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Potential of Integrated (18F) Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying Vulnerable Carotid Plaques

Potential of Integrated (18F) Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying... This Article Free to Access Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2381v1 32/5/950 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Kwee, R. M. Articles by Kooi, M. E. PubMed PubMed Citation Articles by Kwee, R. M. Articles by Kooi, M. E. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:950-954, May 2011 © 2011 American Society of Neuroradiology HEAD AND NECK Potential of Integrated ( 18 F) Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying Vulnerable Carotid Plaques R.M. Kwee a ,b , M.T.B. Truijman a ,b , W.H. Mess b ,c , G.J.J. Teule d , J.W.M. ter Berg g , C.L. Franke h , A.G.G.C. Korten i , B.J. Meems j , M.H. Prins b ,e , J.M.A. van Engelshoven a ,b , J. E. Wildberger a ,b , R.J. van Oostenbrugge b ,f and M.E. Kooi a ,b a From the Department of Radiology (R.M.K., M.T.B.T., J.M.A.v.E., J.E.W., M.E.K.) b Cardiovascular Research Institute Maastricht (R.M.K., M.T.B.T., W.H.M., M.H.P., J.M.A.v.E., J.E.W., R.J.v.O., M.E.K.) c Departments of Clinical Neurophysiology (W.H.M.) d Nuclear Medicine (G.J.J.T.) e Clinical Epidemiology and Medical Technology Assessment (M.H.P.) f Neurology (R.J.v.O.), Maastricht University Medical Center, Maastricht, the Netherlands g Department of Neurology (J.W.M.t.B.), Orbis Medical Center, Sittard, the Netherlands h Department of Neurology (C.L.F.), Atrium Medical Center Parkstad, Heerlen, the Netherlands i Department of Neurology (A.G.G.C.K.), Laurentius Hospital, Roermond, the Netherlands j Department of Neurology (B.J.M.), Vie Curi Medical Center, Venlo, the Netherlands. Please address correspondence to M.E. Kooi, PhD, Department of Radiology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, the Netherlands; e-mail: eline.kooi@mumc.nl BACKGROUND AND PURPOSE: There is a need for improved risk stratification of patients with TIA/stroke and carotid atherosclerosis. The purpose of this study was to prospectively investigate the potential of integrated 18 F-FDG PET / MDCT in identifying vulnerable carotid plaques. MATERIALS AND METHODS: Fifty patients with TIA/stroke with an ipsilateral carotid plaque causing <70% stenosis and a plaque on the contralateral asymptomatic side underwent integrated 18 F-FDG PET/MDCT within 36.1 ± 20.0 days (range, 9–95 days) of the last symptoms. Carotid plaque 18 F-FDG uptake was measured as both the mean and maximum blood-normalized SUV, known as the TBR. Using MDCT, we assessed volumes of vessel wall and individual plaque components. RESULTS: Mean TBR was only significantly larger in the ipsilateral plaques of patients who were imaged within 38 days (1.24 ± 0.04 (SE) versus 1.17 ± 0.05, P = .014). This also accounted for maximum TBR (1.53 ± 0.06 versus 1.42 ± 0.06, P = .015). MDCT-assessed vessel wall and LRNC volumes were larger in ipsilateral plaques of all patients (982.3 ± 121.3 versus 811.3 ± 106.6 mm 3 , P = .016; 164.7 ± 26.1 versus 134.3 ± 35.2 mm 3 , P = .026, respectively). CONCLUSIONS: In the present study, 18 F-FDG PET only detected significant differences between ipsilateral and contralateral asymptomatic plaques in patients with TIA/stroke who were imaged within 38 days, whereas MDCT detected larger vessel wall and LRNC volumes, regardless of time after symptoms. In view of the substantial overlap in measurements of both sides, it remains to be determined whether the differences we found will be clinically meaningful. Abbreviations: CEA, carotid endarterectomy • CV, coefficient of variation • 18 F-FDG, ( 18 F) fluorodeoxyglucose • ICC, intraclass correlation coefficient • LRNC, lipid-rich necrotic core • MDCT, multidetector row spiral CT • NASCET, North American Symptomatic Carotid Endarterectomy Trial • PET, positron-emission tomography • SE, standard error • SUV, standardized uptake value • TBR, target-to-background ratio • TIA, transient ischemic attack Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Potential of Integrated (18F) Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying Vulnerable Carotid Plaques

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References (22)

Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2011 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2381
Publisher site
See Article on Publisher Site

Abstract

This Article Free to Access Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2381v1 32/5/950 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Kwee, R. M. Articles by Kooi, M. E. PubMed PubMed Citation Articles by Kwee, R. M. Articles by Kooi, M. E. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:950-954, May 2011 © 2011 American Society of Neuroradiology HEAD AND NECK Potential of Integrated ( 18 F) Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying Vulnerable Carotid Plaques R.M. Kwee a ,b , M.T.B. Truijman a ,b , W.H. Mess b ,c , G.J.J. Teule d , J.W.M. ter Berg g , C.L. Franke h , A.G.G.C. Korten i , B.J. Meems j , M.H. Prins b ,e , J.M.A. van Engelshoven a ,b , J. E. Wildberger a ,b , R.J. van Oostenbrugge b ,f and M.E. Kooi a ,b a From the Department of Radiology (R.M.K., M.T.B.T., J.M.A.v.E., J.E.W., M.E.K.) b Cardiovascular Research Institute Maastricht (R.M.K., M.T.B.T., W.H.M., M.H.P., J.M.A.v.E., J.E.W., R.J.v.O., M.E.K.) c Departments of Clinical Neurophysiology (W.H.M.) d Nuclear Medicine (G.J.J.T.) e Clinical Epidemiology and Medical Technology Assessment (M.H.P.) f Neurology (R.J.v.O.), Maastricht University Medical Center, Maastricht, the Netherlands g Department of Neurology (J.W.M.t.B.), Orbis Medical Center, Sittard, the Netherlands h Department of Neurology (C.L.F.), Atrium Medical Center Parkstad, Heerlen, the Netherlands i Department of Neurology (A.G.G.C.K.), Laurentius Hospital, Roermond, the Netherlands j Department of Neurology (B.J.M.), Vie Curi Medical Center, Venlo, the Netherlands. Please address correspondence to M.E. Kooi, PhD, Department of Radiology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, the Netherlands; e-mail: eline.kooi@mumc.nl BACKGROUND AND PURPOSE: There is a need for improved risk stratification of patients with TIA/stroke and carotid atherosclerosis. The purpose of this study was to prospectively investigate the potential of integrated 18 F-FDG PET / MDCT in identifying vulnerable carotid plaques. MATERIALS AND METHODS: Fifty patients with TIA/stroke with an ipsilateral carotid plaque causing <70% stenosis and a plaque on the contralateral asymptomatic side underwent integrated 18 F-FDG PET/MDCT within 36.1 ± 20.0 days (range, 9–95 days) of the last symptoms. Carotid plaque 18 F-FDG uptake was measured as both the mean and maximum blood-normalized SUV, known as the TBR. Using MDCT, we assessed volumes of vessel wall and individual plaque components. RESULTS: Mean TBR was only significantly larger in the ipsilateral plaques of patients who were imaged within 38 days (1.24 ± 0.04 (SE) versus 1.17 ± 0.05, P = .014). This also accounted for maximum TBR (1.53 ± 0.06 versus 1.42 ± 0.06, P = .015). MDCT-assessed vessel wall and LRNC volumes were larger in ipsilateral plaques of all patients (982.3 ± 121.3 versus 811.3 ± 106.6 mm 3 , P = .016; 164.7 ± 26.1 versus 134.3 ± 35.2 mm 3 , P = .026, respectively). CONCLUSIONS: In the present study, 18 F-FDG PET only detected significant differences between ipsilateral and contralateral asymptomatic plaques in patients with TIA/stroke who were imaged within 38 days, whereas MDCT detected larger vessel wall and LRNC volumes, regardless of time after symptoms. In view of the substantial overlap in measurements of both sides, it remains to be determined whether the differences we found will be clinically meaningful. Abbreviations: CEA, carotid endarterectomy • CV, coefficient of variation • 18 F-FDG, ( 18 F) fluorodeoxyglucose • ICC, intraclass correlation coefficient • LRNC, lipid-rich necrotic core • MDCT, multidetector row spiral CT • NASCET, North American Symptomatic Carotid Endarterectomy Trial • PET, positron-emission tomography • SE, standard error • SUV, standardized uptake value • TBR, target-to-background ratio • TIA, transient ischemic attack Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: May 1, 2011

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