Carotid plaque inflammation on 18F‐fluorodeoxyglucose positron emission tomography predicts early stroke recurrence

Symptomatic carotid stenosis is associated with a 3‐fold risk of early stroke recurrence compared to other stroke subtypes. Current carotid imaging techniques rely on estimating plaque‐related lumen narrowing but do not evaluate intraplaque inflammation, a key mediator of plaque rupture and thromboembolism. Using combined 18F‐fluorodeoxyglucose positron‐emission tomography (FDG‐PET)/computed tomography, we investigated the relation between inflammation‐related FDG uptake and stroke recurrence.

[1]  J. Pickard,et al.  Imaging Atherosclerotic Plaque Inflammation With [18F]-Fluorodeoxyglucose Positron Emission Tomography , 2002, Circulation.

[2]  L. Badimón,et al.  Imaging of early inflammation in low-to-moderate carotid stenosis by 18-FDG-PET. , 2009, Frontiers in bioscience.

[3]  C. Kidwell,et al.  Magnetic resonance imaging for surrogate outcomes and patient selection. , 2009, Frontiers of neurology and neuroscience.

[4]  P. Rothwell,et al.  Early risk of recurrence by subtype of ischemic stroke in population-based incidence studies , 2004, Neurology.

[5]  J. Jeng,et al.  Characterization of plaques using 18F-FDG PET/CT in patients with carotid atherosclerosis and correlation with matrix metalloproteinase-1. , 2007, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[6]  H. Sillesen,et al.  Molecular pathology in vulnerable carotid plaques: correlation with [18]-fluorodeoxyglucose positron emission tomography (FDG-PET). , 2009, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[7]  M. Eliasziw,et al.  Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery , 2004, The Lancet.

[8]  V. Fuster,et al.  Relationships Among Regional Arterial Inflammation, Calcification, Risk Factors, and Biomarkers: A Prospective Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography Imaging Study , 2009, Circulation. Cardiovascular imaging.

[9]  P. Libby Inflammation in atherosclerosis , 2002, Nature.

[10]  H. Watabe,et al.  (18)F-FDG accumulation in atherosclerotic plaques: immunohistochemical and PET imaging study. , 2004, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[11]  Masatoshi Ishibashi,et al.  Simvastatin attenuates plaque inflammation: evaluation by fluorodeoxyglucose positron emission tomography. , 2006, Journal of the American College of Cardiology.

[12]  L. Daly,et al.  Population-Based Study of ABCD2 Score, Carotid Stenosis, and Atrial Fibrillation for Early Stroke Prediction After Transient Ischemic Attack: The North Dublin TIA Study , 2010, Stroke.

[13]  M. Reiser,et al.  18F-FDG PET/CT Identifies Patients at Risk for Future Vascular Events in an Otherwise Asymptomatic Cohort with Neoplastic Disease , 2009, Journal of Nuclear Medicine.

[14]  M. E. Kooi,et al.  Potential of Integrated [18F] Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying Vulnerable Carotid Plaques , 2011, American Journal of Neuroradiology.

[15]  J. Roquer,et al.  High Risk of Early Neurological Recurrence in Symptomatic Carotid Stenosis , 2009, Stroke.

[16]  G. Karcher,et al.  Arterial Foci of F-18 Fluorodeoxyglucose Are Associated With an Enhanced Risk of Subsequent Ischemic Stroke in Cancer Patients: A Case-Control Pilot Study , 2011, Clinical nuclear medicine.

[17]  J. Halperin,et al.  2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guideline , 2011, Journal of the American College of Cardiology.

[18]  K. Furie,et al.  An evidence‐based causative classification system for acute ischemic stroke , 2005, Annals of neurology.

[19]  H. Sillesen,et al.  Gene expression and 18FDG uptake in atherosclerotic carotid plaques , 2010, Nuclear medicine communications.

[20]  E. Hedley‐Whyte,et al.  Diffusion MRI in ischemic stroke compared to pathologically verified infarction , 2001, Neurology.

[21]  V. Fuster,et al.  Imaging atherosclerotic plaque inflammation by fluorodeoxyglucose with positron emission tomography: ready for prime time? , 2010, Journal of the American College of Cardiology.

[22]  Gary A. Ford,et al.  Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. , 2008, Cerebrovascular diseases.

[23]  E. Ringelstein,et al.  Dual Antiplatelet Therapy With Clopidogrel and Aspirin in Symptomatic Carotid Stenosis Evaluated Using Doppler Embolic Signal Detection: The Clopidogrel and Aspirin for Reduction of Emboli in Symptomatic Carotid Stenosis (CARESS) Trial , 2005, Circulation.

[24]  Ahmed Tawakol,et al.  In vivo 18F-fluorodeoxyglucose positron emission tomography imaging provides a noninvasive measure of carotid plaque inflammation in patients. , 2006, Journal of the American College of Cardiology.

[25]  Renu Virmani,et al.  Histopathology of Carotid Atherosclerotic Disease , 2006, Neurosurgery.

[26]  A. Arauz,et al.  Carotid plaque inflammation detected by 18F-fluorodeoxyglucose-positron emission tomography Pilot study , 2007, Clinical Neurology and Neurosurgery.

[27]  J. Slattery,et al.  Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST) , 1998, The Lancet.

[28]  D. Sackett,et al.  Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. , 1998, The New England journal of medicine.

[29]  Marc Faraggi,et al.  Arterial wall uptake of fluorodeoxyglucose on PET imaging in stable cancer disease patients indicates higher risk for cardiovascular events , 2008, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[30]  M. Eliasziw,et al.  Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis , 2003, The Lancet.

[31]  J. Baron,et al.  Carotid Plaque Inflammation Is Associated With Cerebral Microembolism in Patients With Recent Transient Ischemic Attack or Stroke: A Pilot Study , 2010, Circulation. Cardiovascular imaging.

[32]  David Izquierdo-Garcia,et al.  Comparison of Methods for Magnetic Resonance-Guided [18-F]Fluorodeoxyglucose Positron Emission Tomography in Human Carotid Arteries: Reproducibility, Partial Volume Correction, and Correlation Between Methods , 2009, Stroke.

[33]  Eun Jeong Lee,et al.  Reversal of Vascular 18F-FDG Uptake with Plasma High-Density Lipoprotein Elevation by Atherogenic Risk Reduction , 2008, Journal of Nuclear Medicine.