Relationship between coronary arterial 18F-sodium fluoride uptake and epicardial adipose tissue analyzed using computed tomography

Purpose 18 F-Sodium fluoride ( 18 F-NaF) positron emission tomography (PET) has the potential to detect high-risk coronary plaques. Epicardial adipose tissue (EAT) reportedly correlates with coronary atherosclerosis progression. We evaluated the relationship between coronary arterial 18 F-NaF uptake...

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Veröffentlicht in:European journal of nuclear medicine and molecular imaging 2020-07, Vol.47 (7), p.1746-1756
Hauptverfasser: Kitagawa, Toshiro, Nakamoto, Yumiko, Fujii, Yuto, Sasaki, Ko, Tatsugami, Fuminari, Awai, Kazuo, Hirokawa, Yutaka, Kihara, Yasuki
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Sprache:eng
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Zusammenfassung:Purpose 18 F-Sodium fluoride ( 18 F-NaF) positron emission tomography (PET) has the potential to detect high-risk coronary plaques. Epicardial adipose tissue (EAT) reportedly correlates with coronary atherosclerosis progression. We evaluated the relationship between coronary arterial 18 F-NaF uptake and EAT findings using computed tomography (CT). Methods We studied 40 patients with ≥ 1 coronary plaque detected on cardiac CT who underwent 18 F-NaF PET/CT. EAT volume was measured using CT and indexed to body surface area in each patient. Each plaque was evaluated for CT-based luminal stenosis and high-risk features. The mean EAT density surrounding each plaque was calculated as perilesional EAT density (PLED) using non-contrast CT images. Focal 18 F-NaF uptake in each plaque was quantified using the maximum tissue-to-background ratio (TBR max ). Results EAT volume index was similar between patients with TBR max ≥ 1.28 (previously reported optimal cutoff to predict coronary events) and those with lower TBR max , but patients with TBR max ≥ 1.28 showed higher maximum PLED per patient (− 86 ± 12 Hounsfield units (HU) versus − 98 ± 11 HU, P =  0.0044). In the lesion-based analysis ( n  = 92), PLED was positively correlated with TBR max , and the optimal PLED cutoff to identify TBR max ≥ 1.28 was − 97 HU. On multivariate analysis adjusted for lesion location, obstructive stenosis, and high-risk plaque on CT, PLED ≥ − 97 HU remained a significant predictor of TBR max ≥ 1.28. Conclusions Increased PLED was associated with significant coronary arterial 18 F-NaF uptake. Step-by-step analyses of EAT density on CT and coronary arterial 18 F-NaF uptake on PET may offer novel strategies for risk prediction in coronary artery disease.
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-019-04675-z