[¹⁸F]FDG PET/CT as an endpoint marker in drug interventional studies in atherosclerosis - a structured review

Inflammation plays a central role in the initiation, progression, and destabilization of atherosclerotic plaques. Persistent vascular inflammation despite therapeutic intervention may contribute substantially to residual cardiovascular risk. In this context, [¹⁸F]fluorodeoxyglucose-positron-emission-tomography ([¹⁸F]FDG PET) imaging has emerged as a non-invasive imaging biomarker capable of visualizing and quantifying vascular inflammatory activity in vivo. Previously published studies showed that the use of [¹⁸F]FDG PET may provide a non-invasive assessment of arterial inflammation. Accordingly, we aimed to systematically summarize treatment studies using [¹⁸F]FDG PET as an endpoint marker.

18 studies were considered to be eligible for data extraction. Of these 22 articles, 10 investigated vascular inflammation reduction after trials with lipid-lowering therapies, the other 12 were considering the effect of novel anti-inflammatory drugs on vascular inflammation.

This review provides an overview of the additional value that [¹⁸F]FDG PET can provide as an endpoint marker in clinical intervention trials. Overall, statin therapies demonstrated a more consistent reduction in vascular [¹⁸F]FDG uptake compared to novel anti-inflammatory therapies.