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Imaging Atherosclerosis by PET, With Emphasis on the Role of FDG and NaF as Potential Biomarkers for This Disorder

Molecular imaging has emerged in the past few decades as a novel means to investigate atherosclerosis. From a pathophysiological perspective, atherosclerosis is characterized by microscopic inflammation and microcalcification that precede the characteristic plaque buildup in arterial walls detected...

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Autores principales: Mayer, Michael, Borja, Austin J., Hancin, Emily C., Auslander, Thomas, Revheim, Mona-Elisabeth, Moghbel, Mateen C., Werner, Thomas J., Alavi, Abass, Rajapakse, Chamith S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7642524/
https://www.ncbi.nlm.nih.gov/pubmed/33192540
http://dx.doi.org/10.3389/fphys.2020.511391
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author Mayer, Michael
Borja, Austin J.
Hancin, Emily C.
Auslander, Thomas
Revheim, Mona-Elisabeth
Moghbel, Mateen C.
Werner, Thomas J.
Alavi, Abass
Rajapakse, Chamith S.
author_facet Mayer, Michael
Borja, Austin J.
Hancin, Emily C.
Auslander, Thomas
Revheim, Mona-Elisabeth
Moghbel, Mateen C.
Werner, Thomas J.
Alavi, Abass
Rajapakse, Chamith S.
author_sort Mayer, Michael
collection PubMed
description Molecular imaging has emerged in the past few decades as a novel means to investigate atherosclerosis. From a pathophysiological perspective, atherosclerosis is characterized by microscopic inflammation and microcalcification that precede the characteristic plaque buildup in arterial walls detected by traditional assessment methods, including anatomic imaging modalities. These processes of inflammation and microcalcification are, therefore, prime targets for molecular detection of atherosclerotic disease burden. Imaging with positron emission tomography/computed tomography (PET/CT) using 18F-fluorodeoxyglucose (FDG) and 18F-sodium fluoride (NaF) can non-invasively assess arterial inflammation and microcalcification, respectively. FDG uptake reflects glucose metabolism, which is particularly increased in atherosclerotic plaques retaining macrophages and undergoing hypoxic stress. By contrast, NaF uptake reflects the exchange of hydroxyl groups of hydroxyapatite crystals for fluoride producing fluorapatite, a key biochemical step in calcification of atherosclerotic plaque. Here we review the existing literature on FDG and NaF imaging and their respective values in investigating the progression of atherosclerotic disease. Based on the large volume of data that have been introduced to the literature and discussed in this review, it is clear that PET imaging will have a major role to play in assessing atherosclerosis in the major and coronary arteries. However, it is difficult to draw definitive conclusions on the potential role of FDG in investigating atherosclerosis given the vast number of studies with different designs, image acquisition methods, analyses, and interpretations. Our experience in this domain of research has suggested that NaF may be the tool of choice over FDG in assessing atherosclerosis, especially in the setting of coronary artery disease (CAD). Specifically, global NaF assessment appears to be superior in detecting plaques in tissues with high background FDG activity, such as the coronary arteries.
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spelling pubmed-76425242020-11-13 Imaging Atherosclerosis by PET, With Emphasis on the Role of FDG and NaF as Potential Biomarkers for This Disorder Mayer, Michael Borja, Austin J. Hancin, Emily C. Auslander, Thomas Revheim, Mona-Elisabeth Moghbel, Mateen C. Werner, Thomas J. Alavi, Abass Rajapakse, Chamith S. Front Physiol Physiology Molecular imaging has emerged in the past few decades as a novel means to investigate atherosclerosis. From a pathophysiological perspective, atherosclerosis is characterized by microscopic inflammation and microcalcification that precede the characteristic plaque buildup in arterial walls detected by traditional assessment methods, including anatomic imaging modalities. These processes of inflammation and microcalcification are, therefore, prime targets for molecular detection of atherosclerotic disease burden. Imaging with positron emission tomography/computed tomography (PET/CT) using 18F-fluorodeoxyglucose (FDG) and 18F-sodium fluoride (NaF) can non-invasively assess arterial inflammation and microcalcification, respectively. FDG uptake reflects glucose metabolism, which is particularly increased in atherosclerotic plaques retaining macrophages and undergoing hypoxic stress. By contrast, NaF uptake reflects the exchange of hydroxyl groups of hydroxyapatite crystals for fluoride producing fluorapatite, a key biochemical step in calcification of atherosclerotic plaque. Here we review the existing literature on FDG and NaF imaging and their respective values in investigating the progression of atherosclerotic disease. Based on the large volume of data that have been introduced to the literature and discussed in this review, it is clear that PET imaging will have a major role to play in assessing atherosclerosis in the major and coronary arteries. However, it is difficult to draw definitive conclusions on the potential role of FDG in investigating atherosclerosis given the vast number of studies with different designs, image acquisition methods, analyses, and interpretations. Our experience in this domain of research has suggested that NaF may be the tool of choice over FDG in assessing atherosclerosis, especially in the setting of coronary artery disease (CAD). Specifically, global NaF assessment appears to be superior in detecting plaques in tissues with high background FDG activity, such as the coronary arteries. Frontiers Media S.A. 2020-10-22 /pmc/articles/PMC7642524/ /pubmed/33192540 http://dx.doi.org/10.3389/fphys.2020.511391 Text en Copyright © 2020 Mayer, Borja, Hancin, Auslander, Revheim, Moghbel, Werner, Alavi and Rajapakse. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Mayer, Michael
Borja, Austin J.
Hancin, Emily C.
Auslander, Thomas
Revheim, Mona-Elisabeth
Moghbel, Mateen C.
Werner, Thomas J.
Alavi, Abass
Rajapakse, Chamith S.
Imaging Atherosclerosis by PET, With Emphasis on the Role of FDG and NaF as Potential Biomarkers for This Disorder
title Imaging Atherosclerosis by PET, With Emphasis on the Role of FDG and NaF as Potential Biomarkers for This Disorder
title_full Imaging Atherosclerosis by PET, With Emphasis on the Role of FDG and NaF as Potential Biomarkers for This Disorder
title_fullStr Imaging Atherosclerosis by PET, With Emphasis on the Role of FDG and NaF as Potential Biomarkers for This Disorder
title_full_unstemmed Imaging Atherosclerosis by PET, With Emphasis on the Role of FDG and NaF as Potential Biomarkers for This Disorder
title_short Imaging Atherosclerosis by PET, With Emphasis on the Role of FDG and NaF as Potential Biomarkers for This Disorder
title_sort imaging atherosclerosis by pet, with emphasis on the role of fdg and naf as potential biomarkers for this disorder
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7642524/
https://www.ncbi.nlm.nih.gov/pubmed/33192540
http://dx.doi.org/10.3389/fphys.2020.511391
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