Abstract
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Background: The extent of arterial calcification is a well-known marker of cardiovascular risk and increases with age particularly in patients with common cardiovascular risk factors. 18F-sodium fluoride (NaF) PET/CT has been proposed to detect and quantify cardiovascular molecular calcification. However, a correlation between age and changes by NaF PET/CT has never been demonstrated.
Objectives: We sought to investigate the relationship between the activity of molecular arterial mineral deposition assessed by NaF PET/CT and age.
Methods: Out of 140 subjects a total of 128 patients in whom carotid artery could be segmented, including 82 healthy controls (mean age 44±14 years, 52% males) and 46 subjects with stable angina pectoris (mean age 56±12, 48% males) were enrolled in the Cardiovascular Molecular Calcification Assessed by 18F-NaF PET/CT (CAMONA). All patients underwent PET/CT imaging 90 min after NaF administration. Tracer uptake in the common carotid arteries was quantitatively assessed by drawing regions of interest comprising the whole artery and measuring the blood-pool-corrected maximum and mean standardized uptake values (SUVmax and SUVmean, respectively) on each axial slice. Finally, average SUVmax and SUVmean were calculated over all slices. Assessment of the common carotid artery uptake was done by two physicians, who were blinded of the patient characteristics. Inter-user correlation coefficients with regard to recording of these variables were: SUVmean r=0.9, p<0.01; SUVmax r=0.8, p<0.01. The correlation between NaF uptake and age was investigated in healthy controls and patients.
Results: Both average SUVmax (β=0.014, p=0.003) and average SUVmean (β=0.011, p=0.004) significantly increased with age in patients with cardiovascular disease, while no relationship with age was observed among healthy controls.
Conclusion: In angina pectoris patients, carotid arterial mineral deposition assessed by NaF PET/CT significantly increases with age. Due to large inter-individual variations, NaF PET/CT imaging will become an important tool for the detection and monitoring of ongoing molecular carotid calcification in the single patient.