Research ArticleCardiology

Three-Hour Delayed Imaging Improves Assessment of Coronary 18F-Sodium Fluoride PET

Jacek Kwiecinski, Daniel S. Berman, Sang-Eun Lee, Damini Dey, Sebastien Cadet, Martin L. Lassen, Guido Germano, Maurits A. Jansen, Marc R. Dweck, David E. Newby, Hyuk-Jae Chang, Mijin Yun and Piotr J Slomka
Journal of Nuclear Medicine April 2019, 60 (4) 530-535; DOI: https://doi.org/10.2967/jnumed.118.217885

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Four patients with significant coronary 18F-NaF uptake (TBR > 1.25) on 1-h PET in left anterior descending artery. Uptake can be difficult to differentiate in this region from blood pool in adjacent pulmonary artery. On 3-h PET, TBR increased significantly, and blood-pool activity reduced, improving image quality.

  • FIGURE 2.
    FIGURE 2.

    Examples of coronary plaques with significant uptake on 3-h PET and low tracer activity on 1-h PET. These short-axis images of proximal left anterior descending, proximal circumflex (A), and distal right (B) coronary artery plaques show TBR of less than 1.0 on 1-h PET and uptake exceeding 1.25 TBR threshold at 3 h.

  • FIGURE 3.
    FIGURE 3.

    18F-NaF coronary uptake on 1-h and 3-h PET. (A) SUVmax was comparable on both scans. (B and C) cSUVmax and TBR were higher on 3-h PET. (D) Background (right atrium blood pool SUVmean) was lower on 3-h imaging.

  • FIGURE 4.
    FIGURE 4.

    Line plots of 18F-NaF coronary uptake on 1-h and 3-h PET. (A) SUVmax was comparable on both scans. (B and C) cSUVmax and TBR were higher on 3-h PET. (D) Background (right atrium blood pool SUVmean) was lower on 3-h imaging.

Tables

  • TABLE 1

    The 20 Patients’ Baseline Clinical Characteristics

    CharacteristicData
    Mean age ± SD (y)67 ± 7
    Male (n)11 (55%)
    Diabetes (n)4 (20%)
    Hyperlipidemia (n)5 (25%)
    Hypertension (n)12 (60%)
    Tobacco use (n)6 (30%)
    Family history of coronary artery disease (n)3 (15%)
    Serum biomarkers
     Total cholesterol (mg/dL)162 (135–189)
     High-density lipoprotein (mg/dL)43 (38–46)
     Low-density lipoprotein (mg/dL)93 (71–107)
     Triglyceride (mg/dL)121 (86–140)
     Creatine (mg/dL)0.8 (0.7–0.9)
    Medications
     Aspirin (n)13 (65%)
     Statin (n)6 (30%)
     ACEI/ARB (n)6 (30%)
     β-blocker (n)7 (35%)
    Leading clinical indication for CTA
     Chest pain (n)15 (75%)
     Dyspnea (n)3 (15%)
     Risk assessment (asymptomatic patient) (n)2 (10%)
    Coronary CTA
     Segment involvement score6 (3–8)
     Multivessel disease (n)6 (30%)
     Coronary calcium score312 (50–770)

    • ACEI/ARB = angiotensin-converting enzyme inhibitor/angiotensin receptor blocker.

    • Qualitative data are expressed as number and percentage; continuous data, except for age, are expressed as median and interquartile range.

  • TABLE 2

    Comparison of 18F-NaF Motion-Corrected Measurements on 1-Hour and 3-Hour PET

    Measurement1-h PET3-h PETP
    SUVmax1.55 (1.43–1.89)1.63 (1.37–1.98)0.30
    TBR1.28 (0.98–1.56)2.30 (1.70–2.68)<0.001
    cSUVmax0.38 (0.27–0.70)0.90 (0.64–1.17)<0.001
    Background1.24 (1.05–1.31)0.71 (0.65–0.81)<0.001
    Noise0.07 (0.06–0.09)0.10 (0.09–0.12)0.02
    Segments with TBR > 1.2526 (8%)33 (10%)0.01
    Patients with TBR > 1.2512 (60%)15 (75%)0.004

    • Qualitative data are expressed as number and percentage; continuous data are expressed as median and interquartile range.

Additional Files

Back to top

In this issue

Print
Download PDF
Article Alerts
Email Article
Citation Tools
Bookmark this article

Jump to section

Keywords