Abstract
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Objectives: 1. Review of the currently available quantification methods of FDG PET/CT and NaF PET/CT for atherosclerosis imaging. 2. Presentation of a novel quantitative method - the Alavi Carlsen Score - for global assessment of cardiovascular molecular calcification using NaF PET/CT among patients at risk of cardiovascular diseases (CVD).
Methods: Atherosclerosis is the underlying mechanism of CVD that involves complex inflammatory processes. Inflammation of the atheromatous plaque is paralleled with micro-calcification in areas of cell death and ischemia, which is correlated with plaque instability and risk of future CVD events. Nonetheless, there is a pressing need to develop novel quantification methods that are able to predict CVD in the era of atherosclerosis imaging. Many studies have reported the applications of FDG PET/CT quantification in the vascular wall as a predictor for CVD events; however, recent observations suggest that quantification of NaF PET/CT is more strongly correlated with the risk of CVD.
Results: Through several quantification analyses in our lab, we have been able to show that a global assessment of NaF uptake is more strongly correlated with presence of CVD risk factors, as compared to FDG PET/CT. We used a global assessment approach to quantify molecular calcification in major arteries as well as the cardiac coronary tree to introduce the Alavi-Carlsen Score (ACS) as a novel quantification method of molecular calcification.
Conclusion: The Alavi-Carlsen Score can be potentially used to perform earlier risk stratification and therapeutic intervention in patients at risk for CVD.