18F-Sodium Fluoride Positron Emission Tomography/Computed Tomography in Ex Vivo Human Coronary Arteries with Histological Correlation

Trisha Youn, Subhi J. Al'Aref, Navneet Narula, Steven Salvatore, David Pisapia, Marc R. Dweck, Jagat Narula, Fay Y. Lin, Yao Lu, Amit Kumar, Renu Virmani, James K. Min

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Objective: 18F-sodium fluoride (NaF) position emission tomography (PET) activity correlates with high-risk plaque. We examined the correlation between 18F-NaF PET activity and extent of calcification (microcalcification and macrocalcification) in coronary arteries. Approach and Results: Eighteen ex vivo human coronary arteries were imaged with 18F-NaF PET/CT, and target to background ratios were analyzed from 101 plaques. Histopathologic analysis evaluated for microcalcification and macrocalcification, plaque morphology, and inflammation. Plaques with microcalcification demonstrated higher 18F-NaF PET activity (n=84; mean target to background ratio±SD, 9.0±9.7,) than plaques without microcalcification (n=17, 2.9±3.8; P<0.0001). Higher 18F-NaF PET activity was associated with advanced plaques characterized by fibroatheroma (n=54, 10.7±10.3) compared with plaques with intimal thickening (n=22, 3.5±3.9) or pathological intimal thickening (n=25, 6.1±8.4; P=0.004). No significant association was found between 18F-NaF PET activity and inflammation (P=0.08). Conclusions: In ex vivo human coronary arteries, higher 18F-NaF PET activity was associated with microcalcification and advanced plaque morphology. Since microcalcification and fibroatheromas are high-risk plaque features, 18F-NaF PET/CT may improve risk-stratification.

Original languageEnglish
Pages (from-to)404-411
Number of pages8
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume40
Issue number2
DOIs
StatePublished - 1 Feb 2020
Externally publishedYes

Keywords

  • atherosclerotic plaque
  • calcification
  • computed tomography angiography
  • inflammation
  • risk factor

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