Vascular Positron Emission Tomography and Restenosis in Symptomatic Peripheral Arterial Disease

• Published in: JACC. Cardiovascular imaging 2020-04, Vol.13 (4), p.1008-1017
• Main Authors: Chowdhury, Mohammed M., Tarkin, Jason M., Albaghdadi, Mazen S., Evans, Nicholas R., Le, Elizabeth P.V., Berrett, Thomas B., Sadat, Umar, Joshi, Francis R., Warburton, Elizabeth A., Buscombe, John R., Hayes, Paul D., Dweck, Marc R., Newby, David E., Rudd, James H.F., Coughlin, Patrick A.
• Format: Article
• Language: English
• Subjects: 18F-fluorodeoxyglucose; 18F-sodium fluoride; atherosclerosis; computed tomography; peripheral arterial disease; positron emission tomography; restenosis
• ISSN: 1936-878X; 1876-7591
• DOI: 10.1016/j.jcmg.2019.03.031

This study determined whether in vivo positron emission tomography (PET) of arterial inflammation (18F-fluorodeoxyglucose [18F-FDG]) or microcalcification (18F-sodium fluoride [18F-NaF]) could predict restenosis following PTA. Restenosis following lower limb percutaneous transluminal angioplasty (PTA) is common, unpredictable, and challenging to treat. Currently, it is impossible to predict which patient will suffer from restenosis following angioplasty. In this prospective observational cohort study, 50 patients with symptomatic peripheral arterial disease underwent 18F-FDG and 18F-NaF PET/computed tomography (CT) imaging of the superficial femoral artery before and 6 weeks after angioplasty. The primary outcome was arterial restenosis at 12 months. Forty subjects completed the study protocol with 14 patients (35%) reaching the primary outcome of restenosis. The baseline activities of femoral arterial inflammation (18F-FDG tissue-to-background ratio [TBR] 2.43 [interquartile range (IQR): 2.29 to 2.61] vs. 1.63 [IQR: 1.52 to 1.78]; p