PURPOSE 18F-Sodium fluoride (18F-NaF) positron emission tomography (PET) has the potential to detect high-risk coronary plaques. Epicardial adipose tissue (EAT) reportedly correlates with coronary atherosclerosis progression. We evaluated the relationship between coronary arterial 18F-NaF uptake and EAT findings using computed tomography (CT). METHODS We studied 40 patients with ≥ 1 coronary plaque detected on cardiac CT who underwent 18F-NaF PET/CT. EAT volume was measured using CT and indexed to body surface area in each patient. Each plaque was evaluated for CT-based luminal stenosis and high-risk features. The mean EAT density surrounding each plaque was calculated as perilesional EAT density (PLED) using non-contrast CT images. Focal 18F-NaF uptake in each plaque was quantified using the maximum tissue-to-background ratio (TBRmax). RESULTS EAT volume index was similar between patients with TBRmax ≥ 1.28 (previously reported optimal cutoff to predict coronary events) and those with lower TBRmax, but patients with TBRmax ≥ 1.28 showed higher maximum PLED per patient (- 86 ± 12 Hounsfield units (HU) versus - 98 ± 11 HU, P = 0.0044). In the lesion-based analysis (n = 92), PLED was positively correlated with TBRmax, and the optimal PLED cutoff to identify TBRmax ≥ 1.28 was - 97 HU. On multivariate analysis adjusted for lesion location, obstructive stenosis, and high-risk plaque on CT, PLED ≥ - 97 HU remained a significant predictor of TBRmax ≥ 1.28. CONCLUSIONS Increased PLED was associated with significant coronary arterial 18F-NaF uptake. Step-by-step analyses of EAT density on CT and coronary arterial 18F-NaF uptake on PET may offer novel strategies for risk prediction in coronary artery disease.

中文翻译：

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使用计算机断层扫描分析冠状动脉18F-氟化钠摄入量与心外膜脂肪组织之间的关系。

目的18F-氟化钠（18F-NaF）正电子发射断层扫描（PET）具有检测高危冠状动脉斑块的潜力。心外膜脂肪组织（EAT）与冠状动脉粥样硬化进展相关。我们使用计算机断层扫描（CT）评估了冠状动脉18F-NaF摄取与EAT结果之间的关系。方法我们研究了40例接受18F-NaF PET / CT的心脏CT冠状动脉斑块≥1例的患者。使用CT测量EAT体积，并以每位患者的体表面积为指标。对每个斑块进行了基于CT的管腔狭窄和高风险特征评估。使用非对比CT图像，将每个斑块周围的平均EAT密度计算为病灶围EAT密度（PLED）。使用最大组织与背景之比（TBRmax）量化每个斑块中的局灶性18F-NaF摄取。结果TBRmax≥1.28（先前报道预测冠状动脉事件的最佳临界值）的患者和TBRmax较低的患者的EAT体积指数相似，但是TBRmax≥1.28的患者每人的最大PLED值较高（-86±12 Hounsfield单位（HU）相对于-98±11 HU，P = 0.0044）。在基于病变的分析中（n = 92），PLED与TBRmax正相关，确定TBRmax≥1.28的最佳PLED截止值为-97 HU。在对病变位置，阻塞性狭窄和CT上的高风险斑块进行校正的多变量分析中，PLED≥-97 HU仍是TBRmax≥1.28的重要预测指标。结论PLED增加与冠状动脉18F-NaF的大量摄取有关。