Retrospective study of coronary uptake of 18F-fluorodeoxyglucose in association with calcification and coronary artery disease: a preliminary study

OBJECTIVETo determine whether focal F-fluorodeoxyglucose (FDG) uptake could be detected along the course of coronary arteries in patients with known coronary artery disease (CAD) and/or coronary artery calcification (CAC) by PET/computed tomography (CT) using a new patient preparation protocol that reduces background myocardial FDG uptake. MATERIALS AND METHODSIn this retrospective, Health Insurance Portability and Accountability Act-compliant study approved by our institutional internal review board, 60 FDG-PET/CT studies performed for noncardiac indications were reviewed and CAC and focal FDG uptake were determined. Cardiac histories were obtained. Age range was 21–88 years (64±16 years); 35 women/25 men; six had CAD documented by myocardial perfusion imaging, cardiac catheterization, or history of percutaneous coronary intervention or coronary artery bypass grafting. Chi-square probabilities were calculated. RESULTSFifteen of the 60 patients studied showed focal FDG uptake along the course of coronary arteries; fourteen of these showed significant CAC scores and four had documented CAD. The concordance of focal FDG coronary artery uptake was 58% with CAC, 77% with cardiac history, and 90% with extracardiac vascular focal FDG uptake. There were 20 focal FDG and coronary artery lesions in 15 patients and 11 of the 20 colocalized with calcification. No preferred anatomic location was found (junction, end of calcification or along coronary artery). CONCLUSIONThis limited retrospective study shows that with a new patient preparation to reduce high FDG uptake by the myocardium on PET/CT scans, foci of increased FDG cardiac uptake can be seen in association with CAC and in patients with a history of CAD. These results provide initial evidence that it may be possible to use FDG-PET/CT to monitor sites of coronary plaque formation. Larger and invasive prospective studies will be necessary to fully determine the suitability of this technique for that purpose.