title: 18F-sodium fluoride uptake is a marker of active calcification and disease progression in patients with aortic stenosis.
abstract: BACKGROUND
  18F-Sodium fluoride (18F-NaF) and 18F-fluorodeoxyglucose (18F-FDG) are promising novel biomarkers of disease activity in aortic stenosis. We compared 18F-NaF and 18F-FDG uptake with histological characterization of the aortic valve and assessed whether they predicted disease progression.
  
  
  RESULTS
  Thirty patients with aortic stenosis underwent combined positron emission and computed tomography using 18F-NaF and 18F-FDG radiotracers. In 12 patients undergoing aortic valve replacement surgery (10 for each tracer), radiotracer uptake (mean tissue/
  
  
  BACKGROUND
  =0.65; P=0.04) and osteocalcin (r=0.68; P=0.03) immunohistochemistry. There was no significant correlation between 18F-FDG uptake and CD68 staining (r=-0.43; P=0.22). After 1 year, aortic valve calcification increased from 314 (193-540) to 365 (207-934) AU (P<0.01). Baseline 18F-NaF uptake correlated closely with the change in calcium score (r=0.66; P<0.01), and this improved further (r=0.75; P<0.01) when 18F-NaF uptake overlying computed tomography-defined macrocalcification was excluded. No significant correlation was noted between valvular 18F-FDG uptake and change in calcium score (r=-0.11; P=0.66).
  
  
  CONCLUSIONS
  18F-NaF uptake identifies active tissue calcification and predicts disease progression in patients with calcific aortic stenosis.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT01358513.
authors: Centre for Cardiovascular Science.
authors: Marc R
authors: MR
authors: Dweck
authors: William S A
authors: WS
authors: Jenkins
authors: Alex T
authors: AT
authors: Vesey
authors: Mark A H
authors: MA
authors: Pringle
authors: Calvin W L
authors: CW
authors: Chin
authors: Tamir S
authors: TS
authors: Malley
authors: William J A
authors: WJ
authors: Cowie
authors: Vasiliki
authors: V
authors: Tsampasian
authors: Hamish
authors: H
authors: Richardson
authors: Alison
authors: A
authors: Fletcher
authors: William A
authors: WA
authors: Wallace
authors: Renzo
authors: R
authors: Pessotto
authors: Edwin J R
authors: EJ
authors: van Beek
authors: Nicholas A
authors: NA
authors: Boon
authors: James H F
authors: JH
authors: Rudd
authors: David E
authors: DE
authors: Newby
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D005462:Fluorine Radioisotopes / Q000493:pharmacokinetics; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012969:Sodium Fluoride / Q000493:pharmacokinetics
chemical_list: D015415:Biomarkers; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D012969:Sodium Fluoride
keywords: aortic valve stenosis; calcification, physiologic; fluorodeoxyglucose F18; inflammation; positron-emission tomography