Arterial wall uptake of fluorodeoxyglucose on PET imaging in stable cancer disease patients indicates higher risk for cardiovascular events

Paulmier, Benoît; Duet, M.; Khayat, R.; Pierquet-Ghazzar, Nadia; Laissy, J.P.; Maunoury, C.; Hugonnet, Florent; Sauvaget, E.; Trinquart, Ludovic; Faraggi, Marc

doi:10.1016/j.nuclcard.2007.10.009

Cited by 152 publications

(92 citation statements)

References 36 publications

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“…In this study, we observed a modest inverse relationship between BAT activity and arterial inflammation. Given that PET/CT measures of arterial inflammation have repeatedly been shown to predict CVD events (13,15,24), we hypothesized that BAT activation would also be associated with CVD events. Indeed, we observed that in individuals who experienced CVD events, arterial 18 F-FDG uptake was higher whereas BAT uptake was significantly lower.…”

Section: Discussionmentioning

confidence: 99%

Supraclavicular Brown Adipose Tissue ¹⁸F-FDG Uptake and Cardiovascular Disease

et al. 2016

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Preclinical data suggest a negative correlation between brown adipose tissue (BAT) and the degree of coronary atherosclerosis. We sought to evaluate the relationship between 18 F-FDG uptake in supraclavicular BAT in relation to arterial inflammation and subsequent cardiovascular disease (CVD) events in humans. Methods: Individuals who underwent 18 F-FDG PET/CT for clinical indications but who did not have either cancer or known atherosclerotic disease at the time of imaging were included. A radiologist masked to clinical data measured 18 F-FDG uptake within BAT (in the supraclavicular region) as well as in subcutaneous adipose tissues. Tissue density was evaluated using CT (Hounsfield units). Arterial inflammation was assessed by measuring arterial 18 F-FDG uptake and calculating target-to-background ratio. CVD events were independently adjudicated by masked cardiologists. Thereafter, the relationship between BAT activity and CVD events was evaluated. Results: A total of 443 patients (age, 55 y [44-66 y]; 44% men; body mass index [BMI], 26 [range, 23-31]) were included, and 30 patients experienced a cardiovascular event during a median follow-up of 4 y. BAT activity negatively correlated with arterial inflammation (r 5 −0.178, P , 0.01), a relationship that persisted after correcting for age and BMI (r 5 −0.147, P , 0.01). When either high sensitivity or high accuracy thresholds (from receiver-operating curve analyses) were used to define elevated BAT, high BAT was associated with a reduced risk of CVD events (P 5 0.048), even after correcting for age (P 5 0.037). Conclusion: Our results suggest that increased supraclavicular BAT activity is inversely associated with arterial inflammation, independently of age and BMI. Additionally, increased BAT may be associated with fewer cardiovascular events.

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Section: Discussionmentioning

confidence: 99%

Supraclavicular Brown Adipose Tissue ¹⁸F-FDG Uptake and Cardiovascular Disease

et al. 2016

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“…Several previous studies reported significant correlations between focally increased 18 F-FDG uptake in the walls of large arteries and the presence of conventional cardiovascular risk factors (22)(23)(24)(25)(26), as if risk factors predispose to inflammatory changes resulting in formation of plaques at risk for rupture. In all these studies, increased vascular wall 18 F-FDG uptake was most strongly correlated with patient age.…”

Section: Correlation Of Baseline Parametersmentioning

confidence: 97%

“…To our knowledge, only a single study to date has systematically investigated the covariance of increased 18 F-FDG uptake and calcifications of the arterial wall with the occurrence of vascular events (24). In that study, on a series of 101 stable cancer patients, most of the registered vascular events occurred before the PET/CT scan.…”

Section: Outcome Events and Survival Analysismentioning

confidence: 99%

“…The study demonstrated that those patients with a recent history of vascular events, occurring within the 6 mo preceding the 18 F-FDG PET/CT scans, showed significantly higher arterial wall 18 F-FDG uptake scores than did patients without previous vascular events. In contrast, those patients whose vascular event had occurred more than 6 mo before PET/CT did not show significantly increased 18 F-FDG uptake (24). In that study, vascular events were broadly defined to include cases of ischemic stroke, symptomatic chronic peripheral artery disease, acute peripheral ischemia, chronic coronary artery disease, acute coronary syndrome, any revascularization procedure, and aortic or peripheral aneurysm.…”

Section: Outcome Events and Survival Analysismentioning

confidence: 99%

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¹⁸F-FDG PET/CT Identifies Patients at Risk for Future Vascular Events in an Otherwise Asymptomatic Cohort with Neoplastic Disease

Rominger¹,

Saam²,

Wolpers³

et al. 2009

J Nucl Med

319

259

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Our objective was to evaluate the association of arterial 18 F-FDG uptake and calcifications in large arteries as detected by 18 F-FDG PET/CT with the subsequent occurrence of vascular events in otherwise asymptomatic cancer patients. Methods: Clinical follow-up information was obtained for 932 cancer patients examined with whole-body 18 F-FDG PET/CT (median follow-up time, 29 mo). Among this cohort, 279 patients had died from their oncologic disease. In 15 of 932 patients (1.6%), a vascular event, defined as ischemic stroke, myocardial infarction, or revascularization, was registered. The maximal standardized uptake value (SUV) was divided by the blood-pool SUV, yielding a target-to-background ratio (TBR) for each arterial segment. The mean TBR as well as a calcified plaque sum score per patient were calculated in the major vessels: ascending, descending, and abdominal aorta, aortic arch, as well as iliac and carotid arteries. Results: A significant correlation was observed between mean TBR and calcified plaque sum (P , 0.001). Although calcified plaque sum significantly correlated with all conventional risk factors for vascular events, mean TBR correlated only with age, the male sex, and hypertension. The Cox regression hazard model identified a mean TBR $ 1.7 and a calcified plaque sum $ 15 as independent predictors for the occurrence of a vascular event. Patients with both mean TBR and calcified plaque sum above these thresholds were identified as having the highest risk for a future vascular event. However, a mean TBR $ 1.7 had greater prognostic value than did a calcified plaque sum $ 15. Conclusion: In a large cohort of cancer patients, increased 18 F-FDG uptake in major arteries emerged as the strongest predictor of a subsequent vascular event. Concomitant severe vascular calcifications seemed to impart a particularly high risk. Given the small event rate in the present study, larger, prospective trials of patients without cancer are required to substantiate these promising results.

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“…31,32 In addition, higher arterial FDG uptake is associated with a substantially increased risk for subsequent stroke and MI. [33][34][35] Taken together, these studies provide justification for using arterial FDG-PET/CT imaging to provide a meaningful measure of arterial inflammation in human clinical studies.…”

Section: See Related Article Pp 372-380mentioning

confidence: 85%

Imaging atherosclerotic burden and inflammation: Insights into the spectrum of atherosclerotic disease in HIV

Tawakol

Grinspoon

2015

Journal of Nuclear Cardiology

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Arterial wall uptake of fluorodeoxyglucose on PET imaging in stable cancer disease patients indicates higher risk for cardiovascular events

Abstract: Extensive arterial 18FDG uptake might be an indicator of an evolving atherosclerotic process and should be mentioned in PET/computed tomography reports.

Cited by 152 publications

References 36 publications

Supraclavicular Brown Adipose Tissue ¹⁸F-FDG Uptake and Cardiovascular Disease

Supraclavicular Brown Adipose Tissue ¹⁸F-FDG Uptake and Cardiovascular Disease

¹⁸F-FDG PET/CT Identifies Patients at Risk for Future Vascular Events in an Otherwise Asymptomatic Cohort with Neoplastic Disease

Imaging atherosclerotic burden and inflammation: Insights into the spectrum of atherosclerotic disease in HIV

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Arterial wall uptake of fluorodeoxyglucose on PET imaging in stable cancer disease patients indicates higher risk for cardiovascular events

Abstract: Extensive arterial 18FDG uptake might be an indicator of an evolving atherosclerotic process and should be mentioned in PET/computed tomography reports.

Cited by 152 publications

References 36 publications

Supraclavicular Brown Adipose Tissue 18F-FDG Uptake and Cardiovascular Disease

Supraclavicular Brown Adipose Tissue 18F-FDG Uptake and Cardiovascular Disease

18F-FDG PET/CT Identifies Patients at Risk for Future Vascular Events in an Otherwise Asymptomatic Cohort with Neoplastic Disease

Imaging atherosclerotic burden and inflammation: Insights into the spectrum of atherosclerotic disease in HIV

Contact Info

Product

Resources

About

Supraclavicular Brown Adipose Tissue ¹⁸F-FDG Uptake and Cardiovascular Disease

Supraclavicular Brown Adipose Tissue ¹⁸F-FDG Uptake and Cardiovascular Disease

¹⁸F-FDG PET/CT Identifies Patients at Risk for Future Vascular Events in an Otherwise Asymptomatic Cohort with Neoplastic Disease