18F-sodium fluoride positron emission tomography following coronary computed tomography angiography in predicting long-term coronary events: a 5-year follow-up study
18F-sodium fluoride positron emission tomography following coronary computed tomography angiography in predicting long-term coronary events: a 5-year follow-up study
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冠状动脉计算机断层扫描血管造影后的 18F-氟化钠正电子发射断层扫描预测长期冠状动脉事件：一项 5 年随访研究
DOI：
10.1007/s12350-023-03277-5
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发表时间：
2023
影响因子：
2.4
通讯作者：
Yukiko Nakano.
中科院分区：
文献类型：
--
作者：
Toshiro Kitagawa;Ko Sasaki;Yuto Fujii;Yuki Ikegami;Fuminari Tatsugami;Kazuo Awai;Yutaka Hirokawa;Yukiko Nakano.
目的 18 F-氟化钠（ 18 F-NaF）正电子发射断层扫描（PET）与冠状动脉计算机断层扫描（CT）血管造影（CCTA）相结合对未来冠状动脉事件的预测价值引起了人们的兴趣。我们评估了CCTA后18F-NaF PET/CT在5年随访期间预测主要冠状动脉事件(MACE)的潜力。方法对40例CCTA检测到的冠状动脉粥样硬化病变患者进行18F-NaF PET/CT检查。评估每个病变的管腔狭窄和高风险斑块（HRP），CCTA 重塑指数≥30 Hounsfield 单位和≥1.1 重塑指数。使用最大组织与背景比(TBRmax)对每个病变中的局部18F-NaF摄取进行量化，并确定每个患者的最大TBRmax(M-TBRmax)。我们对 MACE（心源性死亡、急性冠状动脉综合征和/或 18F-NaF PET/CT 后 6 个月的冠状动脉血运重建）进行了 5 年的随访。 结果总共分析了 142 个冠状动脉病变。 11 名患者经历过任何 MACE。患有MACE的患者表现出比没有MACE的患者更高的M-TBRmax（1.40±0.19 vs. 1.18±0.18，P= .0011），预测MACE的最佳M-TBRmax截止值为1.29。 M-TBRmax ≥1.29 的患者比那些较低值的患者发生 MACE 的风险更高（P= .012，对数秩检验），而阻塞性狭窄患者和 HRP 患者则不然。调整年龄、性别、冠状动脉危险因素和 CCTA 结果的多变量 Cox 比例分析显示，M-TBRmaxof ≥ 1.29 仍然是 5 年 MACE 的独立预测因子（风险比，5.4；95% 置信区间，1.1–25.4；P= .034）。结论 CCTA 后的 18F-NaF PET/CT 为预测 5 年 MACE 提供了有用的策略。
PurposeThe predictive value of18F-sodium fluoride (18F-NaF) positron emission tomography (PET) in combination with coronary computed tomography (CT) angiography (CCTA) for future coronary events has attracted interest. We evaluated the potential of18F-NaF PET/CT following CCTA to predict major coronary events (MACE) during a 5-year follow-up period.MethodsForty patients with coronary atherosclerotic lesions detected on CCTA underwent18F-NaF PET/CT examination. Each lesion was evaluated for luminal stenosis and high-risk plaque (HRP) with < 30 Hounsfield units and a > 1.1 remodeling index on CCTA. Focal18F-NaF uptake in each lesion was quantified using the maximum tissue-to-background ratio (TBRmax), and the maximum TBRmaxper patient (M-TBRmax) was determined. We followed MACE (cardiac death, acute coronary syndrome, and/or coronary revascularization > 6 months after18F-NaF PET/CT) for 5 years.ResultsIn total, 142 coronary lesions were analyzed. Eleven patients experienced any MACE. Patients with MACE showed a higher M-TBRmaxthan those without (1.40 ± .19 vs. 1.18 ± .18,P= .0011), and the optimal M-TBRmaxcutoff to predict MACE was 1.29. Patients with M-TBRmaxof ≥ 1.29 had a higher risk of MACE than those with lower values (P= .012, log-rank test), whereas patients with obstructive stenosis and those with HRP did not. Multivariate Cox proportional analysis adjusted for age, sex, coronary risk factors, and CCTA findings showed that M-TBRmaxof ≥ 1.29 remained an independent predictor of 5-year MACE (hazard ratio, 5.4; 95% confidence interval, 1.1–25.4;P= .034).Conclusion18F-NaF PET/CT following CCTA provides useful strategies to predict 5-year MACE.