Abstract 2331: Detection of Inflamed Coronary Culprit Lesions in Patients using PET-CT
Background: PET imaging has been shown to provide a measure of plaque inflammation in the carotid circulation. The aim of this study was to test the hypothesis that coronary inflammation can be detected using PET-CT.
Methods: PET-CT imaging was performed in 20 patients (mean age 58.25 ± 10.5 years, 75% male). Ten patients with acute plaque rupture (requiring primary stenting of the culprit lesion) were compared to 10 patients with chronic coronary disease (5 with recent PCI, 5 with remote PCI). 64-slice MDCT angiography (Siemens Sensation) was performed followed by PET imaging (Siemens ECAT HR+) 3 hours after injection with 13mCi 18-FDG. Myocardial uptake of FDG was minimized by a dietary modification and beta blockade. Images were coregistered and the recently ruptured plaques were identified by locating the stents that were placed to treat them. SUVs were obtained at the locations of interest and target to background ratios (T/B) were calculated.
Results: Inflammatory activity (T/B) within the recently ruptured culprit plaques was significantly greater than in the rest of the proximal coronary vessels in the same patient (3.42 ± .75 vs 2.21 ± .54, p = 0.015). Plaque activity within the recently stented culprit lesions was significantly higher than within recently stented stable plaques. In contrast, there was no difference in plaque activity between recently stented stable plaques and remotely stented stable plaques (1.63 ± 0.52 vs 1.57 ± 0.55, p=0.81).
Conclusion: This preliminary study suggests that PET/CT may be useful for identifying inflamed coronary lesions. However, further methodological and technical advances will be necessary for broader use of this technology.