F-18 Sodium Fluoride PET Identifies Vulnerable Atherosclerotic Plaque

Background: Rupture of coronary artery plaques leading to acute thrombosis causes myocardial infarction and sudden death. Most plaque ruptures occur at sites of nonobstructive stenosis, prompting interest in identifying high-risk coronary artery lesions using markers other than degree of stenosis. Association of inflammation, and macrophage burden in particular, with plaque rupture has led to the use of 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) to identify high-risk lesions in several studies. Objective: To determine whether 18 F-sodium fluoride (NaF) PET/CT, in comparison with 18 F-FDG PET/CT, can identify ruptured and high-risk atherosclerotic plaques in patients with symptomatic coronary or carotid artery disease. Design/Participants: This prospective clinical trial included 40 patients with acute myocardial infarction (MI) and 40 with stable angina who underwent invasive coronary angiography, and 12 patients who underwent carotid endarterectomy. Methods: Pa more...