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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

View larger version (71K): [in this window] [in a new window]   FIGURE 1.  Coregistered CT (left), 18F-FDG PET (middle), and fused PET/CT (right) images of coronal (A) and sagittal (B) views and maximal-intensity-projection image (C) from 44-y-old male control subject. No discernable 18F-FDG uptake is seen in whole vascular system.

View larger version (22K): [in this window] [in a new window]   FIGURE 2.  Transaxial CT (left), 18F-FDG PET (middle), and fused PET/CT (right) images. Focal 18F-FDG uptake without significant calcifications is demonstrated in aortic arch from 50-y-old man with significant stenosis of right internal carotid artery, suggesting high level of inflammation activity within this soft plaque.

View larger version (44K): [in this window] [in a new window]   FIGURE 3.  CT (left), 18F-FDG PET (middle), and fused PET/CT (right) images of coronal (upper panel) and sagittal (lower panel) view from 75-y-old man, diagnosed with a right carotid territory stroke 1 mo earlier, with a nearly total occlusion of right common and internal carotid artery and 70% luminal stenosis of left common carotid artery on angiogram. Calcifications are seen in the neck bilaterally, whereas the most intense 18F-FDG uptake was demonstrated over the right carotid artery region (arrows). Highly inflammatory right carotid artery plaque could be the cause of this patient's presenting symptoms.

View larger version (11K): [in this window] [in a new window]   FIGURE 4.  Baseline and postprocedural MMP-1 levels in patients with target lesion SUVmax > 2 (left) and 2 (right). *P < 0.05.