Cho Sang-Geon, Park Ki Seong, Kim Jahae, Kang Sae-Ryung, Kwon Seong Young, Seon Hyun Ju, Jabin Zeenat, Kim Young Jae, Jeong Geum-Cheol, Song Minchul, Song Ho-Chun, Min Jung-Joon, Bom Hee-Seung
Department of Nuclear Medicine, Chonnam National University Hospital, 42, Jebong-ro, Dong-gu, Gwang-ju, 61469, Republic of Korea.
Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322, Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do, 58128, Republic of Korea.
Eur J Nucl Med Mol Imaging. 2017 Jan;44(1):129-140. doi: 10.1007/s00259-016-3523-1. Epub 2016 Sep 28.
The purpose of this study is to evaluate whether fluorodeoxyglucose (FDG) uptake of the large arteries can predict coronary artery calcium (CAC) progression in asymptomatic individuals.
Ninety-six asymptomatic individuals who underwent FDG positron emission tomography (PET) and CAC scoring on the same day for health screening and follow-up CAC scoring ≥1 year after baseline studies (mean 4.3 years) were included. Vascular FDG uptake was measured and corrected for blood pool activity to obtain peak and average target-to-blood pool ratios (TBRpeak and TBRavg, respectively) for the carotid arteries, and ascending and abdominal aorta. CAC scores at baseline and follow-up of each individual were measured and absolute CAC change (ΔCAC), annual CAC change (ΔCAC/year), and annual CAC change rate (ΔCAC%/year) were calculated. CAC progression was defined as ΔCAC >0 for individuals with negative baseline CAC; ΔCAC/year ≥10 for those with baseline CAC of 0<x<100; ΔCAC%/year ≥10 % for those with baseline CAC ≥100. Vascular FDG uptake and other clinical risk factors were compared between CAC-progressors and non-CAC-progressors. Multivariate analysis was performed to evaluate whether vascular FDG uptake can independently predict CAC progression.
Thirty-one subjects showed CAC progression. CAC-progressors showed significantly higher TBRpeak and TBRavg as compared to non-CAC-progressors for all three arteries. TBRpeak of the abdominal aorta was significantly associated with CAC progression in multivariate analysis, with age and baseline CAC. A higher TBRpeak of the abdominal aorta (≥2.11) was associated with CAC progression among subjects with negative baseline CAC only. In subjects with positive baseline CAC, only the amount of baseline CAC was significantly associated with CAC progression. However, the positive predictive value of the TBRpeak of the abdominal aorta was <40 % when age was <58 or baseline CAC was negative.
Higher FDG uptake of the large arteries is associated with an increased risk of CAC progression in asymptomatic subjects with negative baseline CAC. But its clinical application needs further validation.
本研究旨在评估大动脉的氟脱氧葡萄糖（FDG）摄取是否能够预测无症状个体的冠状动脉钙化（CAC）进展情况。
纳入96名无症状个体，他们在同一天接受了FDG正电子发射断层扫描（PET）和CAC评分以进行健康筛查，并在基线研究后≥1年（平均4.3年）进行了随访CAC评分。测量血管FDG摄取，并针对血池活性进行校正，以获得颈动脉、升主动脉和腹主动脉的峰值和平均靶标与血池比值（分别为TBRpeak和TBRavg）。测量每个个体基线和随访时的CAC评分，并计算绝对CAC变化（ΔCAC）、年度CAC变化（ΔCAC/年）和年度CAC变化率（ΔCAC%/年）。对于基线CAC为阴性的个体，CAC进展定义为ΔCAC>0；对于基线CAC为0<x<100的个体，ΔCAC/年≥10；对于基线CAC≥100的个体，ΔCAC%/年≥10%。比较CAC进展者和非CAC进展者的血管FDG摄取及其他临床危险因素。进行多变量分析以评估血管FDG摄取是否能够独立预测CAC进展。
31名受试者显示出CAC进展。与非CAC进展者相比，所有三条动脉的CAC进展者均显示出显著更高的TBRpeak和TBRavg。在多变量分析中，腹主动脉的TBRpeak与CAC进展、年龄和基线CAC显著相关。仅在基线CAC为阴性的受试者中，腹主动脉较高的TBRpeak（≥2.11）与CAC进展相关。在基线CAC为阳性的受试者中，仅基线CAC的量与CAC进展显著相关。然而，当年龄<58岁或基线CAC为阴性时，腹主动脉TBRpeak的阳性预测值<40%。
在基线CAC为阴性的无症状受试者中，大动脉较高的FDG摄取与CAC进展风险增加相关。但其临床应用需要进一步验证。
