title: Carotid inflammation on ¹⁸F-fluorodeoxyglucose positron emission tomography associates with recurrent ischemic lesions.
abstract: BACKGROUND
  Inflammation plays an important role in the development of ischemic stroke. We hypothesized that inflammation of carotid atherosclerosis, as measured by (18)F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET), associates with the early recurrent ischemic lesions (ERILs).
  
  
  METHODS
  This prospective study included patients with symptomatic carotid atherosclerosis. ERILs were defined as newly developed ischemic lesions in the territory of symptomatic internal carotid artery stenosis, as detected by follow-up diffusion-weighted imaging (DWI). The patients with and without ERILs were compared in terms of risk factors, inflammatory markers, and FDG uptake on PET.
  
  
  RESULTS
  Of the 21 patients, 8 had ERILs (38.1%). Compared to the patients without ERILs, those with ERILs had higher FDG uptake (maximum standardized uptake value, 3.07 ± 0.79 vs. 2.17 ± 0.68, p=0.013) and were more likely to have irregular carotid plaques (100% vs. 38.5%, p=0.007). Inflammatory markers were not different between the two groups, and also did not correlate with FDG uptake.
  
  
  CONCLUSIONS
  Increased carotid plaque inflammation, as measured by FDG uptake on PET, may be a useful marker for identifying patients with symptomatic carotid atherosclerosis who are at risk of recurrence.
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea.
authors.forename: Hye-Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea.
authors.forename: Minyoung
authors.initials: M
authors.lastname: Oh
authors.affiliation: Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea.
authors.forename: Dae Hyuk
authors.initials: DH
authors.lastname: Moon
authors.affiliation: Department of Neurology, Hallym University College of Medicine, Anyang, Republic of Korea.
authors.forename: Kyung-Ho
authors.initials: KH
authors.lastname: Yu
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea.
authors.forename: Sun U
authors.initials: SU
authors.lastname: Kwon
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea.
authors.forename: Jong S
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea. Electronic address: dwkang@amc.seoul.kr.
authors.forename: Dong-Wha
authors.initials: DW
authors.lastname: Kang
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases; D016893:Carotid Stenosis / Q000150:complications*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging*; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012008:Recurrence; D012307:Risk Factors
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Acute stroke; Carotid atherosclerosis; Inflammation; Inflammatory marker; Positron emission tomography; Recurrence