<p><sup>18</sup>Fluorine-Sodium Fluoride Positron Emission Tomography (<sup>18</sup>F-NaF PET) allows for the detection of arterial micro-calcification, but its data on people with chronic kidney disease (CKD) is limited. This pilot study aimed to determine the optimal time to perform <sup>18</sup>F-NaF PET static scan and to characterize arterial macro- and micro-calcification in CKD. In 7 patients with CKD stages 3b-4 and 3 non-CKD individuals, following the injection of <sup>18</sup>F-NaF, an electrocardiogram-gated chest CT, a 30-min dynamic PET, and three 10-min static PET were acquired. Radiopharmaceutical uptake was quantified for regions including the lumbar spine and 4 aortic segments. Arterial macro-calcification was quantified using Agatston scoring and micro-calcification using tissue-to-background ratio (TBR; reference: right atrium). The standardized uptake value (SUV) in lumbar spine reached a steady state ~ 60&#xa0;min after injection and was comparable at each time point between CKD and non-CKD (p: 0.58–0.92). Among CKD participants, 6 had macro-calcification in coronary arteries. Abdominal aorta had the greatest macro-calcification, and ascending aorta had the lowest TBR<sub>peak</sub>. In the ascending aorta, macro-calcification negatively correlated with TBR<sub>peak</sub> (rho = −&#xa0;0.86, p = 0.01). In descending thoracic aorta, TBR<sub>peak</sub> negatively correlated with serum calcium (rho = −&#xa0;0.81, p = 0.03), and positively correlated with parathyroid hormone (rho = 0.93, p = 0.003) and thrombomodulin (rho = 0.79, p = 0.04). The optimal time for <sup>18</sup>F-NaF PET static scan is ~ 60 min for people with and without CKD. Evaluation of macro- and micro-calcification in aorta revealed preliminary spatial patterns and their associated serum markers. Our findings help to establish technical specifications for image acquisition and analyses of <sup>18</sup>F-NaF PET/CT in CKD.</p>

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18Fluorine-sodium fluoride positron emission tomography to evaluate arterial calcification in patients with chronic kidney disease: a pilot study

  • Aspan M. Shokrekhuda,
  • Rylen Stratford,
  • Wenzhu Mowrey,
  • Na Song,
  • Kexin Zhang,
  • Sara Saini,
  • Mario T. Di Dea,
  • Gabriel Duah,
  • Zahra Karimi,
  • Nicholas E. S. Sibinga,
  • Yonatan Schwartz,
  • Jeffrey M. Levsky,
  • Marc R. Dweck,
  • Renee Moadel,
  • Lionel S. Zuckier,
  • Mark I. Travin,
  • Wei Chen

摘要

18Fluorine-Sodium Fluoride Positron Emission Tomography (18F-NaF PET) allows for the detection of arterial micro-calcification, but its data on people with chronic kidney disease (CKD) is limited. This pilot study aimed to determine the optimal time to perform 18F-NaF PET static scan and to characterize arterial macro- and micro-calcification in CKD. In 7 patients with CKD stages 3b-4 and 3 non-CKD individuals, following the injection of 18F-NaF, an electrocardiogram-gated chest CT, a 30-min dynamic PET, and three 10-min static PET were acquired. Radiopharmaceutical uptake was quantified for regions including the lumbar spine and 4 aortic segments. Arterial macro-calcification was quantified using Agatston scoring and micro-calcification using tissue-to-background ratio (TBR; reference: right atrium). The standardized uptake value (SUV) in lumbar spine reached a steady state ~ 60 min after injection and was comparable at each time point between CKD and non-CKD (p: 0.58–0.92). Among CKD participants, 6 had macro-calcification in coronary arteries. Abdominal aorta had the greatest macro-calcification, and ascending aorta had the lowest TBRpeak. In the ascending aorta, macro-calcification negatively correlated with TBRpeak (rho = − 0.86, p = 0.01). In descending thoracic aorta, TBRpeak negatively correlated with serum calcium (rho = − 0.81, p = 0.03), and positively correlated with parathyroid hormone (rho = 0.93, p = 0.003) and thrombomodulin (rho = 0.79, p = 0.04). The optimal time for 18F-NaF PET static scan is ~ 60 min for people with and without CKD. Evaluation of macro- and micro-calcification in aorta revealed preliminary spatial patterns and their associated serum markers. Our findings help to establish technical specifications for image acquisition and analyses of 18F-NaF PET/CT in CKD.