on October 29, 2009
Published online before print October 29, 2009, doi: 10.1161/STROKEAHA.109.564088
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Submitted on July 29, 2009
From Department of Radiology (R.M.K., P.A.M.H., J.M.A.v.E., J.E.W., M.E.K.), Cardiovascular Research Institute Maastricht (R.M.K., R.J.v.O., W.H.M., M.H.P., J.M.A.v.E., J.E.W., M.E.K.), and Departments of Nuclear Medicine (G.J.J.T.), Neurology (R.J.v.O.), Clinical Neurophysiology (W.H.M.), Clinical Epidemiology (M.H.P.), Maastricht University Medical Center (MUMC), Maastricht, the Netherlands; Department of Radiology (R.J.v.d.G.), Leiden University Medical Center, Leiden, the Netherlands; Department of Neurology (J.W.M.t.B.), Orbis Medical Center, Sittard, the Netherlands; Department of Neurology (C.L.F.), Atrium Medical Center, Heerlen, the Netherlands; Department of Neurology (A.G.G.C.K.), Laurentius Hospital, Roermond, the Netherlands; Department of Neurology (B.J.M.), Vie Curi Medical Center, Venlo, the Netherlands. * To whom correspondence should be addressed. E-mail: eline.kooi{at}mumc.nl.
Background and Purpose—This study's objective was to compare 18F-fluoro-2-deoxyglucose positron emission tomography (18F-FDG PET), CT, and MRI of carotid plaque assessment. Materials and Methods—Fifty patients with symptomatic carotid atherosclerosis underwent 18F-FDG PET/CT and MRI. Correlations and agreement between imaging findings were assessed by Spearman and Pearson rank correlation tests, t tests, and Bland-Altman plots. Results—Spearman Conclusions—Overall, correlations between 18F-FDG PET and CT/MRI findings are weak. Correlations between CT and MRI measurements are moderate to strong, but there is considerable variation in absolute differences.
Accepted on August 28, 2009
Multimodality Imaging of Carotid Artery Plaques. 18F-Fluoro-2-Deoxyglucose Positron Emission Tomography, Computed Tomography, and Magnetic Resonance Imaging
Robert M. Kwee MD;
between plaque 18F-FDG standard uptake values and CT/MRI findings varied from -0.088 to 0.385. Maximum standard uptake value was significantly larger in plaques with intraplaque hemorrhage (1.56 vs 1.47; P=0.032). Standard uptake values did not significantly differ between plaques with an intact and thick fibrous cap and plaques with a thin or ruptured fibrous cap on MRI. (1.21 vs 1.23; P=0.323; and 1.45 vs 1.54; P=0.727). Pearson between CT and MRI measurements varied from 0.554 to 0.794 (P<0.001). For lipid-rich necrotic core volume, the CT–MRI correlation was stronger in mildly (
10%) than in severely (>10%) calcified plaques (Pearson 0.730 vs 0.475). Mean difference in measurement ±95% limits of agreement between CT and MRI for minimum lumen area, volumes of vessel wall, lipid-rich necrotic core, calcifications, and fibrous tissue were 0.4±18.1 mm2 (P=0.744), -41.9 ±761.7 mm3 (P=0.450), 78.4±305.0 mm3 (P<0.001), 180.5±625.7 mm3 (P=0.001), and -296.0±415.8 mm3 (P<0.001), respectively.
Key words: carotid atherosclerosis • computed tomography • 18F-FDG positron emission tomography • magnetic resonance imaging