18F-FDG PET/CT for the quantification of inflammation in large carotid artery plaques

Kjersti Johnsrud, Karolina Skagen, Therese Seierstad, Mona Skjelland, David Russell, Mona Elisabeth Revheim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: There is currently no consensus on the methodology for quantification of 18F-FDG uptake in inflammation in atherosclerosis. In this study, we explore different methods for quantification of 18F-FDG uptake in carotid atherosclerotic plaques and correlate the uptake values to histological assessments of inflammation. Methods and Results: Forty-four patients with atherosclerotic stenosis ≥70% of the internal carotid artery underwent 18F-FDG PET/CT. Maximum standardized uptake values (SUVmax) from all plaque-containing slices were collected. SUVmax for the single highest and the mean of multiple slices with and without blood background correction (by subtraction (cSUV) or by division (target-to-background ratio (TBR)) were calculated. Following endarterectomy 30 plaques were assessed histologically. The length of the plaques at CT was 6-32 mm. The 18F-FDG uptake in the plaques was 1.15-2.66 for uncorrected SUVs, 1.16-3.19 for TBRs, and 0.20-1.79 for cSUVs. There were significant correlations between the different uptake values (r = 0.57-0.99, P < 0.001). Methods with and without blood background correction showed similar, moderate correlations to the amount of inflammation assessed at histology (r = 0.44-0.59, P < 0.02). Conclusions: In large stenotic carotid plaques, 18F-FDG uptake reflects the inflammatory status as assessed at histology. Increasing number of PET slices or background correction did not change the correlation.

Original languageEnglish (US)
Pages (from-to)883-893
Number of pages11
JournalJournal of Nuclear Cardiology
Volume26
Issue number3
DOIs
StatePublished - Jun 15 2019

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Carotid Stenosis
Fluorodeoxyglucose F18
Inflammation
Histology
Endarterectomy
Atherosclerotic Plaques
Atherosclerosis

Keywords

  • F-FDG PET/CT
  • atherosclerosis
  • carotid plaque
  • inflammation
  • quantification method

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

18F-FDG PET/CT for the quantification of inflammation in large carotid artery plaques. / Johnsrud, Kjersti; Skagen, Karolina; Seierstad, Therese; Skjelland, Mona; Russell, David; Revheim, Mona Elisabeth.

In: Journal of Nuclear Cardiology, Vol. 26, No. 3, 15.06.2019, p. 883-893.

Research output: Contribution to journalArticle

Johnsrud, Kjersti ; Skagen, Karolina ; Seierstad, Therese ; Skjelland, Mona ; Russell, David ; Revheim, Mona Elisabeth. / 18F-FDG PET/CT for the quantification of inflammation in large carotid artery plaques. In: Journal of Nuclear Cardiology. 2019 ; Vol. 26, No. 3. pp. 883-893.
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N2 - Background: There is currently no consensus on the methodology for quantification of 18F-FDG uptake in inflammation in atherosclerosis. In this study, we explore different methods for quantification of 18F-FDG uptake in carotid atherosclerotic plaques and correlate the uptake values to histological assessments of inflammation. Methods and Results: Forty-four patients with atherosclerotic stenosis ≥70% of the internal carotid artery underwent 18F-FDG PET/CT. Maximum standardized uptake values (SUVmax) from all plaque-containing slices were collected. SUVmax for the single highest and the mean of multiple slices with and without blood background correction (by subtraction (cSUV) or by division (target-to-background ratio (TBR)) were calculated. Following endarterectomy 30 plaques were assessed histologically. The length of the plaques at CT was 6-32 mm. The 18F-FDG uptake in the plaques was 1.15-2.66 for uncorrected SUVs, 1.16-3.19 for TBRs, and 0.20-1.79 for cSUVs. There were significant correlations between the different uptake values (r = 0.57-0.99, P < 0.001). Methods with and without blood background correction showed similar, moderate correlations to the amount of inflammation assessed at histology (r = 0.44-0.59, P < 0.02). Conclusions: In large stenotic carotid plaques, 18F-FDG uptake reflects the inflammatory status as assessed at histology. Increasing number of PET slices or background correction did not change the correlation.

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