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18F-sodium fluoride uptake may help identify future CV risk
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Researchers for a new study said that 18F-sodium fluoride presents a promising, noninvasive method for the assessment of coronary artery plaque biology.
More than 100 participants (72 years of age; 68% men) with and without aortic valve disease were prospectively recruited for the study. Researchers measured participants’ coronary calcium score and 18F-sodium fluoride (18F-NaF) and 18F-fluorodeoxyglucose (18F-FDG) uptake.
Results showed excellent inter-observer repeatability of coronary 18F-NaF uptake measurements (intra-class coefficient 0.99). Participants with coronary atherosclerosis experienced higher activity when compared with control participants who had a calcium score of zero (1.64 vs. 1.23; P=.003). The researchers found a strong correlation with established coronary calcium (P<.001); however, 41% of participants with calcium scores of more than 1,000 displayed normal uptake. Participants with increased coronary 18F-sodium fluoride activity (n=40) appeared to have higher rates of prior CV events and angina and higher Framingham risk scores. In addition, myocardial activity hampered the quantification of coronary 18F-fluorodeoxyglucose uptake, but this was not increased in participants with atherosclerosis vs. controls.
“Prospective studies with clinical outcomes are now needed to assess whether coronary 18F-sodium fluoride uptake represents a novel marker of plaque vulnerability, recent plaque rupture and future CV risk,” the researchers concluded.
In an accompanying editorial, Richard T. George, MD, of the department of medicine and division of cardiology at Johns Hopkins University School of Medicine, wrote: “This technique shows great promise in the noninvasive study of biological processes that contribute to coronary atherosclerosis. In addition, with further validation, it might be an early marker of plaque progression that could be used to guide clinical trials of novel therapeutics aimed at plaque regression and reducing CV events.”
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Disclosure: The researchers report receiving support from: the British Heart Foundation, Cambridge NIHR Biomedical Research Centre, Chief Scientist Office, HEFCE, the Scottish Imaging Network and Toshiba. Dr. George received research grants from General Electric and Toshiba and is a consultant for ICON Medical Imaging.