Sodium fluoride in cardiovascular disorders: A systematic review

Area of Science:

• Nuclear Medicine
• Cardiovascular Imaging
• Radiopharmaceutical Science

Background:

• 18-Fluorine sodium fluoride (NaF) is a radiotracer primarily used for bone metastasis diagnosis.
• Its association with cardiovascular (CV) risk is suggested, particularly in oncological patients.
• NaF uptake may correlate with CV disease progression and plaque instability due to its role as a microcalcification marker.

Purpose of the Study:

• To systematically review clinical studies on the use of 18-F NaF in cardiovascular conditions.
• To characterize the correlation between NaF uptake and CV risk factors and vascular calcification.
• To evaluate NaF's potential in identifying high-risk plaques and assessing disease progression.

Main Methods:

• Systematic review of clinical studies.
• Analysis of NaF uptake in relation to CV risk factors and vascular calcification.
• Correlation of NaF uptake with plaque characteristics and disease severity in atherosclerosis and aortic stenosis.

Main Results:

• Most studies show a positive correlation between NaF uptake and the burden of CV risk factors and vascular calcification in atherosclerosis.
• Higher NaF uptake is observed in culprit plaques and rupture sites in coronary and carotid arteries.
• NaF uptake increases with disease severity in aortic stenosis and is linked to high-risk plaque features.

Conclusions:

• Sodium fluoride positron emission tomography (NaF-PET) is a promising non-invasive technique for identifying high-risk plaques.
• NaF-PET may aid in evaluating atherosclerotic disease progression and degenerative changes in aortic valve stenosis.
• Further prospective studies are needed to confirm NaF-PET's value in predicting clinical events and guiding treatment.