Noninvasive Detection of Active Microcalcification in an Occlusive Peripheral Vascular Aneurysm Using 18F-NaF PET/CT...

Area of Science:

• Vascular Medicine
• Nuclear Medicine
• Radiology

Background:

• Peripheral artery aneurysms, such as popliteal artery aneurysms, are associated with significant morbidity.
• Calcification plays a crucial role in the pathophysiology and progression of atherosclerotic lesions and aneurysms.
• Current imaging modalities primarily detect macrocalcification, potentially missing earlier stages of vascular remodeling.

Observation:

• A 65-year-old male patient with an occluded popliteal artery aneurysm and calf claudication underwent imaging.
• Fluoride positron emission tomography/computed tomography (PET/CT) using F-NaF was performed to evaluate microcalcification.
• Computed tomography (CT) showed macrocalcification in the aneurysm, correlating with high F-NaF uptake on PET.

Findings:

• PET/CT revealed elevated F-NaF retention in the macrocalcified aneurysm, indicating active microcalcification.
• The imaging detected additional distal arterial sites with focal F-NaF uptake.
• These distal sites showed no evidence of CT-detectable macrocalcification, suggesting early or microcalcific disease.

Implications:

• F-NaF PET/CT can identify active microcalcification in peripheral artery aneurysms, even in the absence of macrocalcification.
• This molecular imaging approach may offer novel insights into the dynamic processes of arterial remodeling in lower extremity atherosclerosis.
• PET/CT could potentially detect earlier stages of vascular disease, aiding in risk stratification and treatment strategies.