Correlation of fluorine 18-labeled sodium fluoride uptake and arterial calcification on whole-body PET/CT in cancer patients

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Abstract

Fluorine-18-labeled sodium fluoride (F-NaF) uptake measured with PET in the vessel walls can indicate active microcalcification, a potential biomarker of higher-risk plaques, which are not indicated by macrocalcification measured with computed tomography (CT). The aim of this study was to determine the extent to which F-NaF uptake is correlated with calcification at arterial plaques in cancer patients undergoing whole-body PET/CT imaging.Patients and methodsImage data from 179 patients who underwent F-NaF PET/CT were evaluated retrospectively. Plaques were categorized into four groups by calcium score (CS) on CT: CS 1 ( and ge;1000); CS 2 (400-999); CS 3 (100-399), and CS 4 ( and lt;100) and into three groups by F-NaF target-to-background ratio (TBR) on PET: TBR low ( and le;1.0), TBR medium (1.0-1.5), and TBR high ( and gt;1.5). Correlations between F-NaF uptake and CS were evaluated.ResultsPlaques with F-NaF uptake or arterial calcification were observed in 122 (76%) of the 179 patients. We found a weak but statistically significant positive correlation between CS and F-NaF uptake. The TBR in CS 1 plaques was higher than those in CS 3 and CS 4 plaques, and the TBR in CS 2 plaques was higher than that in CS 3 plaques (P and lt;0.05). Compared with patients whose plaques were with F-NaF uptake (TBR and gt;1.5) or arterial calcification (CS and gt;0), patients without plaques of F-NaF uptake or calcification were significantly younger (P=0.00) or with significantly more women (P=0.02).ConclusionOur finding of a weak but significant positive correlation between F-NaF uptake and arterial calcification suggests that F-NaF PET/CT could provide complementary information of active microcalcification for atherosclerosis evaluation in cancer patients.

Original languageEnglish (US)
Pages (from-to)604-610
Number of pages7
JournalNuclear medicine communications
Volume40
Issue number6
DOIs
StatePublished - Jun 1 2019

Keywords

  • PET/CT
  • atherosclerosis
  • calcification
  • fluorine-18-sodium fluoride

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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