Department of Radiology, Hospital of University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA.
Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
Ann Nucl Med. 2020 Jun;34(6):424-431. doi: 10.1007/s12149-020-01463-w. Epub 2020 Apr 10.
We aimed to determine whether NaF-PET/CT or FDG-PET/CT can detect abdominal aortic molecular calcification and inflammation in patients with rheumatoid arthritis (RA).
In this study, 18 RA patients (4 women, 14 men; mean age 56.0 ± 11.7) and 18 healthy controls (4 women, 14 men; mean age 55.8 ± 11.9) were included. The controls were matched to patients by sex and age (± 4 years). All subjects of this study underwent NaF-PET/CT scanning 90 min following the administration of NaF. FDG-PET/CT imaging was performed 180 min following intravenous FDG injection. Using OsiriX software, the global mean standardized uptake value (global SUVmean) in abdominal aorta was calculated for both FDG and NaF. The NaF SUVmean and FDG SUVmean were divided by the blood pool activity providing target-to-background ratios (TBR) namely, NaF-TBRmean and FDG-TBRmean. The CT calcium volume score was obtained using a growing region algorithm based on Hounsfield units.
The average NaF-TBRmean score among RA patients was significantly greater than that of healthy controls (median 1.61; IQR 1.49-1.88 and median 1.40; IQR 1.23-1.52, P = 0.002). The average CT calcium volume score among RA patients was also significantly greater than that of healthy controls (median 1.96 cm; IQR 0.57-5.48 and median 0.004 cm; IQR 0.04-0.05, P < 0.001). There was no significant difference between the average FDG-TBRmean scores in the RA patients when compared to healthy controls (median 1.29; IQR 1.13-1.52 and median 1.29; IQR 1.13-1.52, respectively, P = 0.98).
Quantitative assessment with NaF-PET/CT identifies increased molecular calcification in the wall of the abdominal aorta among patients with RA as compared with healthy controls, while quantitative assessment with FDG-PET/CT did not identify a difference in aortic vessel wall FDG uptake between the RA and healthy control groups.
本研究旨在确定氟[18F]钠（NaF）-PET/CT 或氟[18F]脱氧葡萄糖（FDG）-PET/CT 是否可检测类风湿关节炎（RA）患者的腹主动脉分子钙化和炎症。
本研究纳入 18 例 RA 患者（4 名女性，14 名男性；平均年龄 56.0±11.7 岁）和 18 例健康对照者（4 名女性，14 名男性；平均年龄 55.8±11.9 岁）。对照者按照性别和年龄（±4 岁）与患者相匹配。所有研究对象均在静脉注射 NaF 后 90 分钟行 NaF-PET/CT 扫描，在静脉注射 FDG 后 180 分钟行 FDG-PET/CT 成像。使用 OsiriX 软件计算 FDG 和 NaF 时腹主动脉的全局标准化摄取值（global SUVmean）。将 NaF SUVmean 和 FDG SUVmean 除以血池活性，提供目标与背景的比值（TBR），即 NaF-TBRmean 和 FDG-TBRmean。采用基于亨氏单位的生长区域算法获得 CT 钙体积评分。
RA 患者的平均 NaF-TBRmean 评分显著高于健康对照组（中位数 1.61；IQR 1.49-1.88 与中位数 1.40；IQR 1.23-1.52，P=0.002）。RA 患者的平均 CT 钙体积评分也显著高于健康对照组（中位数 1.96cm；IQR 0.57-5.48 与中位数 0.004cm；IQR 0.04-0.05，P<0.001）。RA 患者的平均 FDG-TBRmean 评分与健康对照组相比无显著差异（中位数 1.29；IQR 1.13-1.52 与中位数 1.29；IQR 1.13-1.52，P=0.98）。
与健康对照组相比，NaF-PET/CT 的定量评估可识别 RA 患者腹主动脉壁的分子钙化增加，而 FDG-PET/CT 的定量评估并未发现 RA 组和健康对照组之间主动脉血管壁 FDG 摄取存在差异。
