High-Risk Coronary Plaque Features – from Structural to Molecular Imaging

  • Marika Kalnina (Speaker)
  • Maris Lapsovs (Co-author)
  • Trušinskis, K. (Co-author)

Activity: Talk or presentation types › Oral presentation

Description

Cardiovascular disease remains the leading cause of death globally. For more individualized preventive therapy strategy there is a need to use the best imaging to better assess diagnosis and for risk stratification. There is still no dedicated and precise test that could predict plaque rupture that is the most frequent cause of myocardial infarction. There is a need to optimize diagnostic and risk stratification pathways for best patient outcome.. Our study combines the latest literature review about noninvasive plaque imaging methods and our first patient results. We evaluated coronary arteries for 13 patients randomly who were undergoing an oncological body [18F] FDG PET/CT exam.  [18F]FDG injection was 2.1-2.2 MBq per kg, scanned 60-90 min after injection, 3 min per bed. Anatomy was determined by low dose CT image without breathhold. Further these two patients were evaluated in cardiologist consultation, underwent IVUS/NIRS exam.. From our 13 patients 6.5% (n-2) showed only faint focal uptake (SUVmax 3.2; liver SUVmax 3.0) in the coronary artery wall in PET attenuation corrected image. For both patients IVUS/NIRS were performed in the target lesion vessel. No correlation was found in two patient exams between non-invasive advanced molecular [18F] FDG PET/CT images and intravascular ultrasound.. Our small study sample showed that hot plaques may not be seen too often in oncology patients. No correlation could be explained by too faint metabolic activity that may not have significance and different processes seen in images. IVUs shows fibrous tissue, necrotic core, fibro-fatty tissue and dense calcium while macrophages as an inducer of the inflammation are believed to be a major contributor to [18F]FDG uptake in atherosclerosis. Larger studies with different tracers in conjunction with anatomic imaging (CTA) are needed to show a more realistic picture and hopefully help to noninvasively find culprit lesions before major cardiovascular events.
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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