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KMID : 1130620130090030176
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Journal of Clinical Neurology
2013 Volume.9 No. 3 p.176 ~ p.185
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Complementarity between 18F-FDG PET/CT and Ultrasonography or Angiography in Carotid Plaque Characterization
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Noh Sang-Mi
Choi Won-Jun
Kang Byeong-Teck
Jeong Sang-Wuk
Lee Dong-Kun
Schellingerhout Dawid
Yeo Jeong-Seok
Kim Dong-Eog
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Abstract
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Background and Purpose: To estimate clinical roles of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) versus angiography and ultrasonography in carotid plaque characterization.
Methods: We characterized two groups of patients with recently (<1 month) symptomatic (n=14; age=71.8±8.6 years, mean±SD) or chronic (n=13, age=68.9±9.0 years) carotid stenosis using a battery of imaging tests: diffusion magnetic resonance (MR) imaging, MR or transfemoral angiography, duplex ultrasonography (DUS), and carotid FDG-PET/computed tomography.
Results: The degree of angiographic stenosis was greater in patients with recently symptomatic carotid plaques (67.5±21.5%) than in patients with chronic carotid plaques (32.4±26.8%, p=0.001). Despite the significant difference in the degree of stenosis, lesional maximum standardized uptake values (maxSUVs) on the carotid FDG-PET did not differ between the recently symptomatic (1.56±0.53) and chronic (1.56±0.34, p=0.65) stenosis groups. However, lesional-tocontralesional maxSUV ratios were higher in the recently symptomatic stenosis group (113±17%) than in the chronic stenosis group (98±10%, p=0.017). The grayscale median value of the lesional DUS echodensities was lower in the recently symptomatic stenosis group (28.2±10.0, n=9) than in the chronic stenosis group (53.9±14.0, n=8; p=0.001). Overall, there were no significant correlations between angiographic stenosis, DUS echodensity, and FDG-PET maxSUV. Case/subgroup analyses suggested complementarity between imaging modalities.
Conclusions: There were both correspondences and discrepancies between the carotid FDG-PET images and DUS or angiography data. Further studies are required to determine whether FDGPET could improve the clinical management of carotid stenosis.
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KEYWORD
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carotid plaque, FDG-PET/CT, angiography, ultrasonography, molecular imaging, atherosclerosis
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