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    Identifying active vascular micro‐calcification by 18F‐sodium fluoride positron emission tomography

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    Publication date
    2015-07
    Author
    Vesey, A.T.
    Irkle, A.
    Skepper, J.N.
    Bird, Joseph
    Dweck, M.R.
    Joshi, F.J.
    Gallagher, F.A.
    Warburton, E.A.
    Bennett, M.R.
    Brindle, K.M.
    Newby, D.E.
    Rudd, J.H.
    Davenport, A.P.
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    Keyword
    Vascular; Micro-calcification; 18F-sodium fluoride
    Peer-Reviewed
    No
    
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    Abstract
    Background: Vascular calcification is an active cell-mediated process that is a hallmark of atherosclerosis. Whilst macro-calcification confers stability to plaque, micro-calcification is a key feature of high-risk atheroma associated with major adverse cardiovascular events. Positron emission tomography combined with computed tomography (PET/CT) imaging of atherosclerosis using 18F-sodium fluoride (18F-NaF) has the potential to identify active micro-calcification and thus high-risk plaque. The precise molecular mechanism of 18F-NaF binding has however not been validated. The aim of this study was to provide a comprehensive model describing the binding characteristics, pharmacodynamics and pharmacokinetics of 18F-NaF. Methods: Patients undergoing carotid endarterectomy were studied. 18F-NaF binding was analysed using a combination of electron microscopy, autoradiography, gamma scintigraphy, histology and immunohistochemistry, pre-clinical microPET/microCT and dynamic clinical PET/CT. Results: 18F-NaF was shown to bind to calcium within plaque with high affinity. Binding was selective and specific. 18F-NaF PET was able to identify on-going nascent micro-calcification far beyond the resolution of clinical and pre-clinical CT systems. Furthermore, 18F-NaF was able to distinguish between areas of macro and micro-calcification. Conclusions: 18F-NaF PET/CT is the only currently available clinical imaging platform that can detect micro-calcification in active unstable atherosclerosis. The use of 18F-NaF will foster new approaches to developing treatments targeting unstable plaque and vascular calcification.
    URI
    http://hdl.handle.net/10454/10332
    Version
    No full-text in the repository
    Citation
    Vesey AT, Irkle A, Lewis DY et al (2015) Identifying active vascular microcalcification by 18F-sodium fluoride positron emission tomography. Atherosclerosis. 241(1): e14.
    Link to publisher’s version
    http://dx.doi.org/10.1016/j.atherosclerosis.2015.04.066
    Type
    Other
    Collections
    Life Sciences Publications

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