방사선의학 웹진

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Abstract
Positron emission tomography with 18F-sodium fluoride (NaF) radioligand has been actively investigated in atherosclerosis research because it is known to detect microcalcification activity within atheroma. We studied whether NaF shows any uptake in the brain tissue of patients with acute ischemic stroke. This is a post-hoc analysis of previously reported cerebral atherosclerosis research with positron emission tomography which applied the two radioligands, 18F-fluorodeoxyglucose and NaF for the detection of culprit atheroma among 20 acute cerebral infarction patients (mean age = 75.1 ± 9.0 years; 10 women). In this study, we measured the maximum and mean standardized uptake value (SUVmax and SUVmean) of NaF uptake level in the cerebral infarct region between lesions with and without diffusion weighted image (DWI) positivity, indicating acute ischemic cell death. Correlation analysis was performed between NaF uptake levels and imaging and clinical variables, including neurological severity. The NaF uptake levels were significantly higher in DWI positive lesions than in negative lesions (SUVmax: 2.0 [0.60-4.2] versus 0.20 [0.10-0.40], p = 0.021 by Mann-Whitney U test). The intensity of NaF uptake (SUVmax) was significantly correlated with the initial neurological severity (Spearman's ρ = 0.579, p= 0.007) and white blood cell count (Spearman's ρ = 0.626, p p 0.003). During ischemic stroke NaF was concentrated in brain tissue undergoing acute cell death and its uptake intensity was correlated with neurological severity, suggesting that NaF could reflect acute ischemic cell death after stroke.

Affiliations

Jeong-Min Kim 1, Reeree Lee 2, Hae-Bong Jeong 3, Kwang-Yeol Park 3, Ju Won Seok 4
1Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongnro-gu, Seoul, Korea. bellokim1@gmail.com.
2Department of Nuclear Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 224-1, Heukseok-Dong, Dongjak-Gu, Seoul, 156-755, Korea.
3Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
4Department of Nuclear Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 224-1, Heukseok-Dong, Dongjak-Gu, Seoul, 156-755, Korea. joneseok@cau.ac.kr.