title: Arterial foci of F-18 fluorodeoxyglucose are associated with an enhanced risk of subsequent ischemic stroke in cancer patients: a case-control pilot study.
abstract: OBJECTIVE
  Imaging of F-18 fluorodeoxyglucose (FDG) by positron emission tomography/computed tomography (PET/CT) hybrid systems allows detecting arterial FDG foci, which relate to inflammatory and presumably unstable atherosclerosis, and is increasingly used in cancer patients among whom many are at risk for ischemic events. However, the link between an enhanced arterial FDG uptake and subsequent ischemic events remains to be clearly established. This pilot study aimed at determining whether the prior arterial FDG uptake in cancer patients presenting a subsequent stroke was higher than that of stroke-free controls.
  
  
  METHODS
  Patients referred to FDG PET/CT for conventional oncologic indications were retrospectively included and compared between: (i) 7 case-patients with subsequent hospitalizations for documented ischemic stroke and (ii) 16 event-free controls, matched to the case-patients according to age, gender, and cancer site.
  
  
  RESULTS
  Stroke was related with previous arterial FDG foci when detected on the aortic arch (stroke patients, 86% vs. Controls, 31%; P = 0.03) and especially on carotid bifurcations (stroke patients, 71% vs. Controls, 6%; P = 0.006); and among the 5 case-patients with stroke from carotid territory, 4 (80%) had FDG foci on ipsilateral carotid bifurcations.
  
  
  CONCLUSIONS
  This pilot study shows that the previous detection of FDG foci on aortic arch and especially on carotid bifurcations of cancer patients is associated with the risk of subsequent ischemic stroke. A further confirmation on larger populations is needed.
authors.affiliation: Department of Nuclear Medicine, CHU-Nancy, F-54000, Nancy, France. solene.grandpierre@hotmail.fr
authors.forename: Solène
authors.initials: S
authors.lastname: Grandpierre
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Desandes
authors.forename: Benoit
authors.initials: B
authors.lastname: Meneroux
authors.forename: Wassila
authors.initials: W
authors.lastname: Djaballah
authors.forename: Damien
authors.initials: D
authors.lastname: Mandry
authors.forename: Fanny
authors.initials: F
authors.lastname: Netter
authors.forename: Denis
authors.initials: D
authors.lastname: Wahl
authors.forename: Renaud
authors.initials: R
authors.lastname: Fay
authors.forename: Gilles
authors.initials: G
authors.lastname: Karcher
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Marie
mesh_terms: D000368:Aged; D001158:Arteries / Q000378:metabolism; D001692:Biological Transport; D002545:Brain Ischemia / Q000150:complications*; D016022:Case-Control Studies; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D012306:Risk; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism*; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18