PSMA - Targeted Clinical Molecular Imaging of Atherosclerosis: Correlation with Cardiovascular Risk Factors

Area of Science:

• Nuclear medicine
• Cardiovascular imaging
• Oncology

Background:

• Early diagnosis of atherosclerosis is crucial for preventing ischemic events.
• Prostate-specific membrane antigen (PSMA) ligands, used in prostate cancer imaging, may detect neovascularization and inflammation in other conditions.
• This study investigates PSMA ligand utility for detecting atherosclerosis-related inflammation.

Purpose of the Study:

• To evaluate the potential of PSMA ligand positron emission tomography/computed tomography (PET/CT) for detecting inflammation in the aorta.
• To correlate PSMA uptake in the aorta with cardiovascular risk factors (CVRF).

Main Methods:

• Analysis of PET/CT data from 78 prostate cancer patients re-staged with PSMA ligands.
• Calculation of target-to-background ratios (TBR) for thoracic aorta segments (ascending aorta, descending aorta, aortic arch).
• Statistical analysis, including linear regression, correlating PSMA uptake with CVRF like BMI.

Main Results:

• Mean TBRmax was highest in the aortic arch (1.66 ± 0.33).
• PSMA ligand uptake in the ascending aorta correlated significantly with BMI (r=0.347, p=0.001).
• Higher PSMA uptake was observed in patients with preadiposity and obesity (BMI >25 and >30, respectively) in the ascending aorta.

Conclusions:

• PSMA ligand uptake in the ascending aorta is linked to BMI, suggesting potential for detecting vessel wall inflammation.
• PSMA ligands may indicate inflammation in atherosclerosis to some extent.
• However, PSMA ligands appear less suitable than other tracers for this purpose due to limited correlation with most established CVRFs.