Quantitative assessment of atherosclerotic plaques on 18F-FDG PET/MRI: comparison with a PET/CT hybrid system |
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| Authors: | Xiang Li Daniel Heber Ivo Rausch Dietrich Beitzke Marius E. Mayerhoefer Sazan Rasul Michael Kreissl Markus Mitthauser Wolfgang Wadsak Markus Hartenbach Alexander Haug Xiaoli Zhang Christian Loewe Thomas Beyer Marcus Hacker |
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| Affiliation: | 1.Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy,Medical University of Vienna,Vienna,Austria;2.Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy,Medical University of Vienna,Vienna,Austria;3.Center for Medical Physics and Biomedical Engineering, General Hospital Vienna,Medical University of Vienna,Vienna,Austria;4.Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy,Medical University of Vienna,Vienna,Austria;5.Department of Nuclear Medicine,Klinikum Augsburg,Augsburg,Germany;6.Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease,Fuwai Hospital, National Center for Cardiovascular Diseases,Beijing,China |
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| Abstract: | PurposePET with 18F-FDG has the potential to assess vascular macrophage metabolism. 18F-FDG is most often used in combination with contrast-enhanced CT to localize increased metabolism to specific arterial lesions. Novel 18F-FDG PET/MRI hybrid imaging shows high potential for the combined evaluation of atherosclerotic plaques, due to the superior morphological conspicuity of plaque lesions. The purpose of this study was to evaluate the reliability and accuracy of 18F-FDG PET/MRI uptake quantification compared to PET/CT as a reference standard in patients with carotid atherosclerotic plaques.MethodsThe study group comprised 34 consecutive oncological patients with carotid plaques who underwent both PET/CT and PET/MRI with 18F-FDG on the same day. The presence of atherosclerotic plaques was confirmed by 3 T MRI scans. Maximum standardized uptake values (SUVmax) for carotid plaque lesions and the average SUV of the blood pool within the adjacent internal jugular vein were determined and target-to-blood ratios (TBRs, plaque to blood pool) were calculated.ResultsAtherosclerotic lesions with maximum colocalized focal FDG uptake were assessed in each patient. SUVmax values of carotid plaque lesions were significantly lower on PET/MRI than on PET/CT (2.3?±?0.6 vs. 3.1?±?0.6; P?r?=?0.67, P?max values of plaque lesions were similar on PET/MRI and on PET/CT (2.2?±?0.3 vs. 2.2?±?0.3; P?=?0.4), and again were significantly correlated between PET/MRI and PET/CT (Spearman’s r?=?0.73, P?max and TBRmax values from early to delayed imaging time-points on PET/CT and PET/MRI, respectively, with continuous clearance of radioactivity from the blood, a slight underestimation of TBRmax values may also be expected with PET/MRI compared with PET/CT.ConclusionSUVmax and TBRmax values are widely accepted reference parameters for estimation of the radioactivity of atherosclerotic plaques on PET/CT. However, due to a systematic underestimation of SUVmax and TBRmax with PET/MRI, the optimal cut-off values indicating the presence of inflamed plaque tissue need to be newly defined for PET/MRI. |
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