Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2020 Mar:297:127-135.
doi: 10.1016/j.atherosclerosis.2020.02.014. Epub 2020 Feb 17.

18Fluoride-based molecular imaging of coronary atherosclerosis in HIV infected patients

Giovanni Guaraldi  1 , Jovana Milic  2 , Napoleone Prandini  3 , Guido Ligabue  4 , Francesco Esposito  1 , Giacomo Ciusa  1 , Andrea Malagoli  1 , Riccardo Scaglioni  4 , Giulia Besutti  5 , Barbara Beghetto  1 , Giulia Nardini  1 , Enrica Roncaglia  1 , Cristina Mussini  1 , Paolo Raggi  6
Affiliations
Observational Study

18Fluoride-based molecular imaging of coronary atherosclerosis in HIV infected patients

Giovanni Guaraldi et al. Atherosclerosis. 2020 Mar.

Abstract

Background and aims: Molecular imaging with 18Fluorodeoxyglucose (FDG) and 18F-sodium-fluoride (NaF) captures arterial inflammation and micro-calcification and can reveal potentially unstable atherosclerotic plaques.

Methods: We performed FDG and NaF PET/CT imaging in two clinically similar cohorts of patients living with HIV (PLWH) with no symptomatic cardiovascular disease. The prevalence and intensity of coronary artery uptake of each tracer, measured as target-to-background ratio (TBR), were assessed in patients at low and high cardiovascular risk.

Results: Ninety-three PLWH were submitted to PET/CT imaging with FDG (N = 43) and NaF (N = 50); 42% were at low and 58% at high cardiovascular risk. The intensity of uptake and multivessel coronary artery uptake were significantly higher with NaF than FDG both in low and high-risk patients. When each 18F-tracer was tested in low and high-risk patients, an equal proportion of subjects showed no vessel, single and multivessel NaF uptake; the same was true for no and single vessel uptake of FDG (no multivessel FDG uptake was noted). Waist circumference, CRP, D-dimer, HIV duration and treatment with nucleoside reverse transcriptase inhibitors were associated with high NaF uptake in univariable analyses; D-dimer remained significant in multivariable analyses (OR = 1.05; p=0.02). There were no significant associations with FDG uptake.

Conclusions: The prevalence of coronary artery uptake was higher with NaF compared to FDG both in high and low risk patients, hence microcalcification imaging may be a more sensitive tool to detect coronary atherosclerosis than inflammation imaging. However, the uptake of each 18Fluoride tracer was similar between low and high-risk subjects, and this underscores the discordance between clinical and imaging based risk assessment. Future investigation should address the prognostic significance of NaF coronary artery uptake.

Keywords: Coronary atherosclerosis; Fluorodeoxyglucose; Human immunodeficiency virus; Molecular imaging; Sodium fluoride.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declared they do not have anything to disclose regarding conflict of interest with respect to this manuscript.

Publication types