title: Combined 18F-FDG PET-CT and DCE-MRI to assess inflammation and microvascularization in atherosclerotic plaques.
abstract: OBJECTIVE
  Hallmarks of vulnerable atherosclerotic plaques are inflammation that can be assessed with 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography, and increased neovascularization that can be evaluated by dynamic contrast-enhanced-MRI. It remains unclear whether these parameters are correlated or represent independent imaging parameters. This study determines whether there is a correlation between inflammation and neovascularization in atherosclerotic carotid plaques.
  
  
  METHODS
  A total of 58 patients with transient ischemic attack or minor stroke in the carotid territory and ipsilateral carotid artery stenosis of 30% to 69% were included. All patients underwent positron emission tomography/computed tomography and dynamic contrast-enhanced-MRI of the carotid plaque. 18Fluorine-fluorodeoxyglucose standard uptake values with target/background ratio were determined. Neovascularization was quantified by the mean (leakage) volume transfer constant Ktrans. Spearman rank correlation coefficients between target/background ratio and Ktrans were calculated.
  
  
  RESULTS
  Images suitable for further analysis were obtained in 49 patients. A weak but significant positive correlation between target/background ratio and mean Ktrans (Spearman ρ=0.30 [P=0.035]) and 75th percentile Ktrans (Spearman ρ=0.29 [P=0.041]) was found.
  
  
  CONCLUSIONS
  There is a weak but significant positive correlation between inflammation on positron emission tomography/computed tomography and neovascularization as assessed with dynamic contrast-enhanced-MRI. Future studies should investigate which imaging modality has the highest predictive value for recurrent stroke, as these are not interchangeable.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov. Unique identifier: NCT00451529.
authors.affiliation: From the Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands (M.T.B.T., R.H.M.v.H., E.H., R.J.v.O., J.B., J.E.W., M.E.K.); Departments of Radiology (M.T.B.T., R.M.K., R.H.M.v.H., E.H., W.H.B., J.E.W., M.E.K.), Clinical Neurophysiology (M.T.B.T., W.H.M.), Neurology (R.J.v.O.), Nuclear Medicine (J.B.), Maastricht University Medical Center, Maastricht, The Netherlands; and Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands (M.J.D.).
authors.forename: Martine T B
authors.initials: MT
authors.lastname: Truijman
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kwee
authors.forename: Raf H M
authors.initials: RH
authors.lastname: van Hoof
authors.forename: Evelien
authors.initials: E
authors.lastname: Hermeling
authors.forename: Robert J
authors.initials: RJ
authors.lastname: van Oostenbrugge
authors.forename: Werner H
authors.initials: WH
authors.lastname: Mess
authors.forename: Walter H
authors.initials: WH
authors.lastname: Backes
authors.forename: Mat J
authors.initials: MJ
authors.lastname: Daemen
authors.forename: Jan
authors.initials: J
authors.lastname: Bucerius
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.forename: Marianne Eline
authors.initials: ME
authors.lastname: Kooi
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D058226:Plaque, Atherosclerotic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D020521:Stroke / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: atherosclerosis; imaging; inflammation; magnetic resonance imaging; neovascularization; plaque, atherosclerotic; positron-emission tomography; vascular diseases