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Divergent determinants of 18F–NaF uptake and visible calcium deposition in large arteries: relationship with Framingham risk score

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Abstract

To compare regional vascular distribution and biological determinants of visible calcium load, as assessed by computed tomography, as well as of molecular calcium deposition as assessed by 18F–NaF positron emission tomography. Eighty oncologic patients undergoing 18F–NaF PET/CT scan were included in the study. Cardiovascular-risk stratification was performed according to a simplified version of the Framingham model [including age, diabetes, smoking, systolic blood pressure and body mass index (BMI)]. Arterial 18F–NaF uptake was measured by drawing regions of interest comprising the arteries on each slice of the transaxial PET/CT and normalized to blood 18F–NaF activity to obtain the arterial target-to-background ratio (TBR). The degree of arterial calcification (AC) was measured using a software program providing Agatston-like scores. Differences in mean values and regression analysis were tested. Predictors of AC and TBR were evaluated by univariate and multivariate analysis. p value of 0.05 was considered statistically significant. No correlation was documented between regional calcium load and regional TBR in any of the studied arterial segments. Visible calcium deposition was found to be dependent upon age while it was not influenced by all the remaining determinants of cardiovascular risk. By contrast, 18F–NaF uptake was significantly correlated with all descriptors of cardiovascular risk, with the exception of BMI. Vascular 18F–NaF uptake displays a different regional distribution, as well as different biological predictors, when compared to macroscopic AC. The tight dependency of tracer retention upon ongoing biological determinants of vascular damage suggests that this tool might provide an unexplored window on plaque pathophysiology.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Nuclear Medicine Unit, Department of Health Sciences, IRCCS AOU San Martino, IST, University of Genoa, Largo R. Benzi, 10, 16132, Genoa, Italy

    Silvia Morbelli, Francesco Fiz, Lorena Picori, Michela Massollo, Alessia Democrito & Gianmario Sambuceti

  2. Nuclear Medicine Unit, Galliera Hospital, Genoa, Italy

    Arnoldo Piccardo, Emanuela Pestarino, Manlio Cabria & Giampiero Villavecchia

  3. Institute of Molecular Bioimaging and Physiology, CNR, Genoa, Italy

    Cecilia Marini

  4. Department of Radiology, IRCCS AOU San Martino, IST, Genoa, Italy

    Giuseppe Cittadini

  5. Clinical Epidemiology Unit, IRCCS AOU San Martino, IST, Genoa, Italy

    Paolo Bruzzi

  6. Division of Nuclear Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Abass Alavi

Authors
  1. Silvia Morbelli
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  2. Francesco Fiz
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  3. Arnoldo Piccardo
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  4. Lorena Picori
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  5. Michela Massollo
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  7. Cecilia Marini
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  8. Manlio Cabria
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  9. Alessia Democrito
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  10. Giuseppe Cittadini
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  11. Giampiero Villavecchia
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  12. Paolo Bruzzi
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  13. Abass Alavi
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  14. Gianmario Sambuceti
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Corresponding author

Correspondence to Silvia Morbelli.

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10554_2013_342_MOESM1_ESM.ppt

Fig.A: Correlation analysis between TBR and AC in the analyzed arterial districts. This analysis did not show any concordance between regional calcium load and TBR in any of the studied arterial segments. TBR = Target to Background Ratio. (PPT 224 kb)

10554_2013_342_MOESM2_ESM.ppt

Fig.B: Differences in average SUVmax of all the analyzed arterial districts values across different risk category groups. Significant difference in average SUVmax value was highlighted in high versus low risk groups, *p < 0.05). (PPT 83 kb)

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Morbelli, S., Fiz, F., Piccardo, A. et al. Divergent determinants of 18F–NaF uptake and visible calcium deposition in large arteries: relationship with Framingham risk score. Int J Cardiovasc Imaging 30, 439–447 (2014). https://doi.org/10.1007/s10554-013-0342-3

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  • DOI: https://doi.org/10.1007/s10554-013-0342-3

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