title: Complementarity between (18)F-FDG PET/CT and Ultrasonography or Angiography in Carotid Plaque Characterization.
abstract: OBJECTIVE
  To estimate clinical roles of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) versus angiography and ultrasonography in carotid plaque characterization.
  
  
  METHODS
  We characterized two groups of patients with recently (<1 month) symptomatic (n=14; age=71.8±8.6 years, mean±SD) or chronic (n=13, age=68.9±9.0 years) carotid stenosis using a battery of imaging tests: diffusion magnetic resonance (MR) imaging, MR or transfemoral angiography, duplex ultrasonography (DUS), and carotid FDG-PET/computed tomography.
  
  
  RESULTS
  The degree of angiographic stenosis was greater in patients with recently symptomatic carotid plaques (67.5±21.5%) than in patients with chronic carotid plaques (32.4±26.8%, p=0.001). Despite the significant difference in the degree of stenosis, lesional maximum standardized uptake values (maxSUVs) on the carotid FDG-PET did not differ between the recently symptomatic (1.56±0.53) and chronic (1.56±0.34, p=0.65) stenosis groups. However, lesional-to-contralesional maxSUV ratios were higher in the recently symptomatic stenosis group (113±17%) than in the chronic stenosis group (98±10%, p=0.017). The grayscale median value of the lesional DUS echodensities was lower in the recently symptomatic stenosis group (28.2±10.0, n=9) than in the chronic stenosis group (53.9±14.0, n=8; p=0.001). Overall, there were no significant correlations between angiographic stenosis, DUS echodensity, and FDG-PET maxSUV. Case/subgroup analyses suggested complementarity between imaging modalities.
  
  
  CONCLUSIONS
  There were both correspondences and discrepancies between the carotid FDG-PET images and DUS or angiography data. Further studies are required to determine whether FDG-PET could improve the clinical management of carotid stenosis.
authors.affiliation: Department of Neurology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
authors.forename: Sang-Mi
authors.initials: SM
authors.lastname: Noh
authors.forename: Won Jun
authors.initials: WJ
authors.lastname: Choi
authors.forename: Byeong-Teck
authors.initials: BT
authors.lastname: Kang
authors.forename: Sang-Wuk
authors.initials: SW
authors.lastname: Jeong
authors.forename: Dong Kun
authors.initials: DK
authors.lastname: Lee
authors.forename: Dawid
authors.initials: D
authors.lastname: Schellingerhout
authors.forename: Jeong-Seok
authors.initials: JS
authors.lastname: Yeo
authors.forename: Dong-Eog
authors.initials: DE
authors.lastname: Kim
keywords: FDG-PET/CT; angiography; atherosclerosis; carotid plaque; molecular imaging; ultrasonography
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