title: Divergent determinants of 18F-NaF uptake and visible calcium deposition in large arteries: relationship with Framingham risk score.
abstract: To compare regional vascular distribution and biological determinants of visible calcium load, as assessed by computed tomography, as well as of molecular calcium deposition as assessed by (18)F-NaF positron emission tomography. Eighty oncologic patients undergoing (18)F-NaF PET/CT scan were included in the study. Cardiovascular-risk stratification was performed according to a simplified version of the Framingham model [including age, diabetes, smoking, systolic blood pressure and body mass index (BMI)]. Arterial (18)F-NaF uptake was measured by drawing regions of interest comprising the arteries on each slice of the transaxial PET/CT and normalized to blood (18)F-NaF activity to obtain the arterial target-to-background ratio (TBR). The degree of arterial calcification (AC) was measured using a software program providing Agatston-like scores. Differences in mean values and regression analysis were tested. Predictors of AC and TBR were evaluated by univariate and multivariate analysis. p value of 0.05 was considered statistically significant. No correlation was documented between regional calcium load and regional TBR in any of the studied arterial segments. Visible calcium deposition was found to be dependent upon age while it was not influenced by all the remaining determinants of cardiovascular risk. By contrast, (18)F-NaF uptake was significantly correlated with all descriptors of cardiovascular risk, with the exception of BMI. Vascular (18)F-NaF uptake displays a different regional distribution, as well as different biological predictors, when compared to macroscopic AC. The tight dependency of tracer retention upon ongoing biological determinants of vascular damage suggests that this tool might provide an unexplored window on plaque pathophysiology.
authors: Nuclear Medicine Unit, Department of Health Sciences, IRCCS AOU San Martino, IST, University of Genoa, Largo R. Benzi, 10, 16132, Genoa, Italy, silviadaniela.morbelli@hsanmartino.it.
authors: Silvia
authors: S
authors: Morbelli
authors: Francesco
authors: F
authors: Fiz
authors: Arnoldo
authors: A
authors: Piccardo
authors: Lorena
authors: L
authors: Picori
authors: Michela
authors: M
authors: Massollo
authors: Emanuela
authors: E
authors: Pestarino
authors: Cecilia
authors: C
authors: Marini
authors: Manlio
authors: M
authors: Cabria
authors: Alessia
authors: A
authors: Democrito
authors: Giuseppe
authors: G
authors: Cittadini
authors: Giampiero
authors: G
authors: Villavecchia
authors: Paolo
authors: P
authors: Bruzzi
authors: Abass
authors: A
authors: Alavi
authors: Gianmario
authors: G
authors: Sambuceti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000032:analysis*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000378:metabolism; D003331:Coronary Vessels / Q000737:chemistry / Q000000981:diagnostic imaging*; D005260:Female; D005462:Fluorine Radioisotopes; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D015999:Multivariate Analysis; D058226:Plaque, Atherosclerotic; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012969:Sodium Fluoride; D012984:Software; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000378:metabolism
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D012969:Sodium Fluoride; D002118:Calcium