RT Journal Article SR Electronic T1 Association Between Osteogenesis and Inflammation During the Progression of Calcified Plaque Evaluated by 18F-Fluoride and 18F-FDG JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 968 OP 974 DO 10.2967/jnumed.116.182790 VO 58 IS 6 A1 Xiang Li A1 Daniel Heber A1 Jacobo Cal Gonzalez A1 Georgios Karanikas A1 Marius E. Mayerhoefer A1 Sazan Rasul A1 Dietrich Beitzke A1 Xiaoli Zhang A1 Hermine Agis A1 Markus Mitterhauser A1 Wolfgang Wadsak A1 Thomas Beyer A1 Christian Loewe A1 Marcus Hacker YR 2017 UL http://jnm.snmjournals.org/content/58/6/968.abstract AB 18F-FDG is the most widely validated PET tracer for the evaluation of atherosclerotic inflammation. Recently, 18F-NaF has also been considered a potential novel biomarker of osteogenesis in atherosclerosis. We aimed to analyze the association between inflammation and osteogenesis at different stages of atherosclerosis, as well as the interrelationship between these 2 processes during disease progression. Methods: Thirty-four myeloma patients underwent 18F-NaF and 18F-FDG PET/CT examinations. Lesions were divided into 3 groups (noncalcified, mildly calcified, and severely calcified lesions) on the basis of calcium density as measured in Hounsfield units by CT. Tissue-to-background ratios were determined from PET for both tracers. The association between inflammation and osteogenesis during atherosclerosis progression was evaluated in 19 patients who had at least 2 examinations with both tracers. Results: There were significant correlations between the maximum tissue-to-background ratios of the 2 tracers (Spearman r = 0.5 [P < 0.01]; Pearson r = 0.4 [P < 0.01]) in the 221 lesions at baseline. The highest uptake of both tracers was observed in noncalcified lesions, but without any correlation between the tracers (Pearson r = 0.06; P = 0.76). Compared with noncalcified plaques, mildly calcified plaques showed concordant significantly lower accumulation, with good correlation between the tracers (Pearson r = 0.7; P < 0.01). In addition, enhanced osteogenesis-derived 18F-NaF uptake and regressive inflammation-derived 18F-FDG uptake were observed in severely calcified lesions (Pearson r = 0.4; P < 0.01). During follow-up, increased calcium density and increased mean 18F-NaF uptake were observed, whereas mean 18F-FDG uptake decreased. Most noncalcified (86%) and mildly calcified (81%) lesions and 47% of severely calcified lesions had concordant development of both vascular inflammation and osteogenesis. Conclusion: The combination of 18F-NaF PET imaging and 18F-FDG PET imaging promotes an understanding of the mechanism of plaque progression, thereby providing new insights into plaque stabilization.