Measurement of Arterial Activity on Routine FDG PET/CT Images Improves Prediction of Risk of Future CV Events

Abstract

Arterial FDG uptake, measured from routinely obtained PET/CT images, substantially improved incident CVD prediction beyond FRS among individuals undergoing cancer surveillance and provided information on the potential timing of such events.

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

“…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.…”

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

“…Data from the prospective Dublin Carotid Atherosclerosis Stroke Study showed that increased carotid artery 18 F-FDG uptake can identify patients with increased risk of early stroke recurrence, independent of age and stenosis severity (Figure 4a,b) [122]. Moreover, a retrospective study of imaging from 513 cancer-free patients examined over a 4-year period found that aortic 18 F-FDG uptake strongly predicted risk of cardiovascular events independent of traditional risk factors (hazard ratio: 4.71, P < 0.001), with nearly 30% net reclassification improvement over Framingham risk score in the highest risk group [123].…”

Imaging Cardiovascular Calcification

“…Furthermore, 18 F‐FDG PET/CT can provide additional diagnostic and prognostic information beyond anatomic imaging alone 120. It is becoming increasingly evident that 18 F‐FDG PET/CT is capable of quantifying atherosclerotic inflammation and predicting subsequent cardiovascular events121 and providing a means of evaluating changes with treatment 122. Nevertheless, 18 F‐FDG lacks cell specificity, and in contrast to 18 F‐NaF, is extremely limited for the assessment of coronary arteries because of myocardial spillover in spite of significant efforts at background myocardial suppression 22…”