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J Kwiecinski, D Dey, S E Lee, Y Otaki, M K Doris, E Eisenberg, M Yun, A Cho, M A Jansen, M R Dweck, P J Slomka, D E Newby, H J Chang, D S Berman, P6207
Pericoronary adipose tissue density and low attenuation plaque are associated with 18F-sodium fluoride coronary uptake in vulnerable plaque patients, European Heart Journal, Volume 39, Issue suppl_1, August 2018, ehy566.P6207, https://doi.org/10.1093/eurheartj/ehy566.P6207Close - Share Icon Share
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Background: Coronary 18F- sodium fluoride (NaF) PET uptake reflects active calcification and is considered to be a response to inflammation. Pericoronary adipose tissue (PCAT) density and low attenuation (LD) plaque are also considered to be markers of vascular inflammation.
Purpose: We aimed to assess the association between lesion PCAT density and LD plaque with coronary NaF PET uptake in stable patients with vulnerable plaque, defined as multiple adverse plaque features (APFs) on coronary CT angiography (CTA).
Methods: Patients undergoing clinically indicated coronary CTA were screened for APFs by visual reading and semi-automated quantified software (Autoplaque). Vulnerable plaque (VP) was defined by having at least 3 adverse plaque features [positive remodeling; low attenuation plaque (<30HU); spotty calcification; obstructive coronary stenosis ≥50% or contrast density difference ≥25%; plaque volume >100mm3 or plaque burden ≥40% by quantitative software]. Patients with VPs were recruited for NaF PET/CT within 17 [14,37] days of CTA.
Gated NaF coronary PET was acquired over 30 minutes (Figure 1A-B). Maximal standard uptake values (SUVmax) and target to background ratios (TBR) of coronary lesions were measured on cardiac motion corrected images. In all lesions with stenosis ≥25%, mean PCAT density was measured. Three-dimensional volumes of interest which encompassed tissue with attenuation ranging from -190 up to -30 HU extending radially outward from the vessel wall were interrogated (Figure 1C).
