Association between carotid 18 F-NaF and 18 F-FDG uptake on PET/CT with ischemic vascular brain disease on MRI in patien
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ORIGINAL ARTICLE
Association between carotid 18F‑NaF and 18F‑FDG uptake on PET/CT with ischemic vascular brain disease on MRI in patients with carotid artery disease Kengo Fujimoto1 · Takashi Norikane1 · Yuka Yamamoto1 · Yasukage Takami1 · Katsuya Mitamura1 · Masaki Okada2 · Tetsuhiro Hatakeyama2 · Masahiko Kawanishi2 · Yoshihiro Nishiyama1 Received: 8 August 2019 / Accepted: 24 September 2019 © The Japanese Society of Nuclear Medicine 2019
Abstract Objective Atherosclerosis is a dynamic and complex process characterized by the formation and progression of plaque mediated by various pathophysiologic steps including inflammation and calcification. The present study aimed to evaluate the association between carotid 18F-sodium fluoride (NaF) and 18F-fluorodeoxyglucose (FDG) uptake with the severity of ischemic vascular brain disease on MRI in patients with carotid artery disease. Methods A total of 28 patients who were scheduled to undergo clinically indicated carotid endarterectomy or stenting for carotid artery disease were examined with 18F-NaF and 18F-FDG PET/CT and brain MRI. The PET/CT images were evaluated by qualitative and semiquantitative analyses. The maximum standardized uptake value (SUV) for the plaque and the average of mean SUV within the lumen of both internal jugular veins was calculated, and the target-to-blood pool ratio (TBR) was determined. The ischemic vascular brain disease on MRI was graded separately in the bilateral hemisphere as 0, 1, 2, and 3, with 0 being absent and 3 being the most severe. Results In two patients, only a unilateral carotid artery was analyzed because of previous indwelling stent. 18F-NaF focal uptake was observed in 50 carotid arteries. 18F-FDG focal uptake was observed in 47 carotid arteries. The mean (± SD) 18FNaF TBR (2.93 ± 0.89) was significantly higher than the mean (± SD) 18F-FDG TBR (2.41 ± 0.84) (p
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