Imaging atherosclerotic plaque inflammation with [18F]-fluorodeoxyglucose positron emission tomography.
BACKGROUND
Atherosclerotic plaque rupture is usually a consequence of inflammatory cell activity within the plaque. Current imaging techniques provide anatomic data but no indication of plaque inflammation. The glucose analogue [18F]-fluorodeoxyglucose (18FDG) can be used to image inflammatory cell activity non-invasively by PET. In this study we tested whether 18FDG-PET imaging can identify inflammation within carotid artery atherosclerotic plaques.


RESULTS
Eight patients with symptomatic carotid atherosclerosis were imaged using 18FDG-PET and co-registered CT. Symptomatic carotid plaques were visible in 18FDG-PET images acquired 3 hours post-18FDG injection. The estimated net 18FDG accumulation rate (plaque/integral plasma) in symptomatic lesions was 27% higher than in contralateral asymptomatic lesions. There was no measurable 18FDG uptake into normal carotid arteries. Autoradiography of excised plaques confirmed accumulation of deoxyglucose in macrophage-rich areas of the plaque.


CONCLUSIONS
This study demonstrates that atherosclerotic plaque inflammation can be imaged with 18FDG-PET, and that symptomatic, unstable plaques accumulate more 18FDG than asymptomatic lesions.
Rudd
J H F
JH
Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
Warburton
E A
EA
Fryer
T D
TD
Jones
H A
HA
Clark
J C
JC
Antoun
N
N
Johnström
P
P
Davenport
A P
AP
Kirkpatrick
P J
PJ
Arch
B N
BN
Pickard
J D
JD
Weissberg
P L
PL
D000368:Aged; D001161:Arteriosclerosis / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D014055:Tomography, Emission-Computed / Q000379:methods*; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18