PET-Based Imaging with 18F-FDG and 18F-NaF to Assess Inflammation and Microcalcification in Atherosclerosis and Other Vascular and Thrombotic Disorders

William Y Raynor; Peter Sang Uk Park; Austin J Borja; Yusha Sun; Thomas J Werner; Sze Jia Ng; Hui Chong Lau; Poul Flemming Høilund-Carlsen; Abass Alavi; Mona-Elisabeth Revheim

doi:10.3390/diagnostics11122234

PET-Based Imaging with ¹⁸F-FDG and ¹⁸F-NaF to Assess Inflammation and Microcalcification in Atherosclerosis and Other Vascular and Thrombotic Disorders

Diagnostics (Basel). 2021 Nov 29;11(12):2234. doi: 10.3390/diagnostics11122234.

Authors

William Y Raynor¹, Peter Sang Uk Park^{1

2}, Austin J Borja^{1

2}, Yusha Sun², Thomas J Werner¹, Sze Jia Ng³, Hui Chong Lau³, Poul Flemming Høilund-Carlsen^{4

5}, Abass Alavi¹, Mona-Elisabeth Revheim^{1

6

7}

Affiliations

¹ Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
² Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
³ Department of Medicine, Crozer-Chester Medical Center, Upland, PA 19013, USA.
⁴ Department of Nuclear Medicine, Odense University Hospital, 5000 Odense C, Denmark.
⁵ Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark.
⁶ Division of Radiology and Nuclear Medicine, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway.
⁷ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Problemveien 7, 0315 Oslo, Norway.

Abstract

Positron emission tomography (PET) imaging with ¹⁸F-fluorodeoxyglucose (FDG) represents a method of detecting and characterizing arterial wall inflammation, with potential applications in the early assessment of vascular disorders such as atherosclerosis. By portraying early-stage molecular changes, FDG-PET findings have previously been shown to correlate with atherosclerosis progression. In addition, recent studies have suggested that microcalcification revealed by ¹⁸F-sodium fluoride (NaF) may be more sensitive at detecting atherogenic changes compared to FDG-PET. In this review, we summarize the roles of FDG and NaF in the assessment of atherosclerosis and discuss the role of global assessment in quantification of the vascular disease burden. Furthermore, we will review the emerging applications of FDG-PET in various vascular disorders, including pulmonary embolism, as well as inflammatory and infectious vascular diseases.

Keywords: 18F-fluorodeoxyglucose; 18F-sodium fluoride; FDG; IgG4-RD; NaF; PET; atherosclerosis; calcification; thrombosis; vasculitis.

Publication types

Review