A longitudinal pilot study to assess temporal changes in coronary arterial 18F-sodium fluoride uptake

J Nucl Cardiol. 2023 Jun;30(3):1158-1165. doi: 10.1007/s12350-022-02975-w. Epub 2022 Apr 29.

Abstract

Purpose: How coronary arterial 18F-sodium fluoride (18F-NaF) uptake on positron emission tomography changes over the long term and what clinical factors impact the changes remain unclear. We sought to investigate the topics in this study.

Methods: We retrospectively studied 15 patients with ≥1 coronary atherosclerotic lesion/s detected on cardiac computed tomography who underwent baseline and follow-up (interval of >3 years) 18F-NaF positron emission tomography/computed tomography scans. Focal 18F-NaF uptake in each lesion was quantified using maximum tissue-to-background ratio (TBRmax). The temporal change in TBRmax was assessed using a ratio of follow-up to baseline TBRmax (R-TBRmax).

Results: A total of 51 lesions were analyzed. Mean R-TBRmax was 0.96 ± 0.21. CT-based lesion features (location, obstructive stenosis, plaque types, features of high-risk plaque) did not correlate with an increase in R-TBRmax. In multivariate analysis, baseline TBRmax significantly correlated with higher follow-up TBRmax (β = 0.57, P < 0.0001), and the presence of diabetes mellitus significantly correlated with both higher follow-up TBRmax (β = 0.34, P = 0.001) and elevated R-TBRmax (β = 0.40, P = 0.003).

Conclusion: Higher coronary arterial 18F-NaF uptake is likely to remain continuously high. Diabetes mellitus affects the long-term increase in coronary arterial 18F-NaF uptake.

Keywords: Atherosclerosis; CAD; Diseases/processes; Modalities; Molecular imaging agents; PET; Tests; Tracers; Vascular imaging.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Fluorine Radioisotopes
  • Humans
  • Pilot Projects
  • Plaque, Atherosclerotic*
  • Positron Emission Tomography Computed Tomography / methods
  • Positron-Emission Tomography
  • Retrospective Studies
  • Sodium Fluoride*
  • Tomography, X-Ray Computed

Substances

  • Sodium Fluoride
  • Fluorine Radioisotopes