Observations With Simultaneous 18F-FDG PET and MR Imaging in Peripheral Artery Disease

Dregely, Isabel; Koppara, Tobias; Nekolla, Stephan G.; Nährig, Jörg; Kuhs, Kristin; Langwieser, Nicolas; Dzijan-Horn, Marijana; Ganter, Carl; Laugwitz, Karl Ludwig; Schwaiger, Markus; Ibrahim, Tareq

doi:10.1016/j.jcmg.2016.06.005

Cited by 7 publications

(7 citation statements)

References 4 publications

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“…Simultaneous acquisition of PET, when added to established imaging modalities, may thereby offer valuable complementary information to improve the assessment of atherosclerotic plaque composition in carotid, coronary, and peripheral artery disease (5,29,30). However, as previously reported, we observed no correlation of 18-FDG PET tracer uptake with cellular inflammation in SFA plaques (31), but we noted a trend toward increased uptake in fibroatheromas as compared to fibro-calcific plaques as identified by OCT. Other PET tracers might offer better characterization of LEAD plaques, but they were not available for human application at the time of initiation of our study. Gallium-68 DOTA-0-Tyr3-Octreotate (68Ga-DOTATATE) PET has shown potential in identifying vulnerable atherosclerotic plaques with high somatostatin receptor expression, while 11-carbon (11C)-choline and 18Ffluoromethylcholine (FMCH) tracers may improve the characterization of high-risk atherosclerotic plaques by detecting increased choline metabolism (32).…”

Section: Discussionsupporting

confidence: 59%

Simultaneous 18-FDG PET and MR imaging in lower extremity arterial disease

Koppara,

Dregely,

Nekolla

et al. 2024

Front. Cardiovasc. Med.

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BackgroundSimultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) is a novel hybrid imaging method integrating the advances of morphological tissue characterization of MRI with the pathophysiological insights of PET applications.AimThis study evaluated the use of simultaneous 18-FDG PET/MR imaging for characterizing atherosclerotic lesions in lower extremity arterial disease (LEAD).MethodsEight patients with symptomatic stenoses of the superficial femoral artery (SFA) under simultaneous acquisition of 18-FDG PET and contrast-enhanced MRI using an integrated whole-body PET/MRI scanner. Invasive plaque characterization of the SFA was performed by intravascular imaging using optical coherence tomography. Histological analysis of plaque specimens was performed after directional atherectomy.ResultsMRI showed contrast enhancement at the site of arterial stenosis, as assessed on T2-w and T1-w images, compared to a control area of the contralateral SFA (0.38 ± 0.15 cm vs. 0.23 ± 0.11 cm; 1.77 ± 0.19 vs. 1.57 ± 0.15; p-value <0.05). On PET imaging, uptake of 18F-FDG (target-to-background ratio TBR > 1) at the level of symptomatic stenosis was observed in all but one patient. Contrast medium-induced MR signal enhancement was detected in all plaques, whereas FDG uptake in PET imaging was increased in lesions with active fibroatheroma and reduced in fibrocalcified lesions.ConclusionIn this multimodal imaging study, we report the feasibility and challenges of simultaneous PET/MR imaging of LEAD, which might offer new perspectives for risk estimation.

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Section: Discussionsupporting

confidence: 59%

Simultaneous 18-FDG PET and MR imaging in lower extremity arterial disease

Koppara,

Dregely,

Nekolla

et al. 2024

Front. Cardiovasc. Med.

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“…Collectively, nuclear imaging techniques advance the non-invasive evaluation of PAD beyond traditional means by offering quantitative regional analysis of vascular and muscle physiology, whereas traditional non-invasive vascular diagnostic tools have primarily focused on hemodynamic (e.g., ABI, TBI, ultrasound) or structural (e.g., angiography) assessments of the lower extremities. It's important to note that while SPECT/CT and PET/CT imaging have demonstrated potential in PAD, the recent emergence of PET/MR imaging may also provide additional opportunities for partnering high-sensitivity molecular (PET) and high-resolution structural (MR) imaging in the setting of lower extremity PAD ( 38 , 48 ).…”

Section: Discussionmentioning

confidence: 99%

“…One recent study by Jiang et al ( 37 ) applied serial 18 F-FDG PET/CT imaging in PAD patients before and after sonodynamic therapy to the femoropopliteal artery, which demonstrated that PET/CT imaging could detect and quantify therapeutic reductions in arterial inflammation in the setting of PAD. Another recent study focused on evaluating the utility of a combined 18 F-FDG PET and MR imaging approach for simultaneous assessment of both plaque morphology and arterial inflammation in a small sample size of PAD patients, but did not find any significant correlations between 18 F-FDG arterial uptake and histological measures of arterial inflammation ( 38 ). Thus, ongoing work focused on targeted imaging of arterial inflammation in the setting of PAD is warranted to fully elucidate the potential role of PET imaging as a non-invasive biomarker of PAD-induced inflammation.…”

Section: Molecular Imaging Of Peripheral Artery Inflammation and Atherosclerosismentioning

confidence: 99%

Molecular Imaging of Lower Extremity Peripheral Arterial Disease: An Emerging Field in Nuclear Medicine

Stacy

2022

Front. Med.

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Peripheral arterial disease (PAD) is an atherosclerotic disorder of non-coronary arteries that is associated with vascular stenosis and/or occlusion. PAD affecting the lower extremities is characterized by a variety of health-related consequences, including lifestyle-limiting intermittent claudication, ulceration of the limbs and/or feet, increased risk for lower extremity amputation, and increased mortality. The diagnosis of lower extremity PAD is typically established by using non-invasive tests such as the ankle-brachial index, toe-brachial index, duplex ultrasound, and/or angiography imaging studies. While these common diagnostic tools provide hemodynamic and anatomical vascular assessments, the potential for non-invasive physiological assessment of the lower extremities has more recently emerged through the use of magnetic resonance- and nuclear medicine-based approaches, which can provide insight into the functional consequences of PAD-related limb ischemia. This perspectives article specifically highlights and discusses the emerging applications of clinical nuclear medicine techniques for molecular imaging investigations in the setting of lower extremity PAD.

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“…In terms of molecular markers, there is a need to identify and validate novel markers that are specific and sensitive to PAD pathophysiology. Unlike carotid and coronary plaques, previous studies found that femoral artery plaque 18 F-FDG uptake did not correlate with plaque macrophage content and activity, suggesting a unique pathophysiology of PAD and a need for specific markers [ 116 , 146 ]. However, translating molecular markers from preclinical studies to clinical settings presents its challenges.…”

Section: Challenges and Future Directionsmentioning

confidence: 99%

Multi-Modality Imaging of Atheromatous Plaques in Peripheral Arterial Disease: Integrating Molecular and Imaging Markers

Wang

Nai

Gan

et al. 2023

IJMS

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Peripheral artery disease (PAD) is a common and debilitating condition characterized by the narrowing of the limb arteries, primarily due to atherosclerosis. Non-invasive multi-modality imaging approaches using computed tomography (CT), magnetic resonance imaging (MRI), and nuclear imaging have emerged as valuable tools for assessing PAD atheromatous plaques and vessel walls. This review provides an overview of these different imaging techniques, their advantages, limitations, and recent advancements. In addition, this review highlights the importance of molecular markers, including those related to inflammation, endothelial dysfunction, and oxidative stress, in PAD pathophysiology. The potential of integrating molecular and imaging markers for an improved understanding of PAD is also discussed. Despite the promise of this integrative approach, there remain several challenges, including technical limitations in imaging modalities and the need for novel molecular marker discovery and validation. Addressing these challenges and embracing future directions in the field will be essential for maximizing the potential of molecular and imaging markers for improving PAD patient outcomes.

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Observations With Simultaneous 18F-FDG PET and MR Imaging in Peripheral Artery Disease

Cited by 7 publications

References 4 publications

Simultaneous 18-FDG PET and MR imaging in lower extremity arterial disease

Simultaneous 18-FDG PET and MR imaging in lower extremity arterial disease

Molecular Imaging of Lower Extremity Peripheral Arterial Disease: An Emerging Field in Nuclear Medicine

Multi-Modality Imaging of Atheromatous Plaques in Peripheral Arterial Disease: Integrating Molecular and Imaging Markers

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