Relationship Between ¹⁸F-fluorodeoxyglucose Uptake on Positron Emission Tomography and Aortic Calcification

Area of Science:

• Cardiovascular Imaging
• Nuclear Medicine
• Radiology

Background:

• 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) assesses inflammation.
• The link between atherosclerosis extent/severity and FDG uptake is underexplored.
• Aortic calcification (AC) is a marker of atherosclerosis.

Purpose of the Study:

• To investigate the association between aortic calcium (AC) scores and 18F-FDG uptake in the aorta.
• To determine if AC severity correlates with increased aortic 18F-FDG uptake on PET/CT.

Main Methods:

• 167 patients with suspected lung cancer underwent non-contrast CT and 18F-FDG PET/CT.
• Aortic calcium (AC) scores were measured using the Agatston method.
• Mean standardized uptake values (Mean TBR) in the ascending aorta were calculated and correlated with AC scores using multivariate regression.

Main Results:

• Mean TBR increased progressively with AC score categories (0, 1-399, ≥400).
• Higher AC scores (1-399 and ≥400) were significantly associated with higher Mean TBR (p<0.001).
• Multivariate analysis confirmed AC scores as a significant predictor of aortic 18F-FDG uptake.

Conclusions:

• Total AC scores are significantly associated with Mean TBR in the aorta.
• Greater AC extent and severity correlate with increased atherosclerotic inflammatory activity.
• 18F-FDG PET/CT can quantify inflammatory activity related to aortic calcifications.