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Carotid Artery FDG Uptake May Serve as a Biomarker for Cardiovascular Risk Stratification in Asymptomatic Adults

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Abstract

Purpose

We investigated the relation between carotid artery FDG uptake and cardiovascular risk based on the Framingham risk score (FRS) and evaluated the possible role of FDG uptake in terms of risk stratification of asymptomatic adults.

Methods

We evaluated 290 adults who underwent FDG PET/CT as part of general health screens. We calculated target-to-background ratios, corrected for pre-scan blood glucose levels, and obtained “TBRglu” values for both common carotid arteries. The FRS and the presence/absence of metabolic syndrome were recorded for each subject. Relationships among TBRglu values, metabolic syndrome status, and clinical parameters were assessed.

Results

Carotid artery FDG uptake was significantly associated with clinical risk factors. Stepwise multiple regression analysis revealed that triglyceride levels, diabetes, and metabolic syndrome were independent determinants of high TBRglu. Of subjects with metabolic syndrome, those exhibiting high carotid artery FDG uptake had significantly higher levels of high sensitivity C-reactive protein (hsCRP). In subjects who did not have metabolic syndrome, FRSs were significantly elevated in those exhibiting high carotid artery FDG uptake compared to those with low uptake (13.1 ± 7.0 vs. 8.2 ± 7.4), as was also true of subjects with the syndrome (21.8 ± 16.0 vs. 13.5 ± 11.9).

Conclusion

High carotid FDG uptake is significantly associated with clinical risk factors and a greater FRS. Of subjects with metabolic syndrome, those with high carotid uptake had significantly higher hsCRP concentrations and FRSs. Therefore, carotid artery FDG activity may serve as a possible biomarker allowing cardiovascular risk stratification of asymptomatic populations.

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References

  1. Berger JS, Jordan CO, Lloyd-Jones D, Blumenthal RS. Screening for cardiovascular risk in asymptomatic patients. J Am Coll Cardiol. 2010;55:1169–77.

    Article  PubMed  Google Scholar 

  2. Lee SJ, On YK, Lee EJ, Choi JY, Kim BT, Lee KH. Reversal of vascular 18 F-FDG uptake with plasma high-density lipoprotein elevation by atherogenic risk reduction. J Nucl Med. 2008;49:1277–82.

    Article  CAS  PubMed  Google Scholar 

  3. Oh M, Kim JY, Shin KH, Park SH, Ryu JS, Kim JS, et al. Imaging atherosclerosis in the carotid arteries with F-18-fluoro-2-deoxy-D-glucose positron emission tomography: effect of imaging time after injection on quantitative measurement. Nucl Med Mol Imaging. 2010;44:261–6.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Bucerius J, Duivenvoorden R, Mani V, Moncrieff C, Rudd JH, Calcagno C, et al. Prevalence and risk factors of carotid vessel wall inflammation in coronary artery disease patients: FDG-PET and CT imaging study. J Am Coll Cardiol Img. 2011;4:1195–205.

    Article  Google Scholar 

  5. Yoo HJ, Kim S, Park MS, Yang SJ, Kim TN, Seo JA, et al. Vascular inflammation stratified by C-reactive protein and low-density lipoprotein cholesterol levels: analysis with 18 F-FDG PET. J Nucl Med. 2011;52:10–7.

    Article  CAS  PubMed  Google Scholar 

  6. Wu YW, Kao HL, Huang CL, Chen MF, Lin LY, Wang YC, et al. The effects of 3-month atorvastatin therapy on arterial inflammation, calcification, abdominal adipose tissue and circulating biomarkers. Eur J Nucl Med Mol Imaging. 2012;39:399–407.

    Article  CAS  PubMed  Google Scholar 

  7. Cocker MS, Mc Ardle B, Spence JD, Lum C, Hammond RR, Ongaro DC, et al. Imaging atherosclerosis with hybrid [(18) F] fluorodeoxyglucose positron emission tomography/computed tomography imaging: what Leonardo da Vinci could not see. J Nucl Cardiol. 2012;19:1211–25.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Kaneko K, Kawasaki T, Masunari S, Yoshida T, Omagari J. Determinants of extraaortic arterial 18 F-FDG accumulation in asymptomatic cohorts: sex differences in the association with cardiovascular risk factors and coronary artery stenosis. J Nucl Med. 2013;54:564–70.

    Article  CAS  PubMed  Google Scholar 

  9. Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med. 2005;352:1685–95.

    Article  CAS  PubMed  Google Scholar 

  10. Rudd JH, Warburton EA, Fryer TD, Jones HA, Clark JC, Antoun N, et al. Imaging atherosclerotic plaque inflammation with [18 F]-fluorodeoxyglucose positron emission tomography. Circulation. 2002;105:2708–11.

    Article  CAS  PubMed  Google Scholar 

  11. Tawakol A, Migrino RQ, Bashian GG, Bedri S, Vermylen D, Cury RC, et al. In vivo 18 F-fluorodeoxyglucose positron emission tomography imaging provides a noninvasive measure of carotid plaque inflammation in patients. J Am Coll Cardiol. 2006;48:1818–24.

    Article  PubMed  Google Scholar 

  12. Tahara N, Kai H, Ishibashi M, Nakaura H, Kaida H, Baba K, et al. Simvastatin attenuates plaque inflammation: evaluation by fluorodeoxyglucose positron emission tomography. J Am Coll Cardiol. 2006;48:1825–31.

    Article  CAS  PubMed  Google Scholar 

  13. Dekker JM, Girman C, Rhodes T, Nijpels G, Stehouwer CD, Bouter LM, et al. Metabolic syndrome and 10-year cardiovascular disease risk in the Hoorn Study. Circulation. 2005;112:666–73.

    Article  PubMed  Google Scholar 

  14. Ford ES, Li C, Zhao G. Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. J Diabetes. 2010;2:180–93.

    Article  PubMed  Google Scholar 

  15. Wilson PW, D’Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation. 2005;112:3066–72.

    Article  CAS  PubMed  Google Scholar 

  16. Tahara N, Kai H, Yamagishi S, Mizoguchi M, Nakaura H, Ishibashi M, et al. Vascular inflammation evaluated by [18 F]-fluorodeoxyglucose positron emission tomography is associated with the metabolic syndrome. J Am Coll Cardiol. 2007;49:1533–9.

    Article  CAS  PubMed  Google Scholar 

  17. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American heart association/national heart, lung, and blood institute scientific statement. Circulation. 2005;112:2735–52.

    Article  PubMed  Google Scholar 

  18. D’Agostino Sr RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al. General cardiovascular risk profile for use in primary care: the Framingham heart study. Circulation. 2008;117:743–53.

    Article  PubMed  Google Scholar 

  19. Boellaard R, O’Doherty MJ, Weber WA, Mottaghy FM, Lonsdale MN, Stroobants SG, et al. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0. Eur J Nucl Med Mol Imaging. 2010;37:181–200.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Bucerius J, Mani V, Moncrieff C, Rudd JH, Machac J, Fuster V, et al. Impact of noninsulin-dependent type 2 diabetes on carotid wall 18 F-fluorodeoxyglucose positron emission tomography uptake. J Am Coll Cardiol. 2012;59:2080–8.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Wahl RL, Henry CA, Ethier SP. Serum glucose: effects on tumor and normal tissue accumulation of 2-[F-18]-fluoro-2-deoxy-D-glucose in rodents with mammary carcinoma. Radiology. 1992;183:643–7.

    Article  CAS  PubMed  Google Scholar 

  22. Shepherd PR, Kahn BB. Glucose transporters and insulin action–implications for insulin resistance and diabetes mellitus. N Engl J Med. 1999;341:248–57.

    Article  CAS  PubMed  Google Scholar 

  23. Yun M, Jang S, Cucchiara A, Newberg AB, Alavi A. 18 F FDG uptake in the large arteries: a correlation study with the atherogenic risk factors. Semin Nucl Med. 2002;32:70–6.

    Article  PubMed  Google Scholar 

  24. Kim TN, Kim S, Yang SJ, Yoo HJ, Seo JA, Kim SG, et al. Vascular inflammation in patients with impaired glucose tolerance and type 2 diabetes: analysis with 18 F-fluorodeoxyglucose positron emission tomography. Circ Cardiovasc Imaging. 2010;3:142–8.

    Article  PubMed  Google Scholar 

  25. Hashimoto H, Kitagawa K, Hougaku H, Shimizu Y, Sakaguchi M, Nagai Y, et al. C-reactive protein is an independent predictor of the rate of increase in early carotid atherosclerosis. Circulation. 2001;104:63–7.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgment

This study was supported by the New Faculty Research Fund provided by Ajou University School of Medicine

Conflict of Interest

Dong Hyun Lee, Su Jin Lee, Duck-Joo Lee, Soo Hyun Kwon, Kyung-Sook Jo, Young-Sil An, and Joon-Kee Yoon declare that they have no conflict of interest.

Ethical Statement

This study was approved by the ethics committee in our hospital and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons enrolled gave their informed consent prior to their inclusion in the study.

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Correspondence to Su Jin Lee.

Additional information

This study was supported by the New Faculty Research Fund provided by Ajou University School of Medicine.

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Lee, D.H., Lee, S.J., Lee, DJ. et al. Carotid Artery FDG Uptake May Serve as a Biomarker for Cardiovascular Risk Stratification in Asymptomatic Adults. Nucl Med Mol Imaging 48, 196–202 (2014). https://doi.org/10.1007/s13139-014-0277-1

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  • DOI: https://doi.org/10.1007/s13139-014-0277-1

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