J Lipid Atheroscler.  2019 Sep;8(2):232-241. 10.12997/jla.2019.8.2.232.

Analysis of ¹⁸F-Fluorodeoxyglucose and ¹⁸F-Fluoride Positron Emission Tomography in Korean Stroke Patients with Carotid Atherosclerosis

Affiliations
  • 1Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea. kwangyeol.park@gmail.com
  • 2Department of Nuclear Medicine, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
  • 3Department of Molecular Medicine and Biopharmaceutical Science, WCU Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
  • 4Department of Nuclear Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea. joneseok@cau.ac.kr

Abstract


OBJECTIVE
The objective of this study was to analyze uptake patterns and intensity of ¹â¸F-fluorodeoxyglucose (FDG) and ¹â¸F-sodium fluoride (NaF) radioligands in carotid atheroma among stroke patients according to carotid atheroma characteristics.
METHODS
Between September 2015 and January 2017, consecutive acute stroke or transient ischemic attack patients with 50% or more proximal internal carotid artery stenosis on brain computed tomography angiography were prospectively enrolled. All patients received FDG and NaF positron emission tomography (PET) evaluation when their neurological status was stabilized. Uptake values of FDG and NaF were compared by target to blood ratio (TBR) according to the calcification burden, atheroma volume and the presence of a necrotic core of carotid atheroma.
RESULTS
A total of 18 patients with 36 carotid arteries were finally enrolled, with 10 patients diagnosed as acute cerebral infarction due to symptomatic carotid stenosis. FDG uptake at symptomatic carotid arteries was significantly more increased than that at asymptomatic arteries (TBR: 1.17±0.23 vs. 1.01±0.15, Mann-Whitney U-test, p=0.02), but NaF uptake was not different (TBR: 1.38±0.49 vs. 1.51±0.40, p=0.40). In terms of calcification degree, NaF uptake increased as calcification burden increased (none, 1.28±0.36; spotty, 1.29±0.29; linear, 1.74±0.44; analysis of variance, p=0.02).
CONCLUSION
Carotid evaluation by FDG is superior to NaF PET in the detection of symptomatic carotid atherosclerosis among stroke patients. NaF PET uptake reflects the overall calcification burden.

Keyword

Stroke; Aarotid artery; Atherosclerosis; Positron emission tomography; Glucose

MeSH Terms

Angiography
Arteries
Atherosclerosis
Brain
Carotid Arteries
Carotid Artery Diseases*
Carotid Stenosis
Cerebral Infarction
Electrons*
Fluorides
Glucose
Humans
Ischemic Attack, Transient
Plaque, Atherosclerotic
Positron-Emission Tomography*
Prospective Studies
Stroke*
Fluorides
Glucose
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