Translational and Molecular Imaging Institute, Mount Sinai School of Medicine, New York, New York 10029, USA.
JACC Cardiovasc Imaging. 2012 Jan;5(1):38-45. doi: 10.1016/j.jcmg.2011.08.019.
A prospective, multicenter (18)fluorine-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) imaging study was performed to estimate the correlations among arterial FDG uptake and atherosclerotic plaque biomarkers in patients with peripheral artery disease.
Inflammation within atherosclerotic plaques is associated with instability of the plaque and future cardiovascular events. Previous studies have shown that (18)F-FDG-PET/CT is able to quantify inflammation within carotid artery atherosclerotic plaques, but no studies to date have investigated this correlation in peripheral arteries with immunohistochemical confirmation.
Thirty patients across 5 study sites underwent (18)F-FDG-PET/CT imaging before SilverHawk atherectomy (FoxHollow Technologies, Redwood City, California) for symptomatic common or superficial femoral arterial disease. Vascular FDG uptake (expressed as target-to-background ratio) was measured in the carotid arteries and aorta and femoral arteries, including the region of atherectomy. Immunohistochemistry was performed on the excised atherosclerotic plaque extracts, and cluster of differentiation 68 (CD68) level as a measure of macrophage content was determined. Correlations between target-to-background ratio of excised lesions, as well as entire arterial regions, and CD68 levels were determined. Imaging was performed during the 2 weeks before surgery in all cases.
Twenty-one patients had adequate-quality (18)F-FDG-PET/CT peripheral artery images, and 34 plaque specimens were obtained. No significant correlation between lesion target-to-background ratio and CD68 level was observed.
There were no significant correlations between CD68 level (as a measure of macrophage content) and FDG uptake in the peripheral arteries in this multicenter study. Differences in lesion extraction technique, lesion size, the degree of inflammation, and imaging coregistration techniques may have been responsible for the failure to observe the strong correlations with vascular FDG uptake observed in previous studies of the carotid artery and in several animal models of atherosclerosis.
一项前瞻性、多中心（18）氟-氟代脱氧葡萄糖（（18）F-FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）成像研究旨在评估外周动脉疾病患者动脉 FDG 摄取与动脉粥样硬化斑块生物标志物之间的相关性。
动脉粥样硬化斑块内的炎症与斑块的不稳定性和未来的心血管事件有关。先前的研究表明，（18）F-FDG-PET/CT 能够定量颈动脉粥样硬化斑块内的炎症，但迄今为止，尚无研究通过免疫组织化学证实来研究外周动脉中的这种相关性。
在 5 个研究地点的 30 名患者中，在进行症状性普通或浅表股动脉疾病的 SilverHawk 旋切术（FoxHollow Technologies，加利福尼亚州雷德伍德城）之前进行了（18）F-FDG-PET/CT 成像。在颈动脉和主动脉以及股动脉（包括旋切部位）中测量血管 FDG 摄取（表示为靶/背景比）。对切除的动脉粥样硬化斑块提取物进行免疫组织化学检测，并测定分化群 68（CD68）水平作为巨噬细胞含量的指标。确定切除病变的靶/背景比以及整个动脉区域与 CD68 水平之间的相关性。在所有病例中，成像均在手术前 2 周内进行。
21 名患者有足够质量的（18）F-FDG-PET/CT 外周动脉图像，获得了 34 个斑块标本。未观察到病变靶/背景比与 CD68 水平之间存在显著相关性。
在这项多中心研究中，外周动脉中 CD68 水平（作为巨噬细胞含量的指标）与 FDG 摄取之间没有显著相关性。病变提取技术、病变大小、炎症程度和成像配准技术的差异可能是导致未能观察到与之前的颈动脉研究以及几种动脉粥样硬化动物模型中观察到的与血管 FDG 摄取之间的强烈相关性的原因。
