Arterial wall uptake of fluorodeoxyglucose on PET imaging in stable cancer disease patients indicates higher risk for cardiovascular events

Abstract

Background: We aimed to evaluate the additional information of 18 fluorodeoxyglucose (FDG) arterial uptake with respect to other conventional cardiovascular risk factors and arterial calcifications in patients with stable cancer.

Methods and results: We compared the rate of cardiovascular events in 2 groups of patients with (n = 45) and without (n = 56) enhanced arterial 18FDG uptake, matched for the main clinical parameters. The extent and intensity of 18FDG uptake were quantified. A calcification index was also determined. About one third of the selected patients had a history of cardiovascular events and thus could be defined as "vulnerable patients." Old cardiovascular events (>6 months before or after positron emission tomography [PET]) and recent cardiovascular events (<6 months before or after PET) were significantly more frequent in the high-FDG uptake group than in the low-FDG uptake group (48% vs 15%, respectively [P = .0006], and 30% vs 1.8%, respectively [P = .0002]). The extent of 18FDG arterial uptake was the unique factor significantly related to the occurrence of a recent event by either logistic regression or discriminant analysis (P = .004 for all). Conversely, calcium index was the single factor related to old events (P = .004 and P = .002, respectively).

Conclusions: Extensive arterial 18FDG uptake might be an indicator of an evolving atherosclerotic process and should be mentioned in PET/computed tomography reports.