Abstract
1666
Objectives Atherosclerosis is a cardiovascular disease marked by inflammation, plaque formation, and calcification within arterial walls. FDG-PET/CT has a well established role for the detection and quantification of atherosclerotic inflammatory disease using standardized uptake value (SUV) measurements. Determination of late arterial aterosclerotic calcification is also feasible via the CT portion of PET/CT. Diabetes mellitus (DM) is a well-known risk factor for atherosclerosis. Our aim was to compare the early inflammatory phase and delayed calcification process of atherosclerosis in the large arteries of subjects with DM on insulin to age-matched controls with no history of DM.
Methods 88 subjects who underwent FDG-PET/CT imaging were retrospectively studied. 44 were diabetics on insulin (62±11 years old); 44 were age-matched controls (61±11 years old). SUVmax and SUVmean for four segments of the aorta (ascending, arch, descending, abdominal) and for the common iliac arteries and common femoral arteries were measured and compared between subject groups. Presence or absence of calcification on CT images for each arterial segment was noted and compared between the two subject groups.
Results SUVmax and SUVmean were statistically significantly greater in subjects with DM on insulin compared to controls in all arterial segments (p<0.05) (Table 1). Presence of calcification was more frequently encountered in the arch, descending thoracic aorta, abdominal aorta, and common iliac arteries, but was statistically significantly different only for the abdominal aorta (39/44 in DM subjects and 25/44 in controls; p=0.0006).
Conclusions In subjects with DM on insulin, atherosclerotic disease within the large arteries as measured by arterial FDG uptake was markedly greater compared to that seen in age-matched controls. Presence of calcification in the abdominal aorta was also more frequently seen in subjects with DM compared to age-matched controls. The early and delayed effects of the atherosclerotic process in large arteries as detected and quantified by FDG-PET/CT appear to be accelerated in subjects with insulin-dependent DM compared to age-matched controls.