TY - JOUR
T1 - Multimodality imaging of atherosclerotic plaque activity and composition using FDG-PET/CT and MRI in carotid and femoral arteries
AU - Silvera, Stephane S.
AU - Aidi, Hamza el
AU - Rudd, James H.F.
AU - Mani, Venkatesh
AU - Yang, Lingde
AU - Farkouh, Michael
AU - Fuster, Valentin
AU - Fayad, Zahi A.
N1 - Funding Information:
This study is supported by the National Institutes of Health (grants R01 HL71021R01, R01 HL78667).
PY - 2009/11
Y1 - 2009/11
N2 - Purpose: To evaluate the relationship between atherosclerotic plaque inflammation, as assessed by FDG-Positron Emission Tomography/Computed Tomography (FDG-PET/CT), and plaque morphology and composition, as assessed by magnetic resonance imaging (MRI), in the carotid and femoral arteries. Materials and methods: Sixteen patients underwent FDG-PET/CT and MRI (T2-weighted (T2W) and proton density weighted (PDW)) of the carotid and femoral arteries. For every image slice, two observers determined the corresponding regions of the FDG-PET/CT and MRI image sets by matching CT and T2W axial images. Each plaque was then classified into one of three groups according to the CT appearance and T2W/PDW signal: (1) collagen, (2) lipid-necrotic core and (3) calcium. Arterial FDG uptake was measured for each plaque and normalized to vein FDG activity to produce a blood-normalized artery activity called the target to background ratio (TBR). The vessel wall thickness (VWT), the vessel wall area and the total vessel wall area were measured from the T2W MR images. Results: The TBR value was higher in the lipid-necrotic core group compared to the collagen and calcium groups, (p < 0.001). The lipid-necrotic core group demonstrated a significant TBR variation according to the median of the VWT (TBR = 1.26 ± 0.25 vs. 1.50 ± 0.12). There was no correlation with other morphological MR parameters. Conclusions: This study demonstrates the complementary value of non-invasive FDG-PET/CT and MR imaging for the evaluation of atherosclerotic plaque composition and activity. Lipid-rich plaques are more inflamed than either calcified or collagen-rich plaques.
AB - Purpose: To evaluate the relationship between atherosclerotic plaque inflammation, as assessed by FDG-Positron Emission Tomography/Computed Tomography (FDG-PET/CT), and plaque morphology and composition, as assessed by magnetic resonance imaging (MRI), in the carotid and femoral arteries. Materials and methods: Sixteen patients underwent FDG-PET/CT and MRI (T2-weighted (T2W) and proton density weighted (PDW)) of the carotid and femoral arteries. For every image slice, two observers determined the corresponding regions of the FDG-PET/CT and MRI image sets by matching CT and T2W axial images. Each plaque was then classified into one of three groups according to the CT appearance and T2W/PDW signal: (1) collagen, (2) lipid-necrotic core and (3) calcium. Arterial FDG uptake was measured for each plaque and normalized to vein FDG activity to produce a blood-normalized artery activity called the target to background ratio (TBR). The vessel wall thickness (VWT), the vessel wall area and the total vessel wall area were measured from the T2W MR images. Results: The TBR value was higher in the lipid-necrotic core group compared to the collagen and calcium groups, (p < 0.001). The lipid-necrotic core group demonstrated a significant TBR variation according to the median of the VWT (TBR = 1.26 ± 0.25 vs. 1.50 ± 0.12). There was no correlation with other morphological MR parameters. Conclusions: This study demonstrates the complementary value of non-invasive FDG-PET/CT and MR imaging for the evaluation of atherosclerotic plaque composition and activity. Lipid-rich plaques are more inflamed than either calcified or collagen-rich plaques.
KW - Atherosclerosis
KW - Carotid artery diseases/radionuclide imaging
KW - Femoral artery diseases/radionuclide imaging
KW - Fluorodeoxyglucose F18/diagnostic use
KW - Humans
KW - Inflammation/diagnosis/radionuclide imaging
KW - Magnetic resonance imaging
KW - Positron Emission Tomography/Computed Tomography imaging
UR - http://www.scopus.com/inward/record.url?scp=70349651913&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2009.04.023
DO - 10.1016/j.atherosclerosis.2009.04.023
M3 - Article
C2 - 19467659
AN - SCOPUS:70349651913
SN - 0021-9150
VL - 207
SP - 139
EP - 143
JO - Atherosclerosis
JF - Atherosclerosis
IS - 1
ER -