Author + information
- Marc Dweck,
- Tamir Malley,
- Mark Pringle,
- William Jenkins,
- William Cowie,
- Hamish Richardson,
- Pessotto Renzo,
- NIcholas A. Boon,
- James HF Rudd and
- David Newby
18F-Sodium fluoride (18FNaF) is a promising biomarker of disease activity in aortic stenosis. We aimed to compare 18FNaF uptake with histology of the aortic valve and assess whether it predicts disease progression.
20 patients with aortic valve disease underwent PET/CT scanning using 18FNaF and 18FFDG. Echocardiography and CT calcium scoring of the valve was performed at baseline and 1 year. A further 7 patients underwent 18FNaF PET/CT prior to aortic valve replacement. Activity was compared to excised valve tissue using immunohistochemistry for osteocalcin and alkaline phosphatase.
Over 1 year aortic valve calcification increased (469±479 vs 580±576 p<0.01) in patients with a range of disease severity (6 sclerosis; 5 mild, 7 moderate, 2 severe stenosis). 18FNaF uptake correlated with disease progression: both in terms of the calcium score (r2=0.44 p<0.01) and aortic valve area (r2=0.24 P=0.03). When 18FNaF overlying existing calcium on the CT was excluded, the correlation improved further (r2= 0.64 p<0.01). There were no associations between 18FFDG uptake and CT or echo measures of disease progression (r2=0.02 p=0.55). There was a good correlation between in vivo 18FNaF uptake and both alkaline phosphatase (n=7; r2=0.79 P<0.01) and osteocalcin staining (n=5; r2=0.43 P=0.22) of the excised tissue.
18F-NaF is a marker of active calcification and disease progression in patients with aortic stenosis with major potential for assessing novel therapeutic strategies.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Cardiac PET: Towards Flow Quantification and Novel Applications
Abstract Category: 21. Imaging: Nuclear
Presentation Number: 1139-327
- 2013 American College of Cardiology Foundation