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Optimizing 18F-FDG PET/CT imaging of vessel wall inflammation: the impact of 18F-FDG circulation time, injected dose, uptake parameters, and fasting blood glucose levels |
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| Authors: | Jan Bucerius Venkatesh Mani Colin Moncrieff Josef Machac Valentin Fuster Michael E. Farkouh Ahmed Tawakol James H. F. Rudd Zahi A. Fayad |
| Affiliation: | 1. Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, P.O. Box 1234, New York, NY, 10029, USA 2. Department of Radiology, Mount Sinai School of Medicine, New York, NY, USA 3. Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands 4. Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands 5. Department of Nuclear Medicine, University Hospital, RWTH Aachen, Aachen, Germany 6. Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute and Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Mount Sinai School of Medicine, New York, NY, USA 7. Division of Nuclear Medicine, Department of Radiology, Mount Sinai School of Medicine, New York, NY, USA 8. The Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain 9. Cardiovascular Imaging Clinical Trials Unit, Mount Sinai School of Medicine, New York, NY, USA 10. Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA 11. Division of Cardiovascular Medicine, Cambridge University, Cambridge, UK |
| Abstract: | Purpose18F-FDG PET is increasingly used for imaging of vessel wall inflammation. However, limited data are available on the impact of methodological variables, i.e. prescan fasting glucose, FDG circulation time and injected FDG dose, and of different FDG uptake parameters, in vascular FDG PET imaging.MethodsIncluded in the study were 195 patients who underwent vascular FDG PET/CT of the aorta and the carotids. Arterial standardized uptake values (meanSUVmax), target-to-background ratios (meanTBRmax) and FDG blood-pool activity in the superior vena cava (SVC) and the jugular veins (JV) were quantified. Vascular FDG uptake values classified according to the tertiles of prescan fasting glucose levels, the FDG circulation time, and the injected FDG dose were compared using ANOVA. Multivariate regression analyses were performed to identify the potential impact of all variables described on the arterial and blood-pool FDG uptake.ResultsTertile analyses revealed FDG circulation times of about 2.5 h and prescan glucose levels of less than 7.0 mmol/l, showing a favorable relationship between arterial and blood-pool FDG uptake. FDG circulation times showed negative associations with aortic meanSUVmax values as well as SVC and JV FDG blood-pool activity, but positive correlations with aortic and carotid meanTBRmax values. Prescan glucose levels were negatively associated with aortic and carotid meanTBRmax and carotid meanSUVmax values, but were positively correlated with SVC blood-pool uptake. The injected FDG dose failed to show any significant association with vascular FDG uptake.ConclusionFDG circulation times and prescan blood glucose levels significantly affect FDG uptake in the aortic and carotid walls and may bias the results of image interpretation in patients undergoing vascular FDG PET/CT. The injected FDG dose was less critical. Therefore, circulation times of about 2.5 h and prescan glucose levels less than 7.0 mmol/l should be preferred in this setting. |
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