Nucl Med Mol Imaging.  2024 Feb;58(1):25-31. 10.1007/s13139-023-00822-5.

Comparison of ­SUV_A/V and ­SUV_A‑V for Evaluating Atherosclerotic Inflammation in  ¹⁸F‑FDG PET/CT

• Ryu J
• Han S
• Han S
• Choi S
• Moon D
• Oh M

• KMID: 2553267
• DOI: http://doi.org/10.1007/s13139-023-00822-5

Abstract

Purpose
This study aimed to compare the clinical significance of two parameters, division of standardized uptake value (SUV) of target arterial activity by background venous blood pool activity ( ­SUV_A/V ) and subtraction of background venous blood pool activity from SUV of target arterial activity ­(SUV_A‑V ) of carotid arteries with atherosclerotic plaques using ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT).
Methods
Patients aged 50 years or more who were diagnosed with carotid artery stenosis of 50% or more with carotid Doppler ultrasonography and had torso ¹⁸F-FDG PET/CT were enrolled retrospectively and classified patients who developed cerebrovascular events (CVEs) within 5 years after ¹⁸F-FDG PET/CT scan as the active group and patients who did not experience the CVE within 5 years as an inactive group. We calculated SUV_A/V and ­SUV_A‑V using measurements of ­SUV_max
Results
SUV_A‑V ­ SUV_{A‑V_high} , and ­SUV_{A‑V_low} were significantly higher in the active group than in the inactive group, but neithe SUV_A/V ­ SUV_{A‑V_high} , nor ­­SUV_{A‑V_low} showed significant differences between the active and inactive groups. The difference in rank between groups of SUV_{A‑V_high} and ­SUV_{A‑V_low} was greater than the difference in rank between groups of SUV_A‑V_high and ­­SUV_{A‑V_low} . The CVE incidence differed between SUV_{A‑V_high} and ­­SUV_{A‑V_low} of high carotid FDG uptake, but the CVE incidence did not differ between SUV_{A‑V_high} and ­­SUV_{A‑V_low} of high carotid FDG uptake.
Conclusion
SUV_A‑V may be a more rational solution than ­SUV_A/V for evaluating atherosclerotic plaque inflammation on ¹⁸F-FDG PET/CT.

Keyword

Atherosclerosis imaging; Carotid artery disease; Vulnerable plaque; FDG ; PET quantification