title: Association Between Osteogenesis and Inflammation During the Progression of Calcified Plaque Evaluated by18F-Fluoride and18F-FDG.
abstract: 18F-FDG is the most widely validated PET tracer for the evaluation of atherosclerotic inflammation. Recently,18F-NaF has also been considered a potential novel biomarker of osteogenesis in atherosclerosis. We aimed to analyze the association between inflammation and osteogenesis at different stages of atherosclerosis, as well as the interrelationship between these 2 processes during disease progression.Methods:Thirty-four myeloma patients underwent18F-NaF and18F-FDG PET/CT examinations. Lesions were divided into 3 groups (noncalcified, mildly calcified, and severely calcified lesions) on the basis of calcium density as measured in Hounsfield units by CT. Tissue-to-background ratios were determined from PET for both tracers. The association between inflammation and osteogenesis during atherosclerosis progression was evaluated in 19 patients who had at least 2 examinations with both tracers.Results:There were significant correlations between the maximum tissue-to-background ratios of the 2 tracers (Spearmanr= 0.5 [P< 0.01]; Pearsonr= 0.4 [P< 0.01]) in the 221 lesions at baseline. The highest uptake of both tracers was observed in noncalcified lesions, but without any correlation between the tracers (Pearsonr= 0.06;P= 0.76). Compared with noncalcified plaques, mildly calcified plaques showed concordant significantly lower accumulation, with good correlation between the tracers (Pearsonr= 0.7;P< 0.01). In addition, enhanced osteogenesis-derived18F-NaF uptake and regressive inflammation-derived18F-FDG uptake were observed in severely calcified lesions (Pearsonr= 0.4;P< 0.01). During follow-up, increased calcium density and increased mean18F-NaF uptake were observed, whereas mean18F-FDG uptake decreased. Most noncalcified (86%) and mildly calcified (81%) lesions and 47% of severely calcified lesions had concordant development of both vascular inflammation and osteogenesis.Conclusion:The combination of18F-NaF PET imaging and18F-FDG PET imaging promotes an understanding of the mechanism of plaque progression, thereby providing new insights into plaque stabilization.
authors.affiliation: Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.affiliation: Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Heber
authors.affiliation: Center for Medical Physics and Biomedical Engineering, General Hospital Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Jacobo
authors.initials: J
authors.lastname: Cal-Gonzalez
authors.affiliation: Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Georgios
authors.initials: G
authors.lastname: Karanikas
authors.affiliation: Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Marius E
authors.initials: ME
authors.lastname: Mayerhoefer
authors.affiliation: Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Sazan
authors.initials: S
authors.lastname: Rasul
authors.affiliation: Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Beitzke
authors.affiliation: Department of Nuclear Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; and.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: Hermine
authors.initials: H
authors.lastname: Agis
authors.affiliation: Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Mitterhauser
authors.affiliation: Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wadsak
authors.affiliation: Center for Medical Physics and Biomedical Engineering, General Hospital Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Beyer
authors.affiliation: Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Loewe
authors.affiliation: Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria Marcus.hacker@meduniwien.ac.at.
authors.forename: Marcus
authors.initials: M
authors.lastname: Hacker
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000000981:diagnostic imaging*; D018450:Disease Progression; D019788:Fluorodeoxyglucose F18; D006801:Humans; D010012:Osteogenesis; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012969:Sodium Fluoride; D061205:Vascular Calcification / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D012969:Sodium Fluoride
keywords: 18F-FDG; 18F-NaF; PET/CT; atherosclerosis; calcification; inflammation