18Fluorodeoxyglucose uptake in relation to fat fraction and R2* in atherosclerotic plaques, using PET/MRI: a pilot study

Abstract

Inflammation inside Atherosclerotic plaques represents a major pathophysiological process driving plaques towards rupture. Pre-clinical studies suggest a relationship between lipid rich necrotic core, intraplaque hemorrhage and inflammation, not previously explored in patients. Therefore, we designed a pilot study to investigate the feasibility of assessing the relationship between these plaque features in a quantitative manner using PET/MRI. In 12 patients with high-grade carotid stenosis the extent of lipid rich necrotic core and intraplaque hemorrhage was quantified from fat and R2* maps acquired with a previously validated 4-point Dixon MRI sequence in a stand-alone MRI. PET/MRI was used to measure 18F-FDG uptake. T1-weighted images from both scanners were used for registration of the quantitative Dixon data with the PET images. The plaques were heterogenous with respect to their volumes and composition. The mean values for the group were as follows: fat fraction (FF) 0.17% (± 0.07), R2* 47.6 s−1 (± 10.9) and target-to-blood pool ratio (TBR) 1.49 (± 0.48). At group level the correlation between TBR and FFmean was − 0.406, p 0.19 and for TBR and R2*mean 0.259, p 0.42. The lack of correlation persisted when analysed on a patient-by-patient basis but the study was not powered to draw definitive conclusions. We show the feasibility of analysing the quantitative relationship between lipid rich necrotic cores, intraplaque haemorrhage and plaque inflammation. The 18F-FDG uptake for most patients was low. This may reflect the biological complexity of the plaques and technical aspects inherent to 18F-FDG measurements.Trial registration: ISRCTN, ISRCTN30673005. Registered 05 January 2021, retrospectively registered.

Interrogating Atherosclerotic Plaque Biology Through Responses to Cardiovascular Risk Management and Imaging

“…In our studies (162)(163)(164) quantitative Dixon MRI sequences are used both for the quantification of lipid rich necrotic core (measured as fat fraction, FF) and intraplaque hemorrhage (measured as R2*). A 4-point gradient Dixon sequence is applied, implying that the four major resonance peaks for fat are being targeted.…”

New Insights into LINC00346 and its Role in Disease

“…Inflammation is considered a key factor in the pathophysiology of atherosclerosis (Sivapalaratnam et al, 2011;Paramel et al, 2020;Good et al, 2021). The upregulation of LINC00346 promoted inflammatory factor expression and functional injury in human umbilical vein endothelial cells (HUVECs) stimulated by OX-LDL (Wang F. et al, 2021).…”