-level risk stratification.
      Methods: Sixty-two prospectively recruited patients with acute coronary syndrome (ACS) underwent multi-vessel OCT, 18 F-NaF PET and CTCA. The maximum tissue to background ratio (TBRmax = standardised uptake value (SUV)max/SUVbloodpool) was measured in each coronary segment on 18 F-NaF PET scans. High-risk plaque features on OCT and CTCA were compared in matched coronary segments. The number of patients testing positive (>2SD above the normal range) for micro-calcification activity was determined.
      Results: In 62 patients (age, mean ± standard deviation (SD) = 61 ± 9 years, 85% male) the coronary segments with elevated 18 F-NaF uptake had higher lipid arc (LA) (median [25th-75th centile]: 74° [35°-117°] versus 48° [15°-83°], p=0.021), higher prevalence of macrophages [n(%): 37 (62%) versus 89 (39%), p=0.008] and lower plaque free wall (PFW) (50° [7°-110°] versus 94° [34°-180°], p=0.027) on OCT, and a higher total plaque burden (p=0.011) and higher dense calcified plaque burden (p= 0.001) on CTCA, when compared with 18 F-NaF negative segments. Patients grouped by increasing number of coronary lesions positive for microcalcification activity (0,1, ≥2) showed decreasing plaque free wall, increasing calcification and increasing macrophages on OCT (respectively p=0.008, p < 0.001 and p=0.028).
      Conclusions: 18 F-NaF uptake is associated with high-risk plaque features on OCT and CTCA in a per-segment and per-patient analysis in subjects hospitalized for ACS.
      (Crown Copyright © 2020. Published by Elsevier B.V. All rights reserved.)
    • Comments:
      Comment in: Atherosclerosis. 2021 Feb;319:118-120. (PMID: 33478799)
    • Grant Information:
      CH/09/002/26360 United Kingdom BHF_ British Heart Foundation; RG/16/10/32375 United Kingdom BHF_ British Heart Foundation
    • Contributed Indexing:
      Keywords: (18)F-Sodium fluoride positron emission tomography; Acute coronary syndrome; Microcalcification; Optical coherence tomography
    • Accession Number:
      0 (Fluorine Radioisotopes)
      0 (Radiopharmaceuticals)
      8ZYQ1474W7 (Sodium Fluoride)
    • Publication Date:
      Date Created: 20201228 Date Completed: 20210623 Latest Revision: 20220323
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/j.atherosclerosis.2020.12.010
    • Accession Number:
      33358367