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Observational Study
. 2019 Nov;46(12):2488-2495.
doi: 10.1007/s00259-019-04454-w. Epub 2019 Aug 5.

Association of aortic vascular uptake of 18FDG by PET/CT and aortic wall thickness by MRI in psoriasis: a prospective observational study

Jacob W Groenendyk  1 , Parag Shukla  1 , Amit K Dey  1 , Youssef A Elnabawi  1 , Milena Aksentijevich  1 , Harry Choi  1 , Leonard D Genovese  1 , Charlotte L Harrington  1 , Balaji Natarajan  1 , Aditya Goyal  1 , Aarthi S Reddy  1 , Justin Rodante  1 , Mohammad Tarek Kabbany  1 , Ahmed Sadek  1 , Mina Al Najafi  1 , Martin P Playford  1 , Aditya A Joshi  1 , Mark A Ahlman  2 , Joel M Gelfand  3 , David A Bluemke  4 , Nehal N Mehta  5
Affiliations
Observational Study

Association of aortic vascular uptake of 18FDG by PET/CT and aortic wall thickness by MRI in psoriasis: a prospective observational study

Jacob W Groenendyk et al. Eur J Nucl Med Mol Imaging. 2019 Nov.

Abstract

Background: The contribution of inflammation to the incidence of cardiovascular disease (CVD) has been increasingly recognized in recent years. We investigated the relationship of aortic vascular uptake of 18F-FDG by PET/CT and aortic wall thickness (AWT) by MRI in psoriasis, a chronic inflammatory disease with increased incidence of CVD. One hundred sixty-five patients with plaque psoriasis participated in an ongoing longitudinal cohort study. Subclinical atherosclerosis was assessed as aortic uptake of 18F-FDG by PET/CT reported as target-to-background ratio (TBR) and AWT by MRI reported as maximal thickness.

Results: Patients with psoriasis were middle aged, predominantly male, and had mild CV risk by traditional risk factors. Psoriasis severity as measured by PASI score was a notable determinant of AWT (ρ = 0.20, p = 0.01). Moreover, aortic vascular uptake of 18F-FDG associated with AWT by MRI at baseline in unadjusted analysis (β = 0.27 p = 0.001) and following adjustment for traditional cardiovascular risk factors, waist-to-hip ratio, and statin use (β = 0.21 p = 0.01). Finally, following 1 year of psoriasis treatment, a decrease in aortic vascular uptake of 18F-FDG was associated with a reduction in AWT in fully adjusted models (β = 0.33, p = 0.02).

Conclusion: In conclusion, we demonstrate that psoriasis severity and aortic vascular uptake of 18F-FDG in the aorta were associated with AWT. Following treatment of psoriasis, a decrease in aortic vascular uptake of 18F-FDG was associated with a reduction in AWT at 1 year. These findings suggest that aortic vascular uptake of 18F-FDG is associated with early evidence of vascular disease assessed by aortic wall thickness. Prospective studies in larger populations including other inflammatory diseases are warranted.

Keywords: 18FDG PET/CT; Atherosclerosis; Inflammation; Psoriasis; Thoracic MRI.

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Conflict of interest statement

Competing interests

  1. NNM is a full-time US government employee and has served as a consultant for Amgen, Eli Lilly, and Leo Pharma receiving grants/other payments; as a principal investigator and/or investigator for AbbVie, Celgene, Janssen Pharmaceuticals, Inc, and Novartis receiving grants and/or research funding and as a principal investigator for the National Institute of Health receiving grants and/or research funding.

  2. JMG was supported by an NIAMS grant (K24-AR-064310); Dr. Gelfand served as a consultant for BMS, Boehringer Ingelheim, GSK, Janssen Biologics, Menlo Therapeutics, Novartis Corp, Regeneron, Dr Reddy’s labs, UCB (DSMB), Sanofi and Pfizer Inc., receiving honoraria; and receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Janssen, Novartis Corp, Sanofi, Celgene, Ortho Dermatologics, and Pfizer Inc.; and received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly and Ortho Dermatologics.

  3. JWG is funded by the NIH Medical Research Scholars Program, a public-private partnership supported jointly by the NIH and generous contributions to the Foundation for the NIH from the Doris Duke Charitable Foundation (DDCF Grant # 2014194), Genentech, Elsevier, and other private donors.

  4. All other authors have no conflict of interest.

Figures

Figure 1:
Figure 1:
Aortic wall thickness in mild and moderate-to-severe psoriasis patients. Legend: Transverse sections of a patient with mild psoriasis (A) at the level of descending aorta depicting lower aortic wall thickness when compared to moderate-to-severe psoriasis patient (B). The green and the red contour represent the outer and the inner border of the aortic wall respectively; QPlaque (Medis, Leiden, The Netherlands).
See this image and copyright information in PMC

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