18F-NaF PET/MRI for Detection of Carotid Atheroma in Acute Neurovascular Syndrome

被引：18

作者：

Kaczynski, Jakub ^{[1
]}

Sellers, Stephanie ^{[2
,3
]}

Seidman, Michael A. ^{[4
]}

Syed, Maaz ^{[1
]}

Dennis, Martin ^{[5
]}

Mcnaught, Gillian ^{[1
,6
]}

Jansen, Maurits ^{[1
]}

Semple, Scott I. ^{[1
,6
]}

Alcaide-Corral, Carlos ^{[1
]}

Tavares, Adriana A. S. ^{[1
]}

MacGillivray, Thomas ^{[6
]}

Debono, Samuel ^{[1
]}

Forsythe, Rachael ^{[5
]}

Tambyraja, Andrew ^{[5
]}

Slomka, Piotr J. ^{[7
]}

Leipsic, Jonathon ^{[2
,3
]}

Dweck, Marc R. ^{[1
]}

Whiteley, William ^{[5
]}

Wardlaw, Joanna ^{[5
]}

van Beek, Edwin J. R. ^{[1
,6
]}

Newby, David E. ^{[1
,6
]}

Williams, Michelle C. ^{[1
,6
]}

机构：

[1] Univ Edinburgh, BHF Ctr Cardiovasc Sci, Chancellors Bldg,49 Little France Crescent, Edinburgh EH16 4SB, Midlothian, Scotland

[2] St Pauls Hosp, Ctr Heart Lung Innovat, Vancouver, BC, Canada

[3] Univ British Columbia, Vancouver, BC, Canada

[4] Univ Hlth Network, Gen Hosp, Lab Med Program, Toronto, ON, Canada

[5] Royal Infirm Edinburgh NHS Trust, Edinburgh, Midlothian, Scotland

[6] Queens Med Res Inst, Edinburgh Imaging, Edinburgh, Midlothian, Scotland

[7] Cedars Sinai Med Ctr, Dept Med, Div Artificial Intelligence Med, Los Angeles, CA 90048 USA

来源：

RADIOLOGY | 2022年 / 305卷 / 01期

基金：

英国生物技术与生命科学研究理事会;

关键词：

ATHEROSCLEROTIC PLAQUES; INFLAMMATION; STROKE; RISK; FEASIBILITY; MRI;

D O I：

10.1148/radiol.212283

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Background: MRI and fluorine 18-labeled sodium fluoride (F-18-NaF) PET can be used to identify features of plaque instability, rupture, and disease activity, but large studies have not been performed. Purpose: To evaluate the association between F-18-NaF activity and culprit carotid plaque in acute neurovascular syndrome. Materials and Methods: In this prospective observational cohort study (October 2017 to January 2020), participants underwent F-18-NaF PET/MRI. An experienced clinician determined the culprit carotid artery based on symptoms and record review. F-18-NaF uptake was quantified using standardized uptake values and tissue-to-background ratios. Statistical significance was assessed with the Welch, chi(2), Wilcoxon, or Fisher test. Multivariable models were used to evaluate the relationship between the imaging markers and the culprit versus nonculprit vessel. Results: A total of 110 participants were evaluated (mean age, 68 years +/- 10 [SD]; 70 men and 40 women). Of the 110, 34 (32%) had prior cerebrovascular disease, and 26 (24%) presented with amaurosis fugax, 54 (49%) with transient ischemic attack, and 30 (27%) with stroke. Compared with nonculprit carotids, culprit carotids had greater stenoses (>= 50% stenosis: 30% vs 15% [P = .02]; >= 70% stenosis: 25% vs 4.5% [P < .001]) and had increased prevalence of MRI-derived adverse plaque features, including intraplaque hemorrhage (42% vs 23%; P = .004), necrotic core (36% vs 18%; P = .004), thrombus (7.3% vs 0%; P = .01), ulceration (18% vs 3.6%; P = .001), and higher F-18-NaF uptake (maximum tissue-to-background ratio, 1.38 [IQR, 1.12-1.82] vs 1.26 [IQR, 0.99-1.66], respectively; P = .04). Higher F-18-NaF uptake was positively associated with necrosis, intraplaque hemorrhage, ulceration, and calcification and inversely associated with fibrosis (P = .04 to P < .001). In multivariable analysis, carotid stenosis at or over 70% (odds ratio, 5.72 [95% CI: 2.2, 18]) and MRI-derived adverse plaque characteristics (odds ratio, 2.16 [95% CI: 1.2, 3.9]) were both associated with the culprit versus nonculprit carotid vessel. Conclusion: Fluorine 18-labeled sodium fluoride PET/MRI characteristics were associated with the culprit carotid vessel in study participants with acute neurovascular syndrome. (C) RSNA, 2022

引用

页码：137 / 148

页数：12

共 29 条

[1] Imaging plaque inflammation in asymptomatic cocaine addicted individuals with simultaneous positron emission tomography/magnetic resonance imaging [J].