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그림 1. F-18 FDG PET에서 복부대동맥의 FDG 섭취를 측정하는 과정

그림 2. 관상동맥 칼슘이 증가된 환자들이 그렇지 않은 환자에 비해 높은 혈관 FDG 섭취 정도를 보였으며, 경동맥, 흉부 및 복부대동맥에서 동일하게 나타남.

그림 3. 복부대동맥의 TBRpeak가 2.1 이상인 경우 나이와 무관하게 관상동맥 칼슘 증가를 예측할 수 있었으나(a), 첫 검사에서 이미 관상동맥 칼슘이 있는 환자의 경우 통계적으로 의미 있는 예측은 할 수 없었음(b).

그림 4. 첫 검사에서 관상동맥 칼슘이 없었으나(c), 높은 복부대동맥 FDG 섭취를 보였고(a-b), 3.6년 후 시행된 추적관찰 검사에서 칼슘이 증가한(d, 화살표) 49세 남성의 실제 검사 영상. 칼슘 점수는 0에서 156.4까지 증가함.

Abstract

METHODS:

Ninety-six asymptomatic individuals who underwent FDG positron emission tomography (PET) and CAC scoring on the same day for health screening and follow-up CAC scoring ≥1 year after baseline studies (mean 4.3 years) were included. Vascular FDG uptake was measured and corrected for blood pool activity to obtain peak and average target-to-blood pool ratios (TBRpeak and TBRavg, respectively) for the carotid arteries, and ascending and abdominal aorta. CAC scores at baseline and follow-up of each individual were measured and absolute CAC change (ΔCAC), annual CAC change (ΔCAC/year), and annual CAC change rate (ΔCAC%/year) were calculated. CAC progression was defined as ΔCAC >0 for individuals with negative baseline CAC; ΔCAC/year ≥10 for those with baseline CAC of 0

RESULTS:

Thirty-one subjects showed CAC progression. CAC-progressors showed significantly higher TBRpeak and TBRavg as compared to non-CAC-progressors for all three arteries. TBRpeak of the abdominal aorta was significantly associated with CAC progression in multivariate analysis, with age and baseline CAC. A higher TBRpeak of the abdominal aorta (≥2.11) was associated with CAC progression among subjects with negative baseline CAC only. In subjects with positive baseline CAC, only the amount of baseline CAC was significantly associated with CAC progression. However, the positive predictive value of the TBRpeak of the abdominal aorta was <40 % when age was <58 or baseline CAC was negative.

CONCLUSIONS:

Higher FDG uptake of the large arteries is associated with an increased risk of CAC progression in asymptomatic subjects with negative baseline CAC. But its clinical application needs further validation.

Author information​

4Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322, Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do, 58128, Republic of Korea. hsbom@jnu.ac.kr.