CLINICAL RESEARCH: CARDIAC IMAGING
18Fluorodeoxyglucose Positron Emission Tomography Imaging of Atherosclerotic Plaque Inflammation Is Highly ReproducibleImplications for Atherosclerosis Therapy Trials
James H.F. Rudd, MD, PhD*,1,*,
Kelly S. Myers, BS*,
Sameer Bansilal, MD ,
Josef Machac, MD ,
Ash Rafique, BS ,
Michael Farkouh, MD, MSc ,
Valentin Fuster, MD, PhD and
Zahi A. Fayad, PhD, FACC, FAHA*
* Imaging Science Laboratories, Mount Sinai School of Medicine, New York, New York
Cardiovascular Imaging Clinical Trials Unit, Mount Sinai School of Medicine, New York, New York
Division of Nuclear Medicine, Department of Radiology, Mount Sinai School of Medicine, New York, New York
The Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josee and Henry R. Kravis Cardiovascular Health Center, Mount Sinai School of Medicine, New York, New York.
Manuscript received February 19, 2007;
revised manuscript received May 9, 2007,
accepted May 14, 2007.
* Reprint requests and correspondence: Dr. James H. F. Rudd, ACCI Level 3, Addenbrookes Hospital, Cambridge CB2 2QQ, United Kingdom. (Email: jhfr2{at}cam.ac.uk).
Objectives: This study tested the near-term reproducibility of 18fluorodeoxyglucose positron emission tomography (FDG-PET) imaging of atherosclerosis.
Background: It is known that FDG-PET can measure inflammation within the aorta, carotid, and vertebral arteries with histologic validation in humans and animal models of disease. By tracking changes in inflammation over time, PET could be used as a surrogate marker of antiatheroma drug efficacy. However, the short-term variability and reproducibility of the technique are unknown.
Methods: We imaged the carotid arteries and aorta in 11 subjects with FDG-PET/computed tomography twice, 14 days apart. We assessed interobserver and intraobserver agreement and interscan variability.
Results: Interscan plaque FDG variability over 2 weeks was very low; intraclass correlation coefficients (ICC) ranged between 0.79 and 0.92. Interobserver agreement was high across all territories imaged except aortic arch (ICC values from 0.90 to 0.97, arch 0.71). Intraobserver agreement was high, with ICC values between 0.93 and 0.98.
Conclusions: Spontaneous change in plaque FDG uptake is low over 2 weeks, with favorable inter- and intraobserver agreement. Power calculations suggest that drug studies using FDG-PET imaging would require few subjects compared with other imaging modalities. This study strengthens the case for FDG-PET as a noninvasive plaque imaging technique.
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Abbreviations and Acronyms
| | CT = computed tomography | | FDG = 18fluorodeoxyglucose | | ICC = intraclass correlation coefficient | | MRI = magnetic resonance imaging | | PET = positron emission tomography | | ROI = region of interest | | SUV = standardized uptake value | | TBR = tissue-to-background ratio | | 2D = 2-dimensional | | 3D = 3-dimensional |
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|
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|
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|

|
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|
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|
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|
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|
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|
 |
|

|
 |

|
 |
 
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October 1, 2009;
29(10):
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[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
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July 1, 2009;
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983 - 991.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
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July 1, 2009;
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1009 - 1016.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
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J. Am. Coll. Cardiol. Img.,
June 1, 2009;
2(6):
729 - 730.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
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Vascular Inflammation Imaging with 18F-FDG PET/CT: When to Image?
J. Nucl. Med.,
June 1, 2009;
50(6):
854 - 857.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. J. Fox and H. W. Strauss
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J. Nucl. Med.,
April 1, 2009;
50(4):
497 - 500.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. Wykrzykowska, S. Lehman, G. Williams, J. A. Parker, M. R. Palmer, S. Varkey, G. Kolodny, and R. Laham
Imaging of Inflamed and Vulnerable Plaque in Coronary Arteries with 18F-FDG PET/CT in Patients with Suppression of Myocardial Uptake Using a Low-Carbohydrate, High-Fat Preparation
J. Nucl. Med.,
April 1, 2009;
50(4):
563 - 568.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. Tahara, T. Imaizumi, R. Virmani, and J. Narula
Clinical Feasibility of Molecular Imaging of Plaque Inflammation in Atherosclerosis
J. Nucl. Med.,
March 1, 2009;
50(3):
331 - 334.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
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Circ Cardiovasc Imaging,
March 1, 2009;
2(2):
107 - 115.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
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Multimodality Cardiovascular Molecular Imaging, Part II
Circ Cardiovasc Imaging,
January 1, 2009;
2(1):
56 - 70.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
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Comparison of Methods for Magnetic Resonance-Guided [18-F]Fluorodeoxyglucose Positron Emission Tomography in Human Carotid Arteries: Reproducibility, Partial Volume Correction, and Correlation Between Methods
Stroke,
January 1, 2009;
40(1):
86 - 93.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. J. Lee, Y. K. On, E. J. Lee, J. Y. Choi, B.-T. Kim, and K.-H. Lee
Reversal of Vascular 18F-FDG Uptake with Plasma High-Density Lipoprotein Elevation by Atherogenic Risk Reduction
J. Nucl. Med.,
August 1, 2008;
49(8):
1277 - 1282.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. H.F. Rudd, K. S. Myers, S. Bansilal, J. Machac, C. A. Pinto, C. Tong, A. Rafique, R. Hargeaves, M. Farkouh, V. Fuster, et al.
Atherosclerosis Inflammation Imaging with 18F-FDG PET: Carotid, Iliac, and Femoral Uptake Reproducibility, Quantification Methods, and Recommendations
J. Nucl. Med.,
June 1, 2008;
49(6):
871 - 878.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. Sanz, P. R. Moreno, and V. Fuster
The Year in Atherothrombosis
J. Am. Coll. Cardiol.,
March 4, 2008;
51(9):
944 - 955.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. P. S. Dunphy, H. Schoder, and H. W. Strauss
Radionuclide Techniques for Identifying Vulnerable Plaque
J. Nucl. Med.,
November 1, 2007;
48(11):
1753 - 1755.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Hartung, A. Petrov, N. Haider, S. Fujimoto, F. Blankenberg, A. Fujimoto, R. Virmani, F. D. Kolodgie, H. W. Strauss, and J. Narula
Radiolabeled Monocyte Chemotactic Protein 1 for the Detection of Inflammation in Experimental Atherosclerosis
J. Nucl. Med.,
November 1, 2007;
48(11):
1816 - 1821.
[Abstract]
[Full Text]
[PDF]
|
 |
|
|