Quantitative thoracic aorta calcification assessment by 18F-NaF PET/CT and its correlation with atherosclerotic
Koosha Paydary1, Mona-Elisabeth Revheim1,2,3, Sahra Emamzadehfard1
1Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA.
Insights
Sodium fluoride (NaF)-PET/CT imaging reveals that thoracic aorta calcification correlates with age and cardiovascular disease risk factors. This imaging technique shows potential for assessing arterial micro-calcification and predicting cardiovascular events.
Area of Science:
- Cardiovascular Imaging
- Nuclear Medicine
- Arterial Physiology
Background:
- Thoracic aorta (TA) calcification is a marker of cardiovascular disease (CVD).
- Assessing active calcification in the TA can provide insights into CVD risk.
- NaF-PET/CT imaging offers a method to visualize and quantify arterial calcification.
Purpose of the Study:
- To evaluate the correlation between age and cardiovascular risk factors with NaF-PET/CT imaging in the TA.
- To determine if NaF uptake measurements can predict cardiovascular disease (CVD) risk.
- To explore the utility of NaF-PET/CT in assessing active arterial calcification.
Main Methods:
- Prospective study involving 80 healthy controls and 44 patients with chest pain.
- NaF-PET/CT imaging of the ascending, arch, and descending thoracic aorta.
- Calculation of SUVmax, SUVmean, and Alavi-Carlsen Score (ACS); correlation with age and CVD risk factors using regression models.
Main Results:
- Significantly higher NaF uptake (SUVmax, SUVmean, ACS) in patients compared to controls.
- All NaF uptake measures correlated significantly with age, particularly in patients.
- Alavi-Carlsen Score (ACS) of the entire TA was a stronger predictor of Framingham Risk Score (FRS) and unfavorable CVD risk profile.
Conclusions:
- Active micro-calcification in the thoracic aorta, assessed by NaF-PET/CT, correlates with age.
- This correlation is amplified in individuals with existing cardiovascular disease (CVD) risk factors.
- NaF-PET/CT shows promise for evaluating arterial calcification and its association with cardiovascular events.
Objectives:
We aimed to assess the correlation between age and cardiovascular risk factors with NaF-PET/CT imaging in the thoracic aorta (TA).
Methods:
In this prospective study, 80 healthy controls and 44 patients with chest pain underwent NaF-PET/CT imaging, and three segments of the aorta (ascending, arch, and descending) were examined. Average SUVmax, SUVmean, and Alavi-Carlsen Score (ACS) were calculated in each segment and the entire vessel. The degree of NaF uptake in controls and patients and its correlation with age were determined. Multivariate linear regression and logistic regression models were employed to determine the predictabilities of Framingham Risk Score (FRS) and unfavorable cardiovascular disease (CVD) risk profile by these measurements.
Results:
Average SUVmax, average SUVmean, and ACS were significantly higher in patients than in controls, and all correlated well with age. The correlation of average SUVmean with age was significant in both controls (r = 0.32, p = 0.04) and patients (r = 0.64, p < 0.001). ACS of the entire TA was a stronger predictor of FRS compared with average SUVmax and average SUVmean (adjusted R2 = 0.38, standardized β = 0.58, p < 0.001). ACS was a significant predictor of unfavorable CVD risk profile as compared with other values (odds ratio = 1.006, 95% CI = 1.000-1.013, p = 0.05).
Conclusions:
Active calcification in TA correlates with age, and its correlation is higher among subjects with CVD risk factors. Global assessment (ACS) can predict unfavorable CVD risk profile. These data provide evidence for the potential role of NaF in assessing micro-calcification in arteries and its relations to cardiovascular events.
Key Points:
• Global micro-calcification in the thoracic aorta as measured by NaF-PET/CT imaging correlates with increasing age. • The extent of the correlation was higher among patients with cardiovascular disease (CVD) risk factors. • These data provide evidence for the potential role of NaF in assessing active calcification in arteries and its relations to cardiovascular events.
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