TY - JOUR T1 - FDG PET imaging of vascular and systemic inflammation in patients with PTSD JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 302 LP - 302 VL - 59 IS - supplement 1 AU - Jakub Toczek AU - Ansel Hillmer AU - Jinah Han AU - Hamed Emami AU - Chi Liu AU - Dana Peters AU - Irina Esterlis AU - Kelly Cosgrove AU - Mehran Sadeghi Y1 - 2018/05/01 UR - http://jnm.snmjournals.org/content/59/supplement_1/302.abstract N2 - 302Objectives: The prevalence of Cardiovascular diseases (CVD) is increased in subjects with post-traumatic stress disorder (PTSD). Vascular inflammation mediates CVD and may be assessed by 18F-fluorodeoxyglucose (FDG) PET imaging. In this pilot study, we investigated whether PTSD is associated with enhanced vascular and systemic inflammation, as assessed by FDG PET imaging. Methods: A cohort of 16 subjects (9 PTSD and 7 controls) without prior history of CVD was included in the study. The subjects’ medical, psychiatric and social history information, including cardiovascular risk factors and current treatment were collected. The presence of PTSD was evaluated using PCL5/CAPS questionnaires, with a CAPS score of 23 or more considered diagnostic of PTSD. Samples of blood were collected in all subjects to determine blood glucose level, lipid panel and systemic inflammatory markers [tumor necrosis factor (TNF)α, interleukin (IL)-1β, IL-6]. FDG PET CT imaging was performed following a low carbohydrate diet for 24 hours and overnight fasting. After CT acquisition, the subjects were injected with 340 ± 28 MBq of FDG and a 2 h-long PET acquisition was performed using a Siemens mCT PET/CT scanner. This included an initial chest focused acquisition (1-bed position) to determine first-pass blood activity followed by a dynamic multi-pass 3 or 4-bed position acquisition covering the neck, chest and abdomen. FDG signal in the ascending aorta was quantified on images in the last 30 min, and was expressed as target-to-background ratio (TBR), by normalizing the average maximal standardized uptake values (SUV) measured on consecutive slices with blood pool activity (SUVmean) measured in the superior vena cava. On the same late images, FDG uptake was quantified in the spleen, bone marrow and brain region of amygdala, and expressed as SUVmean. Results: The two groups matched closely by age and sex, and with regards to cardiovascular risk factors, including the presence of hypertension, smoking history, lipid profile, and blood glucose. None of the subject included in the study showed elevated systemic inflammatory markers (TNFα < 7 pg/mL, IL-1β: < 3 pg/mL, IL-6: < 5 pg/mL for all subjects). No difference in aortic FDG signal was observed between control and PTSD groups (TBR: 2.47 ± 0.25 and 2.37 ± 0.34, respectively, p = ns). There was no difference between the two groups in FDG uptake in the spleen, bone marrow or amygdala (respectively, SUVmean: 2.20 ± 0.37 vs 2.13 ± 0.30, 3.30 ± 0.49 vs 2.94 ± 0.52 and 7.08 ± 0.76 vs 7.09 ± 1.06 for control vs PTSD; p = ns for all). There was a significant correlation between FDG signal in the spleen and bone marrow (r = 0.75, p < 0.01) and the uptake in both tissues correlated with the uptake in the amygdala (r = 0.60, p < 0.05 and r = 0.68, p < 0.01, for spleen and bone marrow, respectively). No correlation was found between aortic TBR and FDG uptake in the bone marrow and amygdala (r = -0.37 and r = -0.30, p = ns for both) and a negative correlation between aortic FDG signal and FDG uptake in the spleen was observed (r = -0.41, p < 0.05). CONCLUSION: This pilot study did not reveal any differential vascular or systemic inflammation in PTSD and control subjects, as assessed by FDG PET imaging. FDG uptake in the spleen and bone marrow correlated with FDG uptake in the amygdala, potentially reflecting a relation between amygdalar activity and systemic inflammation. Funding provided by the VA National Center for PTSD. ER -