Positron Emission Tomography of Atherosclerosis

Abstract

Functional imaging techniques, aimed at visualizing and quantifying key pathophysiological mechanisms of atherosclerotic cardiovascular disease, have gained interest as potent markers of risk for adverse cardiovascular events. The key pathophysiological mechanisms of atherosclerosis include arterial inflammation and vascular calcification, which can be evaluated by 18FDG PET/CT and Na18F PET/CT imaging, respectively. By studying a population of 139 subjects at low cardiovascular disease risk, this dissertation determined that vascular calcification, as assessed by Na18F PET/CT imaging, is associated with an elevated risk for adverse cardiovascular events, while arterial inflammation, as assessed by 18FDG PET/ CT imaging, is not associated with an elevated risk for adverse cardiovascular events. The former observation is in line with the current literature and the hypothesis that the degree of arterial Na18F uptake reflects atherosclerosis severity, while the latter observation challenges the current literature and the hypothesis that arterial 18FDG uptake reflects atherosclerosis severity. For the purpose of cardiovascular risk evaluation, this dissertation supports a role for arterial Na18F PET/CT imaging, whereas this role seems less obvious for arterial 18FDG PET/CT imaging.