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Characterization of Plaques Using ¹⁸F-FDG PET/CT in Patients with Carotid Atherosclerosis and Correlation with Matrix Metalloproteinase-1

¹ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; ² Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan; ³ Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; ⁴ Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan; ⁵ Center for Optoelectronic Biomedicine, College of Medicine, National Taiwan University, Taipei, Taiwan; ⁶ Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; and ⁷ Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan

Correspondence: For correspondence or reprints contact: Wei-Shiung Yang, MD, PhD, Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, No. 1 Chang-Te St., Taipei, 10002, Taiwan. E-mail: wsyang{at}ha.mc.ntu.edu.tw

High tissue matrix metalloproteinase (MMP) activity has been associated with advanced atherosclerosis and plaque rupture. ¹⁸F-FDG uptake has been reported to detect inflammation. This investigation examined the vascular ¹⁸F-FDG uptake by PET/CT and its correlation with circulating MMP-1 levels. Methods: We examined 25 consecutive patients with significant carotid stenosis and 22 healthy control subjects using ¹⁸F-FDG PET/CT. The leukocyte counts, C-reactive protein (CRP), and MMP-1 were measured. Results: ¹⁸F-FDG arterial uptake, as well as calcifications, was significantly higher in extensive distributions in patients with established carotid stenosis. However, their distribution was not consistently overlapping. The values of circulating MMP-1 and leukocyte counts were significantly higher in patients with carotid stenosis (all P < 0.05). In addition, subjects with higher ¹⁸F-FDG uptake (maximum SUV > 2.0) in target lesions had higher baseline and poststenting MMP-1 levels (all P < 0.05). Conclusion: We provide a link between ¹⁸F-FDG uptake and circulating MMP-1. ¹⁸F-FDG PET/CT could be used as an adjunct to the clinical management of high-risk atherosclerosis and an in vivo tool to study plaque biology.

Key Words: atherosclerosis • ¹⁸F-FDG • PET • CT • matrix metalloproteinase-1

COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.

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