NaF-PET/CT promising marker for disease severity and future risk in acute aortic syndrome patients: Study
UK: PET-CT with F-18 sodium fluoride (NaF) is a promising noninvasive marker of disease severity and future risk in patients with acute aortic syndrome, suggests a recent study in the journal JACC: Cardiovascular Imaging. The study showed 18F-NaF uptake was enhanced at sites of disease activity and was linked with aortic growth and clinical events.
Acute aortic syndrome is linked with aortic medial degeneration. 18F-NaF PET can help in detecting microscopic tissue calcification as a marker of disease activity. Considering this, Maaz B.J.Syed, University of Edinburgh, Edinburgh, United Kingdom, and colleagues aimed to establish whether 18F-NaF positron emission tomography (PET) combined with computed tomography (CT) angiography could help in the identification of aortic medial disease activity in acute aortic syndrome patients.
For this purpose, the patients with aortic dissection or intramural hematomas and control subjects underwent 18F-NaF PET and CT angiography of the aorta. The measurement of aortic 18F-NaF uptake was done at the most diseased segment, and the maximum value was corrected for background blood pool activity (maximum tissue-to-background ratio [TBRmax]). The researchers then compared the uptake with the change in aortic size and major adverse aortic events (aortic rupture, aorta-related death, or aortic repair) over 45 ± 13 months.
Key findings include:
- Aortic 18F-NaF uptake co-localized with histologically defined regions of microcalcification and elastin disruption.
- Compared with control subjects, patients with acute aortic syndrome had increased 18F-NaF uptake (TBRmax: 1.36 ± 0.39 [n = 20] vs 2.02 ± 0.42 [n = 47] respectively) with enhanced uptake at the site of intimal disruption (+27.5%).
- 18F-NaF uptake in the false lumen was associated with aortic growth (+7.1 mm/year), and uptake in the outer aortic wall was associated with major adverse aortic events (HR: 8.5).
"18F-NaF uptake was enhanced at sites of disease activity in patients with acute aortic syndrome and was associated with aortic growth and clinical events," wrote the authors. "18F-NaF PET-CT holds promise as a noninvasive marker of disease severity and future risk in patients with acute aortic syndrome."
Reference:
The study titled, "18F-Sodium Fluoride Positron Emission Tomography and Computed Tomography in Acute Aortic Syndrome," was published in the journal JACC: Cardiovascular Imaging.
DOI: https://doi.org/10.1016/j.jcmg.2022.01.003
KEYWORDS: JACC, acute aortic syndrome, PET, CT, sodium fluoride, imaging, aortic wall, Maaz B J Syed, computed tomography, positron emission tomography, cardiovascular imaging, aorta
