title: In vivo imaging of mineral deposition in carotid plaque using 18F-sodium fluoride PET/CT: correlation with atherogenic risk factors.
abstract: The purpose of this study was to correlate (18)F-sodium fluoride accumulation in the common carotid arteries of neurologically asymptomatic patients with cardiovascular risk factors and carotid calcified plaque burden.
  
  
  METHODS
  Two hundred sixty-nine oncologic patients were examined by (18)F-sodium fluoride PET/CT. Tracer accumulation in the common carotid arteries was analyzed both qualitatively and semiquantitatively by measuring the blood-pool-corrected standardized uptake value (target-to-background ratio) and comparing it with cardiovascular risk factors and calcified plaque burden.
  
  
  RESULTS
  (18)F-sodium fluoride uptake was observed at 141 sites in 94 (34.9%) patients. Radiotracer accumulation was colocalized with calcification in all atherosclerotic lesions. (18)F-sodium fluoride uptake was significantly associated with age (P < 0.0001), male sex (P < 0.0001), hypertension (P < 0.002), and hypercholesterolemia (P < 0.05). The presence of calcified plaque correlated significantly with these risk factors but also with diabetes (P < 0.0001), history of smoking (P = 0.03), and prior cardiovascular events (P < 0.01). There was a highly significant correlation between the presence of (18)F-sodium fluoride uptake and number of present cardiovascular risk factors (r = 0.30, P < 0.0001).
  
  
  CONCLUSIONS
  Carotid (18)F-sodium fluoride uptake is a surrogate measure of calcifying carotid plaque, correlates with cardiovascular risk factors, and is more frequent in patients with a high-risk profile for atherothrombotic events but demonstrates a weaker correlation with risk factors than does calcified plaque burden. This study provides a rationale to conduct further prospective studies to determine whether (18)F-sodium fluoride uptake can predict vascular events, or if it may be used to monitor pharmacologic therapy.
authors.affiliation: Department of Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. t.derlin@uke.uni-hamburg.de
authors.forename: Thorsten
authors.initials: T
authors.lastname: Derlin
authors.forename: Christian
authors.initials: C
authors.lastname: Wisotzki
authors.forename: Ulrich
authors.initials: U
authors.lastname: Richter
authors.forename: Ivayla
authors.initials: I
authors.lastname: Apostolova
authors.forename: Peter
authors.initials: P
authors.lastname: Bannas
authors.forename: Christoph
authors.initials: C
authors.lastname: Weber
authors.forename: Janos
authors.initials: J
authors.lastname: Mester
authors.forename: Susanne
authors.initials: S
authors.lastname: Klutmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000175:diagnosis* / Q000453:epidemiology*; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000175:diagnosis* / Q000453:epidemiology*; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data; D015995:Prevalence; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D012307:Risk Factors; D012969:Sodium Fluoride; D013223:Statistics as Topic; D013382:Subtraction Technique / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D012969:Sodium Fluoride