Optimizing FDG-PET/CT imaging of inflammation in atherosclerosis

Saraste, Antti; Knuuti, Juhani

doi:10.1007/s12350-015-0112-9

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…For this, the results of larger, long-term prospective studies (BioImage [32] and Progression and Early detection of Subclinical Atherosclerosis [33] ) are awaited. Second, despite the published recommendations on PET imaging protocols 34 , 48 , substantial variation in patient preparation (e.g., glucose levels, time of fasting), PET image protocol (e.g., time and areas of scanning) and technology (e.g., acquisition, reconstruction), and measurement parameters exists and harmonization is warranted 28 , 29 , 30 , 31 . As such, extrapolation of our thresholds is limited to studies using similar imaging and analysis protocols.…”

Section: Discussionmentioning

confidence: 99%

“…Several of these studies enriched their study populations by excluding subjects with 18 F-FDG uptake below pre-defined thresholds. However, a consensus regarding the most appropriate thresholds is lacking 28 , 29 , 30 , 31 , primarily because healthy subjects, presumably without pathological arterial inflammation, have not been systematically imaged, and large-scale prospective outcome studies are awaited 32 , 33 . Without these data, it is challenging to enroll patients with sufficient arterial inflammation to need therapy and to avoid randomizing those unlikely to respond.…”

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Thresholds for Arterial Wall Inflammation Quantified by 18F-FDG PET Imaging

Valk

Verweij

Zwinderman

et al. 2016

JACC: Cardiovascular Imaging

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ObjectivesThis study assessed 5 frequently applied arterial 18fluorodeoxyglucose (18F-FDG) uptake metrics in healthy control subjects, those with risk factors and patients with cardiovascular disease (CVD), to derive uptake thresholds in each subject group. Additionally, we tested the reproducibility of these measures and produced recommended sample sizes for interventional drug studies.Background18F-FDG positron emission tomography (PET) can identify plaque inflammation as a surrogate endpoint for vascular interventional drug trials. However, an overview of 18F-FDG uptake metrics, threshold values, and reproducibility in healthy compared with diseased subjects is not available.Methods18F-FDG PET/CT of the carotid arteries and ascending aorta was performed in 83 subjects (61 ± 8 years) comprising 3 groups: 25 healthy controls, 23 patients at increased CVD risk, and 35 patients with known CVD. We quantified 18F-FDG uptake across the whole artery, the most-diseased segment, and within all active segments over several pre-defined cutoffs. We report these data with and without background corrections. Finally, we determined measurement reproducibility and recommended sample sizes for future drug studies based on these results.ResultsAll 18F-FDG uptake metrics were significantly different between healthy and diseased subjects for both the carotids and aorta. Thresholds of physiological 18F-FDG uptake were derived from healthy controls using the 90th percentile of their target to background ratio (TBR) value (TBRmax); whole artery TBRmax is 1.84 for the carotids and 2.68 in the aorta. These were exceeded by >52% of risk factor patients and >67% of CVD patients. Reproducibility was excellent in all study groups (intraclass correlation coefficient >0.95). Using carotid TBRmax as a primary endpoint resulted in sample size estimates approximately 20% lower than aorta.ConclusionsWe report thresholds for physiological 18F-FDG uptake in the arterial wall in healthy subjects, which are exceeded by the majority of CVD patients. This remains true, independent of readout vessel, signal quantification method, or the use of background correction. We also confirm the high reproducibility of 18F-FDG PET measures of inflammation. Nevertheless, because of overlap between subject categories and the relatively small population studied, these data have limited generalizability until substantiated in larger, prospective event-driven studies. (Vascular Inflammation in Patients at Risk for Atherosclerotic Disease; NTR5006)

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Thresholds for Arterial Wall Inflammation Quantified by 18F-FDG PET Imaging

Valk

Verweij

Zwinderman

et al. 2016

JACC: Cardiovascular Imaging

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Comparison of SUVA/V and SUVA-V for Evaluating Atherosclerotic Inflammation in 18F-FDG PET/CT

Ryu,

Han,

Han

et al. 2023

Nucl Med Mol Imaging

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Discovering Macrophage Functions Using In Vivo Optical Imaging Techniques

Liu

2018

Front. Immunol.

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Macrophages are an important component of host defense and inflammation and play a pivotal role in immune regulation, tissue remodeling, and metabolic regulation. Since macrophages are ubiquitous in human bodies and have versatile physiological functions, they are involved in virtually every disease, including cancer, diabetes, multiple sclerosis, and atherosclerosis. Molecular biological and histological methods have provided critical information on macrophage biology. However, many in vivo dynamic behaviors of macrophages are poorly understood and yet to be discovered. A better understanding of macrophage functions and dynamics in pathogenesis will open new opportunities for better diagnosis, prognostic assessment, and therapeutic intervention. In this article, we will review the advances in macrophage tracking and analysis with in vivo optical imaging in the context of different diseases. Moreover, this review will cover the challenges and solutions for optical imaging techniques during macrophage intravital imaging.

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Optimizing FDG-PET/CT imaging of inflammation in atherosclerosis

Cited by 3 publications

References 20 publications

Thresholds for Arterial Wall Inflammation Quantified by 18F-FDG PET Imaging

Thresholds for Arterial Wall Inflammation Quantified by 18F-FDG PET Imaging

Comparison of SUVA/V and SUVA-V for Evaluating Atherosclerotic Inflammation in 18F-FDG PET/CT

Discovering Macrophage Functions Using In Vivo Optical Imaging Techniques

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