Two-year change in 18F-sodium fluoride uptake in the aorta of healthy subjects and angina pectoris patients

Introduction: Microcalcification in the arterial wall traced by 18F-sodium fluoride (NaF) positron emission tomography (PET) is considered an indicator of early phase atherosclerosis and a potential precursor of macrocalcification detectable by computed tomography (CT). In this study, we aimed to examine 2-year changes in aortic NaF uptake. We hypothesized that NaF uptake would increase in both healthy controls and angina pectoris patients.

Methods: Twenty-nine healthy subjects and 20 angina pectoris patients underwent 90-min NaF-PET/CT twice two years apart using the same scanner in each patient on both occasions. Three sections of the aorta (arch, thoracic, abdominal) were manually segmented. NaF uptake was expressed as the mean and total standardized uptake values without and with partial volume correction (SUVmean, SUVtotal and cSUVmean, cSUVtotal).

Results: NaF uptake among the participants are shown in Table 1. Insignificant tendencies were higher NaF uptake in angina patients at both time points with less uptake in healthy subjects and higher uptake in angina patients after 2 years. Thus, mean (± standard deviation) aortic cSUVmean of angina patients was 1.14±0.35 and 1.29±0.71 at baseline and after 2 years vs. 0.99±0.31 and 0.95±0.28 in healthy subjects. NaF uptake at baseline could not predict a change in CT-calcification after 2 years. NaF uptake in all parts of the aorta correlated positively with age.

Conclusions: Slightly, but consistently, higher arterial NaF uptake in the angina group indicated more ongoing microcalcification at both time points in patients than in healthy subjects. The 2-year changes were very small in both groups, albeit with a tendency of slight decreases among healthy controls and slight increases in angina patients despite statin therapy in half of these.

• Download figure
• Open in new tab
• Download powerpoint