title: Impact of Personal Characteristics and Technical Factors on Quantification of Sodium 18F-Fluoride Uptake in Human Arteries: Prospective Evaluation of Healthy Subjects.
abstract: Sodium 18F-fluoride (18F-NaF) PET/CT imaging is a promising imaging technique for the assessment of atherosclerosis but is hampered by a lack of validated quantification protocols. Both personal characteristics and technical factors can affect quantification of arterial 18F-NaF uptake. This study investigated whether blood activity, renal function, injected dose, circulating time, and PET/CT system affect quantification of arterial 18F-NaF uptake.
  
  
  METHODS
  Eighty-nine healthy subjects were prospectively examined by 18F-NaF PET/CT imaging. Arterial 18F-NaF uptake was quantified at the level of the ascending aorta, aortic arch, descending thoracic aorta, and coronary arteries by calculating the maximum 18F-NaF activity (NaFmax), the maximum/mean target-to-background ratio (TBRmax/mean), and the maximum blood-subtracted 18F-NaF activity (bsNaFmax). Multivariable linear regression assessed the effect of personal characteristics and technical factors on quantification of arterial 18F-NaF uptake.
  
  
  RESULTS
  NaFmax and TBRmax/mean were dependent on blood activity (β=0.34 to 0.44, P<0.001, and β=-0.68 to -0.58, P<0.001, respectively) and PET/CT system (β=-0.80 to -0.53, P<0.001, and β=-0.80 to -0.23, P<0.031, respectively). bsNaFmax depended on PET/CT system (β=-0.91 to -0.57, P<0.001) but not blood activity. This finding was observed at the level of the ascending aorta, aortic arch, descending thoracic aorta, and the coronary arteries. In addition to blood activity and PET/CT system, injected dose affected quantification of arterial 18F-NaF uptake, whereas renal function and circulating time did not.
  
  
  CONCLUSIONS
  The prospective evaluation of 89 healthy subjects demonstrated that quantification of arterial 18F-NaF uptake is affected by blood activity, injected dose, and PET/CT system. Therefore, blood activity, injected dose, and PET/CT system should be considered to generate accurate estimates of arterial 18F-NaF uptake.
authors.affiliation: Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands b.a.blomberg@umcutrecht.nl.
authors.forename: Björn Alexander
authors.initials: BA
authors.lastname: Blomberg
authors.affiliation: Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Thomassen
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Pim A
authors.initials: PA
authors.lastname: de Jong
authors.affiliation: Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Simonsen
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Marnix G E H
authors.initials: MG
authors.lastname: Lam
authors.affiliation: Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Nielsen
authors.affiliation: Department of Cardiology, Odense University Hospital, Odense, Denmark.
authors.forename: Hans
authors.initials: H
authors.lastname: Mickley
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Willem P T M
authors.initials: WP
authors.lastname: Mali
authors.affiliation: Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; and.
authors.forename: Abass
authors.initials: A
authors.lastname: Alavi
authors.affiliation: Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
authors.forename: Poul F
authors.initials: PF
authors.lastname: Høilund-Carlsen
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000378:metabolism; D001011:Aorta / Q000000981:diagnostic imaging / Q000378:metabolism; D001158:Arteries / Q000000981:diagnostic imaging / Q000378:metabolism*; D005260:Female; D005462:Fluorine Radioisotopes / Q000097:blood / Q000493:pharmacokinetics*; D064368:Healthy Volunteers; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012016:Reference Values; D015203:Reproducibility of Results; D012969:Sodium Fluoride / Q000097:blood / Q000493:pharmacokinetics*; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging / Q000378:metabolism; D055815:Young Adult
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D012969:Sodium Fluoride
keywords: PET/CT; atherosclerosis; quantification; sodium 18F-fluoride (18F-NaF); vascular calcification