Количественная оценка активности атеросклеротического налета и воспаления сосудистой помощи [18 F] фтордезоксиглюкозы позитронно-эмиссионной томографии / компьютерной томографии (FDG-PET/CT)
Summary
Существует большая необходимость выявления атеросклероза неинвазивным, и здесь мы демонстрируем FDG-PET/CT может быть использована для выявления и количественной атеросклеротической бляшки деятельности и сосудистого воспаления.
Abstract
Conventional non-invasive imaging modalities of atherosclerosis such as coronary artery calcium (CAC)1 and carotid intimal medial thickness (C-IMT)2 provide information about the burden of disease. However, despite multiple validation studies of CAC3-5, and C-IMT2,6, these modalities do not accurately assess plaque characteristics7,8, and the composition and inflammatory state of the plaque determine its stability and, therefore, the risk of clinical events9-13.
[18F]-2-fluoro-2-deoxy-D-glucose (FDG) imaging using positron-emission tomography (PET)/computed tomography (CT) has been extensively studied in oncologic metabolism14,15. Studies using animal models and immunohistochemistry in humans show that FDG-PET/CT is exquisitely sensitive for detecting macrophage activity16, an important source of cellular inflammation in vessel walls. More recently, we17,18 and others have shown that FDG-PET/CT enables highly precise, novel measurements of inflammatory activity of activity of atherosclerotic plaques in large and medium-sized arteries9,16,19,20. FDG-PET/CT studies have many advantages over other imaging modalities: 1) high contrast resolution; 2) quantification of plaque volume and metabolic activity allowing for multi-modal atherosclerotic plaque quantification; 3) dynamic, real-time, in vivo imaging; 4) minimal operator dependence. Finally, vascular inflammation detected by FDG-PET/CT has been shown to predict cardiovascular (CV) events independent of traditional risk factors21,22 and is also highly associated with overall burden of atherosclerosis23. Plaque activity by FDG-PET/CT is modulated by known beneficial CV interventions such as short term (12 week) statin therapy24 as well as longer term therapeutic lifestyle changes (16 months)25.
The current methodology for quantification of FDG uptake in atherosclerotic plaque involves measurement of the standardized uptake value (SUV) of an artery of interest and of the venous blood pool in order to calculate a target to background ratio (TBR), which is calculated by dividing the arterial SUV by the venous blood pool SUV. This method has shown to represent a stable, reproducible phenotype over time, has a high sensitivity for detection of vascular inflammation, and also has high inter-and intra-reader reliability26. Here we present our methodology for patient preparation, image acquisition, and quantification of atherosclerotic plaque activity and vascular inflammation using SUV, TBR, and a global parameter called the metabolic volumetric product (MVP). These approaches may be applied to assess vascular inflammation in various study samples of interest in a consistent fashion as we have shown in several prior publications.9,20,27,28
Protocol
Discussion
Методология, представленная здесь, просто выполнить, и может дать полезную информацию о деятельности атеросклеротической бляшки и сосудистого воспаления в клинически значимой артериальной кровати. Есть несколько важных особенностей этого анализа подход, который гарантирует вниман?…
Disclosures
The authors have nothing to disclose.
Acknowledgements
NNM поддерживается за счет гранта Национального фонда псориаза, NHLBI 5K23HL97151-3 и HL111293. JMG поддерживается NHLBI R01 и R01 HL089744 HL111293.
Materials
| Name of the Equipment | Company |
| Gemini TF PET/CT Scanner | Philips Healthcare |
| Extended Brilliance Workstation | Philips Healthcare |
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