Contribution of 18F-sodium fluoride PET/CT to the study of the carotid atheroma calcification

Aim To assess the calcification process of the carotid plaque by 18 F-sodium fluoride PET/CT imaging. Material and methods A prospectively designed study including 15 patients in whom an atheroma plaque was detected by contrast enhanced CT scan during a neurological work-up was performed. A total of 29 plaques, 19 asymptomatic and 10 symptomatic, were studied. An 18 F-sodium fluoride PET/CT scan was acquired 180 min after the i.v. injection of 370 MBq of 18 F-sodium fluoride in all the patients. The images obtained were analyzed visually according to the intensity of the uptake. Results All the plaques showed 18 F-sodium fluoride uptake, regardless of the intensity. However, the plaques of the symptomatic group showed a level of 2 or greater intensity while the intensity in 6 of the 19 in the asymptomatic group was lower than 2. Conclusions Although the study is limited by the small number of cases, the results show the feasibility of the technique to study the calcification of the atheroma using 18 F-sodium fluoride and suggest an association between symptomatology and higher uptake of 18 F-sodium fluoride. Thus, these results encourage us to continue this study, with the inclusion of a larger number of patients.