Molecular Coronary Plaque Imaging Using (18)F-Fluoride.
Molecular Coronary Plaque Imaging Using (18)F-Fluoride.
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DOI：
10.1161/circimaging.118.008574
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发表时间：
2019-08
期刊：
影响因子：
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通讯作者：
Adamson PD
中科院分区：
文献类型：
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作者：
Moss AJ;Doris MK;Andrews JPM;Bing R;Daghem M;van Beek EJR;Forsyth L;Shah ASV;Williams MC;Sellers S;Leipsic J;Dweck MR;Parker RA;Newby DE;Adamson PD
补充数字内容可在正文中找到。冠状动脉18F-氟化物正电子发射断层扫描识别破裂和高危动脉粥样硬化斑块。识别、量化和分类冠状动脉18F-氟摄取增加并确定其重复性的最佳方法尚未建立。这项研究旨在优化冠状动脉粥样硬化斑块中18F-氟化物活性增加的识别、量化、分类和扫描重复性。在一项前瞻性观察研究中，对多支冠状动脉疾病患者进行了系列18F-氟化物正电子发射断层扫描。参照最大组织与本底比，对冠状动脉18F-氟化物的活性进行目视评估、量化和分类。在扫描和观察者之间确定了视觉和定量方法的一致性水平。30例患者(男性90%，稳定性冠状动脉疾病20例，近期1型心肌梗死10例)在12±5天内进行了成对的正电子发射断层扫描-冠状动脉CT血管成像。近期急性冠脉综合征患者平均每例18F-氟斑块阳性斑块数为3.7±1.8个，而稳定性冠脉疾病患者平均为2.4±2.3个。在观察者之间(平均差异，−0.01；95%的一致性限，−0.32至0.30)或扫描之间(平均差异0.06，95%的一致性限，−0.49至0.61)，在视觉阳性斑块的最大组织与背景比测量中的一致性偏差较低。仅用目测评估对局灶性18F-氟化物摄取的分类有很好的一致性(κ=0.66)，并且在较高的最大组织与背景比值时进一步改善。冠状动脉~(18)F-氟活度是冠状动脉血管系统的一项精确和可重复性的指标。18F-氟化物的分析性能足以评估这种放射性示踪剂作为斑块易损性的非侵入性成像生物标志物的预后效用。网址：http://www.clinicaltrials.gov.唯一标识：NCT02110303和NCT02278211。
Supplemental Digital Content is available in the text. Coronary 18F-fluoride positron emission tomography identifies ruptured and high-risk atherosclerotic plaque. The optimal method to identify, to quantify, and to categorize increased coronary 18F-fluoride uptake and determine its reproducibility has yet to be established. This study aimed to optimize the identification, quantification, categorization, and scan-rescan reproducibility of increased 18F-fluoride activity in coronary atherosclerotic plaque. In a prospective observational study, patients with multi-vessel coronary artery disease underwent serial 18F-fluoride positron emission tomography. Coronary 18F-fluoride activity was visually assessed, quantified, and categorized with reference to maximal tissue to background ratios. Levels of agreement for both visual and quantitative methods were determined between scans and observers. Thirty patients (90% male, 20 patients with stable coronary artery disease, and 10 with recent type 1 myocardial infarction) underwent paired serial positron emission tomography-coronary computed tomography angiography imaging within an interval of 12±5 days. A mean of 3.7±1.8 18F-fluoride positive plaques per patient was identified after recent acute coronary syndrome, compared with 2.4±2.3 positive plaques per patient in stable coronary artery disease. The bias in agreement in maximum tissue to background ratio measurements in visually positive plaques was low between observers (mean difference, −0.01; 95% limits of agreement, −0.32 to 0.30) or between scans (mean difference, 0.06; 95% limits of agreement, −0.49 to 0.61). Good agreement in the categorization of focal 18F-fluoride uptake was achieved using visual assessment alone (κ=0.66) and further improved at higher maximum tissue to background ratio values. Coronary 18F-fluoride activity is a precise and reproducible metric in the coronary vasculature. The analytical performance of 18F-fluoride is sufficient to assess the prognostic utility of this radiotracer as a noninvasive imaging biomarker of plaque vulnerability. URL: http://www.clinicaltrials.gov. Unique identifiers: NCT02110303 and NCT02278211.