F-18-sodium fluoride positron emission tomography assessed microcalcifications in culprit and non-culprit human carotid plaques

Hop, H., de Boer, S. A., Reijrink, M., Kamphuisen, P. W., de Borst, M. H., Pol, R. A., Zeebregts, C. J., Hillebrands, J. L., Slart, R. H. J. A., Boersma, H. H., Doorduin, J. & Mulder, D. J., Aug-2019, In : Journal of Nuclear Cardiology. 26, 4, p. 1064-1075 12 p.

Research output: Contribution to journalArticleAcademicpeer-review

BACKGROUND: 18F-NaF positron emission tomography (PET) targets microcalcifications. We compared in vitro microPET assessed 18F-NaF uptake between culprit and non-culprit human carotid plaques. Furthermore, we compared 18F-NaF uptake with calcification visualized on microcomputed tomography (microCT).

METHODS: Carotid plaques from stroke patients undergoing surgery were incubated in 18F-NaF and scanned using a microPET and a microCT scan. The average PET assessed 18F-NaF uptake was expressed as percentage of the incubation dose per gram (%Inc/g). 18F-NaF PET volume of interest (VOI) was compared with CT calcification VOI.

RESULTS: 23 carotid plaques (17 culprit, 6 non-culprit) were included. The average 18F-NaF uptake in culprit carotid plaques was comparable with the uptake in non-culprit carotid plaques (median 2.32 %Inc/g [IQR 1.98 to 2.81] vs. median 2.35 %Inc/g [IQR 1.77 to 3.00], P = 0.916). Only a median of 10% (IQR 4 to 25) of CT calcification VOI showed increased 18F-NaF uptake, while merely a median of 35% (IQR 6 to 42) of 18F-NaF PET VOI showed calcification on CT.

CONCLUSIONS: 18F-NaF PET represents a different stage in the calcification process than CT. We observed a similar PET assessed 18F-NaF uptake and pattern in culprit and non-culprit plaques of high-risk patients, indicating that this method may be of more value in early atherosclerotic stenosis development.

Original languageEnglish
Pages (from-to)1064-1075
Number of pages12
JournalJournal of Nuclear Cardiology
Issue number4
Early online date25-Jun-2018
Publication statusPublished - Aug-2019


  • F-18-sodium fluoride (F-18-NaF), Calcification, PET/CT imaging, Vulnerable atherosclerotic plaque, Carotid artery stenosis, ATHEROSCLEROTIC PLAQUE, VASCULAR CALCIFICATION, ENDARTERECTOMY, MARKER, PET/CT, FEASIBILITY, PROGRESSION, DENSITY, CALCIUM, IMPACT
Related Prizes
  1. Frans J Th Wackers Award for Best Clinical Paper

    Hilde Hop (Recipient), Stefanie Boer, de (Recipient), Reijrink, Melanie (Recipient), Kamphuisen, Pieter Willem (Recipient), Borst, de, Martin (Recipient), Pol, Robert (Recipient), Zeebregts, Clark (Recipient), Hillebrands, Jan Luuk (Recipient), Slart, Riemer (Recipient), Boersma, Hendrikus (Recipient), Doorduin, Janine (Recipient) & Mulder, Udo (Recipient), 2020


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