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Gotuzzo I, Slart RHJA, Gimelli A, Ashri N, Anagnostopoulos C, Bucerius J, Buechel RR, Gaemperli O, Gheysens O, Glaudemans AWJM, Habib G, Hyafil F, Lubberink M, Saraste A, Podlesnikar T, Dweck MR, Erba PA. Nuclear medicine practice for the assessment of cardiac sarcoidosis and amyloidosis. A survey endorsed by the EANM and EACVI. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06727-5. [PMID: 38679624 DOI: 10.1007/s00259-024-06727-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Affiliation(s)
- Irene Gotuzzo
- Department of Medicine and Surgery, Nuclear Medicine Unit, University of Milan Bicocca, ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Riemer H J A Slart
- Medical Imaging Center, Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, the Netherlands
- Biomedical Photonic Imaging Group, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands
| | - Alessia Gimelli
- Department of Imaging, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Nabila Ashri
- European Association of Nuclear Medicine (EANM), Vienna, Austria
| | | | - Jan Bucerius
- Department of Nuclear Medicine, Georg-August University Göttingen, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | | | - Olivier Gheysens
- Department of Nuclear Medicine, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, 1200, Belgium
| | - Andor W J M Glaudemans
- Medical Imaging Center, Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, the Netherlands
| | - Gilbert Habib
- Department of Cardiology, APHM, La Timone Hospital, Marseille, France
| | - Fabian Hyafil
- Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, Paris, F75015, France
| | - Mark Lubberink
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Antti Saraste
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Tomaz Podlesnikar
- Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia
- Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, Edinburgh Heart Centre, University of Edinburgh, Chancellors Building, Little France Crescent, Edinburgh, UK
| | - Paola A Erba
- Department of Medicine and Surgery, Nuclear Medicine Unit, University of Milan Bicocca, ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy.
- Medical Imaging Center, Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, the Netherlands.
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2
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Besson FL, Treglia G, Bucerius J, Anagnostopoulos C, Buechel RR, Dweck MR, Erba PA, Gaemperli O, Gimelli A, Gheysens O, Glaudemans AWJM, Habib G, Hyafil F, Lubberink M, Rischpler C, Saraste A, Slart RHJA. A systematic review for the evidence of recommendations and guidelines in hybrid nuclear cardiovascular imaging. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06597-x. [PMID: 38221570 DOI: 10.1007/s00259-024-06597-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/01/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVES This study aimed to evaluate the level of evidence of expert recommendations and guidelines for clinical indications and procedurals in hybrid nuclear cardiovascular imaging. METHODS From inception to August 2023, a PubMed literature analysis of the latest version of guidelines for clinical hybrid cardiovascular imaging techniques including SPECT(/CT), PET(/CT), and PET(/MRI) was performed in two categories: (1) for clinical indications for all-in primary diagnosis; subgroup in prognosis and therapy evaluation; and for (2) imaging procedurals. We surveyed to what degree these followed a standard methodology to collect the data and provide levels of evidence, and for which topic systematic review evidence was executed. RESULTS A total of 76 guidelines, published between 2013 and 2023, were included. The evidence of guidelines was based on systematic reviews in 7.9% of cases, non-systematic reviews in 47.4% of cases, a mix of systematic and non-systematic reviews in 19.7%, and 25% of guidelines did not report any evidence. Search strategy was reported in 36.8% of cases. Strengths of recommendation were clearly reported in 25% of guidelines. The notion of external review was explicitly reported in 23.7% of cases. Finally, the support of a methodologist was reported in 11.8% of the included guidelines. CONCLUSION The use of evidence procedures for developing for evidence-based cardiovascular hybrid imaging recommendations and guidelines is currently suboptimal, highlighting the need for more standardized methodological procedures.
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Affiliation(s)
- Florent L Besson
- Department of Nuclear Medicine-Molecular Imaging, DMU SMART IMAGING, Hôpitaux Universitaires Paris-Saclay, AP-HP, CHU Bicêtre, Le Kremlin Bicetre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicetre, France
- Commissariat À L'énergie Atomique Et Aux Énergies Alternatives (CEA), Centre National de La Recherche Scientifique (CNRS), Inserm, BioMaps, Université Paris-Saclay, Le Kremlin-Bicetre, France
| | - Giorgio Treglia
- Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6501, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900, Lugano, Switzerland
| | - Jan Bucerius
- Department of Nuclear Medicine, Georg-August University Göttingen, Universitätsmedizin Göttingen, Gottingen, Germany
| | | | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, Edinburgh Heart Centre, University of Edinburgh, Chancellors Building, Little France Crescent, Edinburgh, UK
| | - Paula A Erba
- Department of Medicine and Surgery, University of Milan Bicocca, and Nuclear Medicine Unit ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Olivier Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Institut Roi Albert II, Université Catholique de Louvain, 1200, Brussels, Belgium
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gilbert Habib
- Department of Cardiology, APHM, La Timone Hospital, Marseille, France
| | - Fabian Hyafil
- Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, F75015, Paris, France
| | - Mark Lubberink
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | | | - Antti Saraste
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
- Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, Enschede, the Netherlands.
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3
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van de Velden D, Heide EC, Bouter C, Bucerius J, Riedel CH, Focke NK. Effects of inverse methods and spike phases on interictal high-density EEG source reconstruction. Clin Neurophysiol 2023; 156:4-13. [PMID: 37832322 DOI: 10.1016/j.clinph.2023.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 08/15/2023] [Accepted: 08/24/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVE To determine the effect of inverse methods and timepoints of interictal epileptic discharges (IEDs) used for high-density electric source imaging (hd-ESI) in pharmacoresistant focal epilepsies. METHODS We retrospectively evaluated the hd-ESI and [18F]fluorodeoxyglucose positron emission tomography (18FDG-PET) of 21 operated patients with pharmacoresistant focal epilepsy (Engel I). Volumetric hd-ESI was performed with three different inverse methods such as the inverse solution linearly constrained minimum variance (LCMV, a beamformer method), standardized low resolution electromagnetic tomography (sLORETA) and weighted minimum-norm estimation (wMNE) and at different IED phases. Hd-ESI accuracy was determined by volumetric overlap and distance between hd-ESI source maximum, as well as 18FDG-PET hypometabolic region relative to the resection zone (RZ). RESULTS In our cohort, the shortest distances and greatest volumetric overlaps to the RZ were found in the half-rise and peak-phase for all inverse methods. The distance to the RZ was not different between the centroid of the clinical hypothesis-based cluster and the source maximum in peak-phase. However, the distance of the hypothesis-based cluster was significantly shorter compared to the cluster selected by the smallest p-value. CONCLUSIONS Hd-ESI provides the greatest accuracy in determining the RZ at the IED half-rise and peak-phase for all applied inverse methods, whereby sLORETA and LCMV were equally accurate. SIGNIFICANCE Our results offer guidance in selecting inverse methods and IED phases for hd-ESI, compare the performance of hd-ESI and 18FDG-PET and encourage future studies in investigating the relationship between interictal ESI and 18FDG-PET hypometabolism.
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Affiliation(s)
- Daniel van de Velden
- University Medical Center Göttingen, Clinic for Neurology, 37075 Göttingen, Germany.
| | - Ev-Christin Heide
- University Medical Center Göttingen, Clinic for Neurology, 37075 Göttingen, Germany
| | - Caroline Bouter
- University Medical Center Göttingen, Department of Nuclear Medicine, 37075 Göttingen, Germany
| | - Jan Bucerius
- University Medical Center Göttingen, Department of Nuclear Medicine, 37075 Göttingen, Germany
| | - Christian H Riedel
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Neuroradiology, 37075 Göttingen, Germany
| | - Niels K Focke
- University Medical Center Göttingen, Clinic for Neurology, 37075 Göttingen, Germany.
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4
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Kassem M, Nies KPH, Boswijk E, van der Pol J, Aizaz M, Gijbels MJJ, Li D, Bucerius J, Mess WH, Wildberger JE, van Oostenbrugge RJ, Moonen RPM, Fan Z, Kooi ME. Quantification of carotid plaque composition with a multi-contrast atherosclerosis characterization (MATCH) MRI sequence. Front Cardiovasc Med 2023; 10:1227495. [PMID: 37680565 PMCID: PMC10481960 DOI: 10.3389/fcvm.2023.1227495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/18/2023] [Indexed: 09/09/2023] Open
Abstract
Background and purpose Carotid atherosclerotic plaques with a large lipid-rich necrotic core (LRNC), intraplaque hemorrhage (IPH), and a thin or ruptured fibrous cap are associated with increased stroke risk. Multi-sequence MRI can be used to quantify carotid atherosclerotic plaque composition. Yet, its clinical implementation is hampered by long scan times and image misregistration. Multi-contrast atherosclerosis characterization (MATCH) overcomes these limitations. This study aims to compare the quantification of plaque composition with MATCH and multi-sequence MRI. Methods MATCH and multi-sequence MRI were used to image 54 carotid arteries of 27 symptomatic patients with ≥2 mm carotid plaque on a 3.0 T MRI scanner. The following sequence parameters for MATCH were used: repetition time/echo time (TR/TE), 10.1/4.35 ms; field of view, 160 mm × 160 mm × 2 mm; matrix size, 256 × 256; acquired in-plane resolution, 0.63 mm2× 0.63 mm2; number of slices, 18; and flip angles, 8°, 5°, and 10°. Multi-sequence MRI (black-blood pre- and post-contrast T1-weighted, time of flight, and magnetization prepared rapid acquisition gradient echo; acquired in-plane resolution: 0.63 mm2 × 0.63 mm2) was acquired according to consensus recommendations, and image quality was scored (5-point scale). The interobserver agreement in plaque composition quantification was assessed by the intraclass correlation coefficient (ICC). The sensitivity and specificity of MATCH in identifying plaque composition were calculated using multi-sequence MRI as a reference standard. Results A significantly lower image quality of MATCH compared to that of multi-sequence MRI was observed (p < 0.05). The scan time for MATCH was shorter (7 vs. 40 min). Interobserver agreement in quantifying plaque composition on MATCH images was good to excellent (ICC ≥ 0.77) except for the total volume of calcifications and fibrous tissue that showed moderate agreement (ICC ≥ 0.61). The sensitivity and specificity of detecting plaque components on MATCH were ≥89% and ≥91% for IPH, ≥81% and 85% for LRNC, and ≥71% and ≥32% for calcifications, respectively. Overall, good-to-excellent agreement (ICC ≥ 0.76) of quantifying plaque components on MATCH with multi-sequence MRI as the reference standard was observed except for calcifications (ICC = 0.37-0.38) and fibrous tissue (ICC = 0.59-0.70). Discussion and conclusion MATCH images can be used to quantify plaque components such as LRNC and IPH but not for calcifications. Although MATCH images showed a lower mean image quality score, short scan time and inherent co-registration are significant advantages.
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Affiliation(s)
- Mohamed Kassem
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Kelly P. H. Nies
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Ellen Boswijk
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Location VUmc, Amsterdam, Netherlands
| | - Jochem van der Pol
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Mueez Aizaz
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Marion J. J. Gijbels
- Department of Pathology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, Netherlands
- Department of Medical Biochemistry, Experimental Vascular Biology, Amsterdam Cardiovascular Sciences, Amsterdam Infection and Immunity, Amsterdam UMC, Amsterdam, Netherlands
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Jan Bucerius
- Department of Nuclear Medicine, Georg-August University Göttingen, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Werner H. Mess
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, Netherlands
- Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Joachim E. Wildberger
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Robert J. van Oostenbrugge
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, Netherlands
- Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Rik P. M. Moonen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Zhaoyang Fan
- Department of Radiology, University of Southern California, Los Angeles, CA, United States
| | - M. Eline Kooi
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands
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Totzeck M, Aide N, Bauersachs J, Bucerius J, Georgoulias P, Herrmann K, Hyafil F, Kunikowska J, Lubberink M, Nappi C, Rassaf T, Saraste A, Sciagra R, Slart RHJA, Verberne H, Rischpler C. Nuclear medicine in the assessment and prevention of cancer therapy-related cardiotoxicity: prospects and proposal of use by the European Association of Nuclear Medicine (EANM). Eur J Nucl Med Mol Imaging 2023; 50:792-812. [PMID: 36334105 PMCID: PMC9852191 DOI: 10.1007/s00259-022-05991-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
Cardiotoxicity may present as (pulmonary) hypertension, acute and chronic coronary syndromes, venous thromboembolism, cardiomyopathies/heart failure, arrhythmia, valvular heart disease, peripheral arterial disease, and myocarditis. Many of these disease entities can be diagnosed by established cardiovascular diagnostic pathways. Nuclear medicine, however, has proven promising in the diagnosis of cardiomyopathies/heart failure, and peri- and myocarditis as well as arterial inflammation. This article first outlines the spectrum of cardiotoxic cancer therapies and the potential side effects. This will be complemented by the definition of cardiotoxicity using non-nuclear cardiovascular imaging (echocardiography, CMR) and biomarkers. Available nuclear imaging techniques are then presented and specific suggestions are made for their application and potential role in the diagnosis of cardiotoxicity.
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Affiliation(s)
- Matthias Totzeck
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Nicolas Aide
- Nuclear Medicine Department, University Hospital, Caen, France
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Jan Bucerius
- Department of Nuclear Medicine, University Medicine Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Panagiotis Georgoulias
- Department of Nuclear Medicine, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Ken Herrmann
- Clinic for Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Fabien Hyafil
- Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, Assistance-Publique – Hôpitaux de Paris, University of Paris, Paris, France
| | - Jolanta Kunikowska
- Nuclear Medicine Department, Medical University of Warsaw, Warsaw, Poland
| | - Mark Lubberink
- Medical Physics, Uppsala University Hospital, Uppsala, Sweden
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, Italy
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Antti Saraste
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Roberto Sciagra
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
| | - Riemer H. J. A. Slart
- Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands ,Department of Biomedical Photonic Imaging, Faculty of Science and Technology, Enschede, The Netherlands
| | - Hein Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Christoph Rischpler
- Clinic for Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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6
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Totzeck M, Aide N, Bauersachs J, Bucerius J, Georgoulias P, Herrmann K, Hyafil F, Kunikowska J, Lubberink M, Nappi C, Rassaf T, Saraste A, Sciagra R, Slart RH, Verberne H, Rischpler C. Correction to: Nuclear medicine in the assessment and prevention of cancer therapy‑related cardiotoxicity: prospects and proposal of use by the European Association of Nuclear Medicine (EANM). Eur J Nucl Med Mol Imaging 2023; 50:970. [PMID: 36409318 PMCID: PMC9852205 DOI: 10.1007/s00259-022-06039-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Matthias Totzeck
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Nicolas Aide
- Nuclear Medicine Department, University Hospital, Caen, France
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Jan Bucerius
- Department of Nuclear Medicine, University Medicine Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | - Panagiotis Georgoulias
- Department of Nuclear Medicine, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Ken Herrmann
- Clinic for Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Fabien Hyafil
- Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, Assistance-Publique – Hôpitaux de Paris, University of Paris, Paris, France
| | - Jolanta Kunikowska
- Nuclear Medicine Department, Medical University of Warsaw, Warsaw, Poland
| | - Mark Lubberink
- Medical Physics, Uppsala University Hospital, Uppsala, Sweden
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, Italy
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Antti Saraste
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Roberto Sciagra
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
| | - Riemer H.J.A. Slart
- Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands ,Department of Biomedical Photonic Imaging, Faculty of Science and Technology, Enschede, The Netherlands
| | - Hein Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Christoph Rischpler
- Clinic for Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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7
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Schmidt M, Bartenstein P, Bucerius J, Dietlein M, Drzezga A, Herrmann K, Lapa C, Lorenz K, Musholt TJ, Nagarajah J, Reiners C, Sahlmann CO, Kreissl MC. Correction: Individualized treatment of differentiated thyroid cancer: The value of surgery in combination with radioiodine imaging and therapy - A German position paper from Surgery and Nuclear Medicine. Nuklearmedizin 2022. [PMID: 35477170 DOI: 10.1055/a-1824-1280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Matthias Schmidt
- Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany
- Thyroid Committee, German Society of Nuclear Medicine (DGN e. V.)
- Guideline Committee, German Society of Nuclear Medicine (DGN e. V.)
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
- Guideline Committee, German Society of Nuclear Medicine (DGN e. V.)
| | - Jan Bucerius
- Department of Nuclear Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Markus Dietlein
- Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany
- Guideline Committee, German Society of Nuclear Medicine (DGN e. V.)
| | - Alexander Drzezga
- Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen and German Cancer Consortium (DKTK), Essen, Germany
| | - Constantin Lapa
- Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Member of the Board, German Society of Nuclear Medicine (DGN e. V.)
| | - Kerstin Lorenz
- Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University of Halle Wittenberg, Faculty of Medicine, Halle, Germany
- Member of the surgical working group for endocrinology (CAEK) of the German society for general and visceral surgery (DGAV)
| | - Thomas J Musholt
- Section of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
- Member of the surgical working group for endocrinology (CAEK) of the German society for general and visceral surgery (DGAV)
| | - James Nagarajah
- Department of Medical Imaging, Nuclear Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherland
- Thyroid Committee, German Society of Nuclear Medicine (DGN e. V.)
- Guideline Committee, German Society of Nuclear Medicine (DGN e. V.)
| | - Christoph Reiners
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Carsten O Sahlmann
- Department of Nuclear Medicine, University Medical Center Göttingen, Göttingen, Germany
- Thyroid Committee, German Society of Nuclear Medicine (DGN e. V.)
| | - Michael C Kreissl
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Germany
- Thyroid Committee, German Society of Nuclear Medicine (DGN e. V.)
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8
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Schmidt M, Bartenstein P, Bucerius J, Dietlein M, Drzezga A, Herrmann K, Lapa C, Lorenz K, Musholt TJ, Nagarajah J, Reiners C, Sahlmann CO, Kreissl MC. Individualized treatment of differentiated thyroid cancer: The value of surgery in combination with radioiodine imaging and therapy - A German position paper from Surgery and Nuclear Medicine. Nuklearmedizin 2022; 61:87-96. [PMID: 35299276 DOI: 10.1055/a-1783-8154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A consensus statement about indications for post-surgical radioiodine therapy (RIT) in differentiated thyroid cancer patients (DTC) was recently published by the European Thyroid Association (ETA) 1. This publication discusses indications for RIT on the basis of an individual risk assessment. Many of the conclusions of this consensus statement are well founded and accepted across the disciplines involved. However, especially from the perspective of nuclear medicine, as the discipline responsible for indicating and executing RIT, some of the recommendations may require further clarification with regard to their compatibility with established best practice and national standards of care. Assessment of the indications for RIT is strongly dependent on the weighing up of benefits and risks. On the basis of longstanding clinical experience in nuclear medicine, RIT represents a highly specific precision medicine procedure of proven efficacy with a favorable side-effect profile. This distinguishes RIT significantly from other adjuvant oncological therapies and has resulted in the establishment of this procedure as a usually well-tolerated, standard safety measure. With regard to its favorable risk/benefit ratio, this procedure should not be unnecessarily restricted, in the interest of offering reassurance to the patients. Both patients' interests and regional/national differences need to be taken into account. We would therefore like to comment on the recent consensus from the perspective of authors and to provide recommendations based on the respective published data.
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Affiliation(s)
- Matthias Schmidt
- Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany.,Thyroid Committee, German Society of Nuclear Medicine (DGN e. V.).,Guideline Committee, German Society of Nuclear Medicine (DGN e. V.)
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany.,Guideline Committee, German Society of Nuclear Medicine (DGN e. V.)
| | - Jan Bucerius
- Department of Nuclear Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Markus Dietlein
- Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany.,Guideline Committee, German Society of Nuclear Medicine (DGN e. V.)
| | - Alexander Drzezga
- Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen and German Cancer Consortium (DKTK), Essen, Germany
| | - Constantin Lapa
- Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany.,Member of the Board, German Society of Nuclear Medicine (DGN e. V.)
| | - Kerstin Lorenz
- Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University of Halle Wittenberg, Faculty of Medicine, Halle, Germany.,Member of the surgical working group for endocrinology (CAEK) of the German society for general and visceral surgery (DGAV)
| | - Thomas J Musholt
- Section of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.,Member of the surgical working group for endocrinology (CAEK) of the German society for general and visceral surgery (DGAV)
| | - James Nagarajah
- Department of Medical Imaging, Nuclear Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherland.,Thyroid Committee, German Society of Nuclear Medicine (DGN e. V.).,Guideline Committee, German Society of Nuclear Medicine (DGN e. V.)
| | - Christoph Reiners
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Carsten O Sahlmann
- Department of Nuclear Medicine, University Medical Center Göttingen, Göttingen, Germany.,Thyroid Committee, German Society of Nuclear Medicine (DGN e. V.)
| | - Michael C Kreissl
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Germany.,Thyroid Committee, German Society of Nuclear Medicine (DGN e. V.)
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9
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Sanders KJC, Wierts R, van Marken Lichtenbelt WD, de Vos-Geelen J, Plasqui G, Kelders MCJM, Schrauwen-Hinderling VB, Bucerius J, Dingemans AMC, Mottaghy FM, Schols AMWJ. Brown adipose tissue activation is not related to hypermetabolism in emphysematous chronic obstructive pulmonary disease patients. J Cachexia Sarcopenia Muscle 2022; 13:1329-1338. [PMID: 35166050 PMCID: PMC8978002 DOI: 10.1002/jcsm.12881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 09/27/2021] [Accepted: 11/01/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Brown adipose tissue (BAT) has been primarily researched as a potential target for mitigating obesity. However, the physiological significance of BAT in relation to cachexia remains poorly understood. The objective of this study was to investigate the putative contribution of BAT on different components of energy metabolism in emphysematous chronic obstructive pulmonary disease (COPD) patients. METHODS Twenty COPD patients (mean ± SD age 62 ± 6, 50% female, median [range] BMI 22.4 [15.1-32.5] kg/m2 and 85% low FFMI) were studied. Basal metabolic rate (BMR) was assessed by ventilated hood, total daily energy expenditure (TDEE) by doubly labelled water and physical activity by triaxial accelerometry. BMR was adjusted for fat-free mass (FFM) as assessed by deuterium dilution. Analysis of BAT and WAT was conducted in a subset of ten patients and six age-matched, gender-matched and BMI-matched healthy controls. BAT glucose uptake was assessed by means of cold-stimulated integrated [18F]FDG positron-emission tomography and magnetic resonance imaging. WAT was collected from subcutaneous abdominal biopsies to analyse metabolic and inflammatory gene expression levels. Lung function was assessed by spirometry and body plethysmography and systemic inflammation by high sensitivity C-reactive protein. RESULTS Mean TDEE was 2209 ± 394 kcal/day, and mean BMR was 1449 ± 214 kcal/day corresponding to 120% of predicted. FFM-adjusted BMR did not correlate with lung function or C-reactive protein. Upon cooling, energy expenditure increased, resulting in a non-shivering thermogenesis of (median [range]) 20.1% [3.3-41.3] in patients and controls. Mean BAT glucose uptake was comparable between COPD and controls (1.5 [0.1-6.2] vs. 1.1 [0.7-3.9]). In addition, no correlation was found between BMR adjusted for FFM and BAT activity or between cold-induced non-shivering energy expenditure and BAT activity. Gene expression levels of the brown adipocyte or beige markers were also comparable between the groups. No (serious) adverse events were reported. CONCLUSIONS Although COPD patients were hypermetabolic at rest, no correlation was found between BMR or TDEE and BAT activity. Furthermore, both BAT activity and gene expression levels of the brown adipocyte or beige markers were comparable between COPD patients and controls.
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Affiliation(s)
- Karin J C Sanders
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Roel Wierts
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Wouter D van Marken Lichtenbelt
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Judith de Vos-Geelen
- Department of Internal Medicine, Division of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marco C J M Kelders
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Vera B Schrauwen-Hinderling
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Radiology and Nuclear Medicine, NUTRIM School for Nutrition and Translational Research in Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jan Bucerius
- Department of Radiology and Nuclear Medicine and CARIM School for Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Nuclear Medicine, University Medicine Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | | | - Felix M Mottaghy
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Nuclear Medicine and CIO ABCD, University Hospital RWTH Aachen University, Aachen, Germany
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
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10
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Boswijk E, de Ligt M, Habets MFJ, Mingels AMA, van Marken Lichtenbelt WD, Mottaghy FM, Schrauwen P, Wildberger JE, Bucerius J. Resveratrol treatment does not reduce arterial inflammation in males at risk of type 2 diabetes: a randomized crossover trial. Nuklearmedizin 2021; 61:33-41. [PMID: 34918332 DOI: 10.1055/a-1585-7215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Resveratrol has shown promising anti-inflammatory effects in in vitro and animal studies. We aimed to investigate this effect on arterial inflammation in vivo. METHODS This was an additional analysis of a double-blind randomized crossover trial which included eight male subjects with decreased insulin sensitivity who underwent an 18F-fluoroxyglucose (18F-FDG) PET/CT after 34 days of placebo and resveratrol treatment (150 mg/day). 18F-FDG uptake was analyzed in the carotid arteries and the aorta, adipose tissue regions, spleen, and bone marrow as measures for arterial and systemic inflammation. Maximum target-to-background ratios (TBRmax) were compared between resveratrol and placebo treatment with the non-parametric Wilcoxon signed-rank test. Median values are shown with their interquartile range. RESULTS Arterial 18F-FDG uptake was non-significantly higher after resveratrol treatment (TBRmax all vessels 1.7 (1.6-1.7)) in comparison to placebo treatment (1.5 (1.4-1.6); p=0.050). Only in visceral adipose tissue, the increase in 18F-FDG uptake after resveratrol reached statistical significance (p=0.024). Furthermore, CRP-levels were not significantly affected by resveratrol treatment (p=0.091). CONCLUSIONS Resveratrol failed to attenuate arterial or systemic inflammation as measured with 18F-FDG PET in subjects at risk of developing type 2 diabetes. However, validation of these findings in larger human studies is needed.
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Affiliation(s)
- Ellen Boswijk
- Department of Radiology and Nuclear Medicine, Maastricht UMC+, Maastricht, Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Marlies de Ligt
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| | - Marie-Fleur J Habets
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| | - Alma M A Mingels
- Department of Clinical Chemistry, Central Diagnostic Laboratory, Maastricht UMC+, Maastricht, Netherlands
| | - Wouter D van Marken Lichtenbelt
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| | - Felix M Mottaghy
- Department of Radiology and Nuclear Medicine, Maastricht UMC+, Maastricht, Netherlands.,Department of Nuclear Medicine, University Hospital Aachen, Aachen, Germany
| | - Patrick Schrauwen
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| | - Joachim E Wildberger
- Department of Radiology and Nuclear Medicine, Maastricht UMC+, Maastricht, Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Jan Bucerius
- Department of Radiology and Nuclear Medicine, Maastricht UMC+, Maastricht, Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands.,Department of Nuclear Medicine, Universitätsmedizin Göttingen, Gottingen, Germany
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11
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Slart RHJA, Glaudemans AWJM, Gheysens O, Lubberink M, Kero T, Dweck MR, Habib G, Gaemperli O, Saraste A, Gimelli A, Georgoulias P, Verberne HJ, Bucerius J, Rischpler C, Hyafil F, Erba PA. Procedural recommendations of cardiac PET/CT imaging: standardization in inflammatory-, infective-, infiltrative-, and innervation- (4Is) related cardiovascular diseases: a joint collaboration of the EACVI and the EANM: summary. Eur Heart J Cardiovasc Imaging 2021; 21:1320-1330. [PMID: 33245759 PMCID: PMC7695243 DOI: 10.1093/ehjci/jeaa299] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 10/13/2020] [Indexed: 01/18/2023] Open
Abstract
With this summarized document we share the standard for positron emission tomography (PET)/(diagnostic)computed tomography (CT) imaging procedures in cardiovascular diseases that are inflammatory, infective, infiltrative, or associated with dysfunctional innervation (4Is) as recently published in the European Journal of Nuclear Medicine and Molecular Imaging. This standard should be applied in clinical practice and integrated in clinical (multicentre) trials for optimal standardization of the procedurals and interpretations. A major focus is put on procedures using [18F]-2-fluoro-2-deoxyglucose ([18F]FDG), but 4Is PET radiopharmaceuticals beyond [18F]FDG are also described in this summarized document. Whilst these novel tracers are currently mainly applied in early clinical trials, some multicentre trials are underway and we foresee in the near future their use in clinical care and inclusion in the clinical guidelines. Diagnosis and management of 4Is related cardiovascular diseases are generally complex and often require a multidisciplinary approach by a team of experts. The new standards described herein should be applied when using PET/CT and PET/magnetic resonance, within a multimodality imaging framework both in clinical practice and in clinical trials for 4Is cardiovascular indications.
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Affiliation(s)
- Riemer H J A Slart
- Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands.,Faculty of Science and Technology, Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands
| | - Andor W J M Glaudemans
- Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Olivier Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Mark Lubberink
- Department of Surgical Sciences/Radiology, Uppsala University, Uppsala, Sweden
| | - Tanja Kero
- Department of Surgical Sciences/Radiology, Uppsala University, Uppsala, Sweden.,Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Gilbert Habib
- Cardiology Department, APHM, La Timone Hospital, Marseille, France.,Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | | | - Antti Saraste
- Turku PET Centre, Turku University Hospital, University of Turku, Turku, Finland.,Heart Center, Turku University Hospital, Turku, Finland
| | | | - Panagiotis Georgoulias
- Department of Nuclear Medicine, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Bucerius
- Department of Nuclear Medicine, Georg-August University Göttingen, Göttingen, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Fabien Hyafil
- Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, F75015, Paris, France.,University of Paris, PARCC, INSERM, F75007, Paris, France
| | - Paola A Erba
- Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands.,Department of Nuclear Medicine, University of Pisa, Pisa, Italy.,Department of Translational Research and New Technology in Medicine, University of Pisa, Pisa, Italy
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12
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van Gorp RH, Dijkgraaf I, Bröker V, Bauwens M, Leenders P, Jennen D, Dweck MR, Bucerius J, Briedé JJ, van Ryn J, Brandenburg V, Mottaghy F, Spronk HMH, Reutelingsperger CP, Schurgers LJ. Off-target effects of oral anticoagulants - vascular effects of vitamin K antagonist and non-vitamin K antagonist oral anticoagulant dabigatran etexilate. J Thromb Haemost 2021; 19:1348-1363. [PMID: 33687782 PMCID: PMC8252511 DOI: 10.1111/jth.15289] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Vitamin K antagonists (VKA) and non-vitamin K oral antagonist anticoagulants (NOAC) are used in the clinic to reduce risk of thrombosis. However, they also exhibit vascular off-target effects. The aim of this study is to compare VKA and NOAC on atherosclerosis progression and calcification in an experimental setup. MATERIAL AND METHODS Female Apoe-/- mice (age 12 weeks) were fed Western-type diet as control or supplemented with dabigatran etexilate or warfarin for 6 or 18 weeks. Vascular calcification was measured in whole aortic arches using µCT and [18 F]-NaF. Atherosclerotic burden was assessed by (immuno)histochemistry. Additionally, in vitro effects of warfarin, thrombin, and dabigatran on primary vascular smooth muscle cells (VSMC) were assessed. RESULTS Short-term treatment with warfarin promoted formation of atherosclerotic lesions with a pro-inflammatory phenotype, and more rapid plaque progression compared with control and dabigatran. In contrast, dabigatran significantly reduced plaque progression compared with control. Long-term warfarin treatment significantly increased both presence and activity of plaque calcification compared with control and dabigatran. Calcification induced by warfarin treatment was accompanied by increased presence of uncarboxylated matrix Gla protein. In vitro, both warfarin and thrombin significantly increased VSMC oxidative stress and extracellular vesicle release, which was prevented by dabigatran. CONCLUSION Warfarin aggravates atherosclerotic disease activity, increasing plaque inflammation, active calcification, and plaque progression. Dabigatran lacks undesired vascular side effects and reveals beneficial effects on atherosclerosis progression and calcification. The choice of anticoagulation impacts atherosclerotic disease by differential off target effect. Future clinical studies should test whether this beneficial effect also applies to patients.
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Affiliation(s)
- Rick H. van Gorp
- Department of BiochemistryCardiovascular Research Institute MaastrichtMaastricht UniversityMaastrichtThe Netherlands
- Nattopharma ASAOsloNorway
| | - Ingrid Dijkgraaf
- Department of BiochemistryCardiovascular Research Institute MaastrichtMaastricht UniversityMaastrichtThe Netherlands
| | - Vanessa Bröker
- Department of BiochemistryCardiovascular Research Institute MaastrichtMaastricht UniversityMaastrichtThe Netherlands
| | - Matthias Bauwens
- Department of Radiology and Nuclear MedicineMaastricht University Medical Center (MUMC+)MaastrichtThe Netherlands
| | - Peter Leenders
- Department of BiochemistryCardiovascular Research Institute MaastrichtMaastricht UniversityMaastrichtThe Netherlands
| | - Danyel Jennen
- Department of ToxicogenomicsGROW School of Oncology and Developmental BiologyMaastricht UniversityMaastrichtThe Netherlands
| | - Marc R. Dweck
- Centre for Cardiovascular ScienceUniversity of EdinburghEdinburghUK
| | - Jan Bucerius
- Department of Radiology and Nuclear MedicineMaastricht University Medical Center (MUMC+)MaastrichtThe Netherlands
| | - Jacco J. Briedé
- Department of ToxicogenomicsGROW School of Oncology and Developmental BiologyMaastricht UniversityMaastrichtThe Netherlands
| | - Joanne van Ryn
- Department of Cardiometabolic ResearchBoehringer IngelheimBiberachGermany
| | - Vincent Brandenburg
- Klinik Für Kardiologie und NephrologieRhein‐Maas Klinikum WürselenWürselenGermany
| | - Felix Mottaghy
- Department of Radiology and Nuclear MedicineMaastricht University Medical Center (MUMC+)MaastrichtThe Netherlands
- Department of Nuclear MedicineUniversity Hospital RWTH Aachen UniversityAachenGermany
| | - Henri M. H. Spronk
- Department of BiochemistryCardiovascular Research Institute MaastrichtMaastricht UniversityMaastrichtThe Netherlands
| | - Chris P. Reutelingsperger
- Department of BiochemistryCardiovascular Research Institute MaastrichtMaastricht UniversityMaastrichtThe Netherlands
| | - Leon J. Schurgers
- Department of BiochemistryCardiovascular Research Institute MaastrichtMaastricht UniversityMaastrichtThe Netherlands
- Institute of Experimental Medicine and Systems BiologyRWTH Aachen UniversityAachenGermany
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13
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Florea A, Kooi ME, Mess W, Schurgers LJ, Bucerius J, Mottaghy FM. Effects of Combined Vitamin K2 and Vitamin D3 Supplementation on Na[ 18F]F PET/MRI in Patients with Carotid Artery Disease: The INTRICATE Rationale and Trial Design. Nutrients 2021; 13:nu13030994. [PMID: 33808652 PMCID: PMC8003489 DOI: 10.3390/nu13030994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/13/2021] [Accepted: 03/17/2021] [Indexed: 11/29/2022] Open
Abstract
INTRICATE is a prospective double-blind placebo-controlled feasibility study, assessing the influence of combined vitamin K2 and vitamin D3 supplementation on micro-calcification in carotid artery disease as imaged by hybrid Sodium [18F]Fluoride (Na[18F]F) positron emission tomography (PET)/ magnetic resonance imaging (MRI). Arterial calcification is an actively regulated process and results from the imbalance between calcification promoting and inhibiting factors. Considering the recent advancements in medical imaging, ultrasound (US), PET/MRI, and computed tomography (CT) can be used for the selection and stratification of patients with atherosclerosis. Fifty-two subjects with asymptomatic carotid artery disease on at least one side of the neck will be included in the study. At baseline, an Na[18F]F PET/MRI and CT examination will be performed. Afterwards, subjects will be randomized (1:1) to a vitamin K (400 µg MK-7/day) and vitamin D3 (80 µg/day) or to placebo. At the 3-month follow-up, subjects will undergo a second Na[18F]F PET/MRI and CT scan. The primary endpoint is the change in Na[18F]F PET/MRI (baseline vs. after 3 months) in the treatment group as compared to the placebo arm. Secondary endpoints are changes in plaque composition and in blood-biomarkers. The INTRICATE trial bears the potential to open novel avenues for future large scale randomized controlled trials to intervene in the plaque development and micro-calcification progression.
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Affiliation(s)
- Alexandru Florea
- Department of Nuclear Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany;
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands; (M.E.K.); (J.B.)
- School for Cardiovascular Diseases (CARIM), Maastricht University, 6229HX Maastricht, The Netherlands;
| | - M. Eline Kooi
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands; (M.E.K.); (J.B.)
- School for Cardiovascular Diseases (CARIM), Maastricht University, 6229HX Maastricht, The Netherlands;
| | - Werner Mess
- Department of Clinical Neurophysiology, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands;
| | - Leon J. Schurgers
- School for Cardiovascular Diseases (CARIM), Maastricht University, 6229HX Maastricht, The Netherlands;
- Department of Biochemistry, Maastricht University, 6229HX Maastricht, The Netherlands
- Institute of Experimental Medicine and Systems Biology, RWTH Aachen University, 52074 Aachen, Germany
| | - Jan Bucerius
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands; (M.E.K.); (J.B.)
- School for Cardiovascular Diseases (CARIM), Maastricht University, 6229HX Maastricht, The Netherlands;
- Department of Nuclear Medicine, University of Göttingen, 37075 Göttingen, Germany
| | - Felix M. Mottaghy
- Department of Nuclear Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany;
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands; (M.E.K.); (J.B.)
- School for Cardiovascular Diseases (CARIM), Maastricht University, 6229HX Maastricht, The Netherlands;
- Correspondence: ; Tel.: +49-241-80-88741
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14
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Florea A, Sigl JP, Morgenroth A, Vogg A, Sahnoun S, Winz OH, Bucerius J, Schurgers LJ, Mottaghy FM. Sodium [ 18F]Fluoride PET Can Efficiently Monitor In Vivo Atherosclerotic Plaque Calcification Progression and Treatment. Cells 2021; 10:cells10020275. [PMID: 33573188 PMCID: PMC7911917 DOI: 10.3390/cells10020275] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/07/2021] [Accepted: 01/27/2021] [Indexed: 12/13/2022] Open
Abstract
Given the high sensitivity and specificity of sodium [18F]Fluoride (Na[18F]F) for vascular calcifications and positive emerging data of vitamin K on vascular health, the aim of this study is to assess the ability of Na[18F]F to monitor therapy and disease progression in a unitary atherosclerotic mouse model. ApoE−/− mice were placed on a Western-type diet for 12-weeks and then split into four groups. The early stage atherosclerosis group received a chow diet for an additional 12-weeks, while the advanced atherosclerosis group continued the Western-type diet. The Menaquinone-7 (MK-7) and Warfarin groups received MK-7 or Warfarin supplementation during the additional 12-weeks, respectively. Control wild type mice were fed a chow diet for 24-weeks. All of the mice were scanned with Na[18F]F using a small animal positron emission tomography (PET)/computed tomography (CT). The Warfarin group presented spotty calcifications on the CT in the proximal aorta. All of the spots corresponded to dense mineralisations on the von Kossa staining. After the control, the MK-7 group had the lowest Na[18F]F uptake. The advanced and Warfarin groups presented the highest uptake in the aortic arch and left ventricle. The advanced stage group did not develop spotty calcifications, however Na[18F]F uptake was still observed, suggesting the presence of micro-calcifications. In a newly applied mouse model, developing spotty calcifications on CT exclusively in the proximal aorta, Na[18F]F seems to efficiently monitor plaque progression and the beneficial effects of vitamin K on cardiovascular disease.
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Affiliation(s)
- Alexandru Florea
- Department of Nuclear Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.F.); (J.P.S.); (A.M.); (A.V.); (S.S.); (O.H.W.)
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
| | - Julius P. Sigl
- Department of Nuclear Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.F.); (J.P.S.); (A.M.); (A.V.); (S.S.); (O.H.W.)
| | - Agnieszka Morgenroth
- Department of Nuclear Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.F.); (J.P.S.); (A.M.); (A.V.); (S.S.); (O.H.W.)
| | - Andreas Vogg
- Department of Nuclear Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.F.); (J.P.S.); (A.M.); (A.V.); (S.S.); (O.H.W.)
| | - Sabri Sahnoun
- Department of Nuclear Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.F.); (J.P.S.); (A.M.); (A.V.); (S.S.); (O.H.W.)
| | - Oliver H. Winz
- Department of Nuclear Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.F.); (J.P.S.); (A.M.); (A.V.); (S.S.); (O.H.W.)
| | - Jan Bucerius
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
- Department of Nuclear Medicine, University of Göttingen, 37075 Göttingen, Germany
| | - Leon J. Schurgers
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
- Department of Biochemistry, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
- Institute of Experimental Medicine and Systems Biology, RWTH Aachen University, 52074 Aachen, Germany
| | - Felix M. Mottaghy
- Department of Nuclear Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.F.); (J.P.S.); (A.M.); (A.V.); (S.S.); (O.H.W.)
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
- Correspondence: ; Tel.: +49-241-80-88741
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Slart RHJA, Glaudemans AWJM, Gheysens O, Lubberink M, Kero T, Dweck MR, Habib G, Gaemperli O, Saraste A, Gimelli A, Georgoulias P, Verberne HJ, Bucerius J, Rischpler C, Hyafil F, Erba PA. Procedural recommendations of cardiac PET/CT imaging: standardization in inflammatory-, infective-, infiltrative-, and innervation (4Is)-related cardiovascular diseases: a joint collaboration of the EACVI and the EANM. Eur J Nucl Med Mol Imaging 2020; 48:1016-1039. [PMID: 33106926 PMCID: PMC8041672 DOI: 10.1007/s00259-020-05066-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/05/2020] [Indexed: 01/18/2023]
Abstract
With this document, we provide a standard for PET/(diagnostic) CT imaging procedures in cardiovascular diseases that are inflammatory, infective, infiltrative, or associated with dysfunctional innervation (4Is). This standard should be applied in clinical practice and integrated in clinical (multicenter) trials for optimal procedural standardization. A major focus is put on procedures using [18F]FDG, but 4Is PET radiopharmaceuticals beyond [18F]FDG are also described in this document. Whilst these novel tracers are currently mainly applied in early clinical trials, some multicenter trials are underway and we foresee in the near future their use in clinical care and inclusion in the clinical guidelines. Finally, PET/MR applications in 4Is cardiovascular diseases are also briefly described. Diagnosis and management of 4Is-related cardiovascular diseases are generally complex and often require a multidisciplinary approach by a team of experts. The new standards described herein should be applied when using PET/CT and PET/MR, within a multimodality imaging framework both in clinical practice and in clinical trials for 4Is cardiovascular indications.
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Affiliation(s)
- Riemer H J A Slart
- Medical Imaging Centre, Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
- Medical Imaging Centre, Department of Nuclear medicine & Molecular Imaging (EB50), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
- Faculty of Science and Technology Biomedical, Photonic Imaging, University of Twente, Enschede, The Netherlands.
| | - Andor W J M Glaudemans
- Medical Imaging Centre, Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Olivier Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Mark Lubberink
- Department of Surgical Sciences/Radiology, Uppsala University, Uppsala, Sweden
| | - Tanja Kero
- Department of Surgical Sciences/Radiology, Uppsala University, Uppsala, Sweden
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Gilbert Habib
- Cardiology Department, APHM, La Timone Hospital, Marseille, France
- Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Oliver Gaemperli
- HeartClinic, Hirslanden Hospital Zurich, Hirslanden, Switzerland
| | - Antti Saraste
- Turku PET Centre, Turku University Hospital, University of Turku, Turku, Finland
- Heart Center, Turku University Hospital, Turku, Finland
| | | | - Panagiotis Georgoulias
- Department of Nuclear Medicine, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Bucerius
- Department of Nuclear Medicine, Georg-August University Göttingen, Göttingen, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Fabien Hyafil
- Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, F75015 Paris, France
- PARCC, INSERM, University of Paris, F-75006 Paris, France
| | - Paola A Erba
- Medical Imaging Centre, Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Nuclear Medicine, University of Pisa, Pisa, Italy
- Department of Translational Research and New Technology in Medicine, University of Pisa, Pisa, Italy
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16
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Florea A, Morgenroth A, Bucerius J, Schurgers LJ, Mottaghy FM. Locking and loading the bullet against micro-calcification. Eur J Prev Cardiol 2020; 28:1370-1375. [PMID: 33611501 DOI: 10.1177/2047487320911138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 02/14/2020] [Indexed: 12/24/2022]
Abstract
AIMS Despite recent medical advances, cardiovascular disease remains the leading cause of death worldwide. As (micro)-calcification is a hallmark of atherosclerosis, this review will elaborately discuss advantages of sodium fluoride positron emission tomography (PET) as a reliable cardiovascular imaging technique for identifying the early onset of vascular calcification (i.e. locking onto the target). We assess state-of-the-art meta-analysis and clinical studies of possible treatment options and evaluate the concept of vitamin K supplementation to preserve vascular health (i.e. loading the bullet). METHODS AND RESULTS After a structured PubMed search, we identified 18F-sodium fluoride (18F-NaF) PET as the most suitable technique for detecting micro-calcification. Presenting the pros and cons of available treatments, vitamin K supplementation should be considered as a possible safe and cost-effective option to inhibit vascular (micro)-calcification. CONCLUSION This review demonstrates need for more extensive research in the concept of vitamin K supplementation (i.e. loading the bullet) and recommends monitoring the effects on vascular calcification using 18F-NaF PET (i.e. locking onto the target).
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Affiliation(s)
- Alexandru Florea
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
- Department of Radiology and Nuclear Medicine, Academic Hospital Maastricht, Maastricht, Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University, Netherlands
| | - Agnieszka Morgenroth
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Jan Bucerius
- Department of Radiology and Nuclear Medicine, Academic Hospital Maastricht, Maastricht, Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University, Netherlands
- Department of Nuclear Medicine, University of Göttingen, Göttingen, Germany
| | - Leon J Schurgers
- School for Cardiovascular Diseases (CARIM), Maastricht University, Netherlands
- Department of Biochemistry, Maastricht University, Maastricht, Netherlands
| | - Felix M Mottaghy
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
- Department of Radiology and Nuclear Medicine, Academic Hospital Maastricht, Maastricht, Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University, Netherlands
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17
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Bucerius J, Biersack HJ. Radioisotope Therapy of Malignant Pleural and Peritoneal Effusions. Clin Nucl Med 2020. [DOI: 10.1007/978-3-030-39457-8_38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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18
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Boswijk E, Franssen R, Vijgen GHEJ, Wierts R, van der Pol JAJ, Mingels AMA, Cornips EMJ, Majoie MHJM, van Marken Lichtenbelt WD, Mottaghy FM, Wildberger JE, Bucerius J. Short-term discontinuation of vagal nerve stimulation alters 18F-FDG blood pool activity: an exploratory interventional study in epilepsy patients. EJNMMI Res 2019; 9:101. [PMID: 31773320 PMCID: PMC6879675 DOI: 10.1186/s13550-019-0567-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 10/16/2019] [Indexed: 11/15/2022] Open
Abstract
Background Vagus nerve activation impacts inflammation. Therefore, we hypothesized that vagal nerve stimulation (VNS) influenced arterial wall inflammation as measured by 18F-FDG uptake. Results Ten patients with left-sided VNS for refractory epilepsy were studied during stimulation (VNS-on) and in the hours after stimulation was switched off (VNS-off). In nine patients, 18F-FDG uptake was measured in the right carotid artery, aorta, bone marrow, spleen, and adipose tissue. Target-to-background ratios (TBRs) were calculated to normalize the respective standardized uptake values (SUVs) for venous blood pool activity. Median values are shown with interquartile range and compared using the Wilcoxon signed-rank test. Arterial SUVs tended to be higher during VNS-off than VNS-on [SUVmax all vessels 1.8 (1.5–2.2) vs. 1.7 (1.2–2.0), p = 0.051]. However, a larger difference was found for the venous blood pool at this time point, reaching statistical significance in the vena cava superior [meanSUVmean 1.3 (1.1–1.4) vs. 1.0 (0.8–1.1); p = 0.011], resulting in non-significant lower arterial TBRs during VNS-off than VNS-on. Differences in the remaining tissues were not significant. Insulin levels increased after VNS was switched off [55.0 pmol/L (45.9–96.8) vs. 48.1 pmol/L (36.9–61.8); p = 0.047]. The concurrent increase in glucose levels was not statistically significant [4.8 mmol/L (4.7–5.3) vs. 4.6 mmol/L (4.5–5.2); p = 0.075]. Conclusions Short-term discontinuation of VNS did not show a consistent change in arterial wall 18F-FDG-uptake. However, VNS did alter insulin and 18F-FDG blood levels, possibly as a result of sympathetic activation.
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Affiliation(s)
- Ellen Boswijk
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands
| | - Renee Franssen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Guy H E J Vijgen
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands.,Department of Surgery, Erasmus Medical Center (EMC), Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - Roel Wierts
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Jochem A J van der Pol
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Alma M A Mingels
- Department of Clinical Chemistry, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Erwin M J Cornips
- Department of Neurosurgery, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Marian H J M Majoie
- Department of Research & Development, Epilepsy Center Kempenhaeghe, Sterkselseweg 65, 5591 VE, Heeze, The Netherlands.,Department of Neurology, Academic Center for Epileptology, Epilepsy Center Kempenhaeghe & Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.,MHENS School of Mental Health & Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands.,School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Wouter D van Marken Lichtenbelt
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - Felix M Mottaghy
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.,Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Joachim E Wildberger
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands
| | - Jan Bucerius
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands. .,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands. .,Department of Nuclear Medicine, Georg-August University Göttingen, Robert-Koch-Strasse 40, 37075, Göttingen, Germany.
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19
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Swart LE, Gomes A, Scholtens AM, Sinha B, Tanis W, Lam MGEH, van der Vlugt MJ, Streukens SAF, Aarntzen EHJG, Bucerius J, van Assen S, Bleeker-Rovers CP, van Geel PP, Krestin GP, van Melle JP, Roos-Hesselink JW, Slart RHJA, Glaudemans AWJM, Budde RPJ. Improving the Diagnostic Performance of 18F-Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography in Prosthetic Heart Valve Endocarditis. Circulation 2019; 138:1412-1427. [PMID: 30018167 DOI: 10.1161/circulationaha.118.035032] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND 18F-Fluorodeoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) was recently introduced as a new tool for the diagnosis of prosthetic heart valve endocarditis (PVE). Previous studies reporting a modest diagnostic accuracy may have been hampered by unstandardized image acquisition and assessment, and several confounders, as well. The aim of this study was to improve the diagnostic performance of FDG PET/CT in patients in whom PVE was suspected by identifying and excluding possible confounders, using both visual and standardized quantitative assessments. METHODS In this multicenter study, 160 patients with a prosthetic heart valve (median age, 62 years [43-73]; 68% male; 82 mechanical valves; 62 biological; 9 transcatheter aortic valve replacements; 7 other) who underwent FDG PET/CT for suspicion of PVE, and 77 patients with a PV (median age, 73 years [65-77]; 71% male; 26 mechanical valves; 45 biological; 6 transcatheter aortic valve replacements) who underwent FDG PET/CT for other indications (negative control group), were retrospectively included. Their scans were reassessed by 2 independent observers blinded to all clinical data, both visually and quantitatively on available European Association of Nuclear Medicine Research Ltd-standardized reconstructions. Confounders were identified by use of a logistic regression model and subsequently excluded. RESULTS Visual assessment of FDG PET/CT had a sensitivity/specificity/positive predictive value/negative predictive value for PVE of 74%/91%/89%/78%, respectively. Low inflammatory activity (C-reactive protein <40 mg/L) at the time of imaging and use of surgical adhesives during prosthetic heart valve implantation were significant confounders, whereas recent valve implantation was not. After the exclusion of patients with significant confounders, diagnostic performance values of the visual assessment increased to 91%/95%/95%/91%. As a semiquantitative measure of FDG uptake, a European Association of Nuclear Medicine Research Ltd-standardized uptake value ratio of ≥2.0 was a 100% sensitive and 91% specific predictor of PVE. CONCLUSIONS Both visual and quantitative assessments of FDG PET/CT have a high diagnostic accuracy in patients in whom PVE is suspected. FDG PET/CT should be implemented early in the diagnostic workup to prevent the negative confounding effects of low inflammatory activity (eg, attributable to prolonged antibiotic therapy). Recent valve implantation was not a significant predictor of false-positive interpretations, but surgical adhesives used during implantation were.
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Affiliation(s)
- Laurens E Swart
- Department of Radiology and Nuclear Medicine (L.E.S., G.P.K., R.P.J.B.), Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Cardiology (L.E.S., J.W.R.-H.), Erasmus Medical Center, Rotterdam, The Netherlands
| | - Anna Gomes
- Department of Medical Microbiology (A.G., B.S.), University of Groningen, University Medical Center Groningen, The Netherlands
| | - Asbjørn M Scholtens
- Department of Nuclear Medicine, Meander Medical Center, Amersfoort, The Netherlands (A.M.S.)
| | - Bhanu Sinha
- Department of Medical Microbiology (A.G., B.S.), University of Groningen, University Medical Center Groningen, The Netherlands
| | - Wilco Tanis
- Heartcenter, Haga Teaching Hospital, The Hague, The Netherlands (W.T.)
| | - Marnix G E H Lam
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, The Netherlands (M.G.E.H.L.)
| | - Maureen J van der Vlugt
- Department of Cardiology (M.J.v.d.V.), Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Erik H J G Aarntzen
- Department of Radiology and Nuclear Medicine (E.H.J.G.A.), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan Bucerius
- Department of Radiology and Nuclear Medicine (J.B.), Maastricht University Medical Center, The Netherlands.,Cardiovascular Research Institute Maastricht (J.B.), Maastricht University Medical Center, The Netherlands.,Department of Nuclear Medicine, University Hospital Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Germany (J.B.)
| | - Sander van Assen
- Department of Internal Medicine, Treant Care Group, Hoogeveen/Emmen/Stadskanaal, The Netherlands (S.v.A.)
| | - Chantal P Bleeker-Rovers
- Department of Internal Medicine (C.P.B.-R.), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter Paul van Geel
- Department of Cardiology (P.P.v.G., J.P.v.M.), University of Groningen, University Medical Center Groningen, The Netherlands
| | - Gabriel P Krestin
- Department of Radiology and Nuclear Medicine (L.E.S., G.P.K., R.P.J.B.), Erasmus Medical Center, Rotterdam, The Netherlands
| | - Joost P van Melle
- Department of Cardiology (P.P.v.G., J.P.v.M.), University of Groningen, University Medical Center Groningen, The Netherlands
| | - Jolien W Roos-Hesselink
- Department of Cardiology (L.E.S., J.W.R.-H.), Erasmus Medical Center, Rotterdam, The Netherlands
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center (R.H.J.A.S., A.W.J.M.G.), University of Groningen, University Medical Center Groningen, The Netherlands.,Department of Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands (R.H.J.A.S.)
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center (R.H.J.A.S., A.W.J.M.G.), University of Groningen, University Medical Center Groningen, The Netherlands
| | - Ricardo P J Budde
- Department of Radiology and Nuclear Medicine (L.E.S., G.P.K., R.P.J.B.), Erasmus Medical Center, Rotterdam, The Netherlands
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20
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Hyafil F, Gimelli A, Slart RHJA, Georgoulias P, Rischpler C, Lubberink M, Sciagra R, Bucerius J, Agostini D, Verberne HJ. EANM procedural guidelines for myocardial perfusion scintigraphy using cardiac-centered gamma cameras. Eur J Hybrid Imaging 2019; 3:11. [PMID: 34191169 PMCID: PMC8218102 DOI: 10.1186/s41824-019-0058-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 06/10/2019] [Indexed: 01/28/2023] Open
Abstract
An increasing number of Nuclear Medicine sites in Europe are using cardiac-centered gamma cameras for myocardial perfusion scintigraphy (MPS). Three cardiac-centered gamma cameras are currently the most frequently used in Europe: the D-SPECT (Spectrum Dynamics), the Alcyone (Discovery NM 530c and Discovery NM/CT 570c; General Electric Medical Systems), and the IQ-SPECT (Siemens Healthcare). The increased myocardial count sensitivity of these three cardiac-centered systems has allowed for a decrease in the activities of radiopharmaceuticals injected to patients for myocardial perfusion imaging and, consequently, radiation exposure of patients. When setting up protocols for MPS, the overall objective should be to maintain high diagnostic accuracy of MPS, while injecting the lowest activities reasonably achievable to reduce the level of radiation exposure of patient and staff. These guidelines aim at providing recommendations for acquisition protocols and image interpretation using cardiac-centered cameras. As each imaging system has specific design and features for image acquisition and analysis, these guidelines have been separated into three sections for each gamma camera system. These recommendations have been written by the members of the Cardiovascular Committee of EANM and were based on their own experience with each of these systems and on the existing literature.
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Affiliation(s)
- Fabien Hyafil
- Department of Nuclear Medicine; Bichat University Hospital, Assistance Publique - Hôpitaux de Paris; Inserm UMR 1148, Paris Diderot-Paris 7 University, 46 rue Henri Huchard, 75018, Paris, France.
| | | | - Riemer H J A Slart
- Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands.,TechMed Centre, Department of Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands
| | - Panagiotis Georgoulias
- Department of Nuclear Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mark Lubberink
- Department of Medical Physics and PET Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Roberto Sciagra
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Jan Bucerius
- Department of Nuclear Medicine, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Denis Agostini
- Department of Nuclear Medicine, CHU Caen Normandy University, Caen, France
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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21
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Boswijk E, Sanders KJC, Broeders EPM, de Ligt M, Vijgen GHEJ, Havekes B, Mingels AMA, Wierts R, van Marken Lichtenbelt WD, Schrauwen P, Mottaghy FM, Wildberger JE, Bucerius J. TSH suppression aggravates arterial inflammation - an 18F-FDG PET study in thyroid carcinoma patients. Eur J Nucl Med Mol Imaging 2019; 46:1428-1438. [PMID: 30859432 PMCID: PMC6533218 DOI: 10.1007/s00259-019-04292-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/13/2019] [Indexed: 11/04/2022]
Abstract
Purpose We aimed to investigate the influence of both hypothyroidism and thyroid-stimulating hormone (TSH) suppression on vascular inflammation, as assessed with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT). Methods Ten thyroid carcinoma patients underwent an 18F-FDG PET/CT during post-thyroidectomy hypothyroidism and during thyrotropin (TSH) suppression after 131I (radioiodine) ablation therapy. We analysed the 18F-FDG uptake in the carotids, aortic arch, ascending, descending, and abdominal aorta to investigate the effects of thyroid hormone status on arterial inflammation. Target-to-background ratios (TBRs) corrected for blood pool activity were established for all arterial territories. Results were further compared to euthyroid historic control subjects. Results In general, there was a trend towards higher vascular TBRs during TSH suppression than during hypothyroidism (TBRmax all vessels = 1.6 and 1.8, respectively, p = 0.058), suggesting a higher degree of arterial inflammation. In concurrence with this, we found increased C-reactive protein (CRP) levels after levothyroxine treatment (CRP = 2.9 mg/l and 4.8 mg/l, p = 0.005). An exploratory comparison with euthyroid controls showed significant higher TBRs during TSH suppression for the carotids, aortic arch, thoracic descending aorta, and when all vascular territories were combined (TBRmaxp = 0.013, p = 0.016, p = 0.030 and p = 0.018 respectively). Conclusions Arterial inflammation is increased during TSH suppression. This finding sheds new light on the underlying mechanism of the suspected increased risk of cardiovascular disease in patients with TSH suppression. Electronic supplementary material The online version of this article (10.1007/s00259-019-04292-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ellen Boswijk
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands
| | - Karin J C Sanders
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
- Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - Evie P M Broeders
- Department of Family Medicine, Amsterdam University Medical Centre (Amsterdam UMC), Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Marlies de Ligt
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - Guy H E J Vijgen
- Department of Surgery, Franciscus, Kleiweg 500, 3045 PM, Rotterdam, The Netherlands
| | - Bas Havekes
- Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Alma M A Mingels
- Department of Clinical Chemistry, Central Diagnostic Laboratory, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Roel Wierts
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Wouter D van Marken Lichtenbelt
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - Patrick Schrauwen
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - Felix M Mottaghy
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Joachim E Wildberger
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands
| | - Jan Bucerius
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands.
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
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Bucerius J, Dijkgraaf I, Mottaghy FM, Schurgers LJ. Target identification for the diagnosis and intervention of vulnerable atherosclerotic plaques beyond 18F-fluorodeoxyglucose positron emission tomography imaging: promising tracers on the horizon. Eur J Nucl Med Mol Imaging 2018; 46:251-265. [PMID: 30302506 PMCID: PMC6267660 DOI: 10.1007/s00259-018-4176-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/18/2018] [Indexed: 12/11/2022]
Abstract
Cardiovascular disease is the major cause of morbidity and mortality in developed countries and atherosclerosis is the major cause of cardiovascular disease. Atherosclerotic lesions obstruct blood flow in the arterial vessel wall and can rupture leading to the formation of occlusive thrombi. Conventional diagnostic tools are still of limited value for identifying the vulnerable arterial plaque and for predicting its risk of rupture and of releasing thromboembolic material. Knowledge of the molecular and biological processes implicated in the process of atherosclerosis will advance the development of imaging probes to differentiate the vulnerable plaque. The development of imaging probes with high sensitivity and specificity in identifying high-risk atherosclerotic vessel wall changes and plaques is crucial for improving knowledge-based decisions and tailored individual interventions. Arterial PET imaging with 18F-FDG has shown promising results in identifying inflammatory vessel wall changes in numerous studies and clinical trials. However, due to its limited specificity in general and its intense physiological uptake in the left ventricular myocardium that impair imaging of the coronary arteries, different PET tracers for the molecular imaging of atherosclerosis have been evaluated. This review describes biological, chemical and medical expertise supporting a translational approach that will enable the development of new or the evaluation of existing PET tracers for the identification of vulnerable atherosclerotic plaques for better risk prediction and benefit to patients.
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Affiliation(s)
- Jan Bucerius
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), 6229 HX, Maastricht, The Netherlands. .,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), 6200 MD, Maastricht, The Netherlands. .,Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany.
| | - Ingrid Dijkgraaf
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), 6200 MD, Maastricht, The Netherlands.,Department of Biochemistry, Maastricht University, Maastricht, The Netherlands
| | - Felix M Mottaghy
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), 6229 HX, Maastricht, The Netherlands.,Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Leon J Schurgers
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), 6200 MD, Maastricht, The Netherlands. .,Department of Biochemistry, Maastricht University, Maastricht, The Netherlands.
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23
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Nensa F, Bamberg F, Rischpler C, Menezes L, Poeppel TD, la Fougère C, Beitzke D, Rasul S, Loewe C, Nikolaou K, Bucerius J, Kjaer A, Gutberlet M, Prakken NH, Vliegenthart R, Slart RHJA, Nekolla SG, Lassen ML, Pichler BJ, Schlosser T, Jacquier A, Quick HH, Schäfers M, Hacker M. Hybrid cardiac imaging using PET/MRI: a joint position statement by the European Society of Cardiovascular Radiology (ESCR) and the European Association of Nuclear Medicine (EANM). Eur Radiol 2018; 28:4086-4101. [PMID: 29717368 PMCID: PMC6132726 DOI: 10.1007/s00330-017-5008-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/01/2017] [Accepted: 07/27/2017] [Indexed: 12/19/2022]
Abstract
Positron emission tomography (PET) and magnetic resonance imaging (MRI) have both been used for decades in cardiovascular imaging. Since 2010, hybrid PET/MRI using sequential and integrated scanner platforms has been available, with hybrid cardiac PET/MR imaging protocols increasingly incorporated into clinical workflows. Given the range of complementary information provided by each method, the use of hybrid PET/MRI may be justified and beneficial in particular clinical settings for the evaluation of different disease entities. In the present joint position statement, we critically review the role and value of integrated PET/MRI in cardiovascular imaging, provide a technical overview of cardiac PET/MRI and practical advice related to the cardiac PET/MRI workflow, identify cardiovascular applications that can potentially benefit from hybrid PET/MRI, and describe the needs for future development and research. In order to encourage its wide dissemination, this article is freely accessible on the European Radiology and European Journal of Hybrid Imaging web sites. KEY POINTS • Studies and case-reports indicate that PET/MRI is a feasible and robust technology. • Promising fields of application include a variety of cardiac conditions. • Larger studies are required to demonstrate its incremental and cost-effective value. • The translation of novel radiopharmaceuticals and MR-sequences will provide exciting new opportunities.
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Affiliation(s)
- Felix Nensa
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.
| | - Christoph Rischpler
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Leon Menezes
- UCL Institute of Nuclear Medicine, and NIHR, University College London Hospitals Biomedical Research Centre, 5th Floor Tower, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - Thorsten D Poeppel
- Klinik für Nuklearmedizin, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Christian la Fougère
- Nuklearmedizin und Klinische Molekulare Bildgebung, Otfried-Müller-Straße 14, 72076, Tübingen, Germany
| | - Dietrich Beitzke
- Department of Bioimaging and Image-Guided Therapy, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Sazan Rasul
- Department of Radiology and Nuclear Medicine, Medical University Vienna, Währinger Gürtel 18-20, Floor 5L, 1090, Vienna, Austria
| | - Christian Loewe
- Department of Bioimaging and Image-Guided Therapy, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - Jan Bucerius
- Maastricht Oncology Centre, Medical University Maastricht, P. Debyelaan 25, 6229 HX, Maastrich, Netherlands
| | - Andreas Kjaer
- Section of Endocrinology Research, University of Copenhagen, Panum Instituttet, Blegdamsvej 3, 2200, 12.3, Copenhagen N, Denmark
| | - Matthias Gutberlet
- Diagnostic and Interventional Radiology, University of Leipzig-Heart Center, Strümpellstrasse 39, 04289, Leipzig, Germany
| | - Niek H Prakken
- University Medical Center Groningen, Department of Radiology, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, Netherlands
| | - Rozemarijn Vliegenthart
- University Medical Center Groningen, Department of Radiology, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, Netherlands
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, Netherlands
| | - Stephan G Nekolla
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Martin L Lassen
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, AKH-4L Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Bernd J Pichler
- Abteilung für Präklinische Bildgebung und Radiopharmazie, University of Tübingen, Röntgenweg 13, 72026, Tübingen, Germany
| | - Thomas Schlosser
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Alexis Jacquier
- Department of Cardiovascular and Thoracic Radiology, Assistance Publique Hopitaux de Marseille; University of Aix-Marseille, 264 rue Saint Pierre, 13385, Marseille, France
| | - Harald H Quick
- High-Field and Hybrid MR Imaging, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Michael Schäfers
- Department of Nuclear Medicine and European Institute for Molecular Imaging (EIMI), University of Münster, Albert-Schweitzer-Campus 1, building A1, 48149, Münster, Germany
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Währinger Gürtel 18-20, Floor 5L, 1090, Vienna, Austria
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24
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Trägårdh E, Tan SS, Bucerius J, Gimelli A, Gaemperli O, Lindner O, Agostini D, Übleis C, Sciagrà R, Slart RH, Underwood SR, Hyafil F, Hacker M, Verberne HJ. Systematic review of cost-effectiveness of myocardial perfusion scintigraphy in patients with ischaemic heart disease: A report from the cardiovascular committee of the European Association of Nuclear Medicine. Endorsed by the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2018; 18:825-832. [PMID: 28549119 DOI: 10.1093/ehjci/jex095] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 05/11/2017] [Indexed: 11/13/2022] Open
Abstract
Coronary artery disease (CAD) is a major cause of death and disability. Several diagnostic tests, such as myocardial perfusion scintigraphy (MPS), are accurate for the detection of CAD, as well as having prognostic value for the prediction of cardiovascular events. Nevertheless, the diagnostic and prognostic value of these tests should be cost-effective and should lead to improved clinical outcome. We have reviewed the literature on the cost-effectiveness of MPS in different circumstances: (i) the diagnosis and management of CAD; (ii) comparison with exercise electrocardiography (ECG) and other imaging tests; (iii) as gatekeeper to invasive coronary angiography (ICA), (iv) the impact of appropriate use criteria; (v) acute chest pain, and (vi) screening of asymptomatic patients with type-2 diabetes. In total 57 reports were included. Although most non-invasive imaging tests are cost-effective compared with alternatives, the data conflict on which non-invasive strategy is the most cost-effective. Different definitions of cost-effectiveness further confound the subject. Computer simulations of clinical diagnosis and management are influenced by the assumptions made. For instance, diagnostic accuracy is often defined against an anatomical standard that is wrongly assumed to be perfect. Conflicting data arise most commonly from these incorrect or differing assumptions.
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Affiliation(s)
- Elin Trägårdh
- Clinical Physiology and Nuclear Medicine, Lund University and Skåne University Hospital, Inga Marie Nilssons gata 49, 205 02 Malmö, Sweden
| | - Siok Swan Tan
- Erasmus University Rotterdam, Institute for Medical Technology Assessment, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Jan Bucerius
- Department of Nuclear Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.,Department of Nuclear Medicine, University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany
| | - Alessia Gimelli
- Fondazione Toscana Gabriele Monasterio, Via Guiseppe Moruzzi 1, 56124 Pisa, Italy
| | - Oliver Gaemperli
- Cardiac Imaging and Interventional Cardiology, University Heart Centre, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Oliver Lindner
- Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Centre North Rhine-Westphalia, University Hospital of the Ruhr University Bochum, Georgstrasse 11, 32545 Bad Oeynhausen, Germany
| | - Denis Agostini
- Department of Nuclear Medicine, University Hospital of Caen and Normandie Université, Avenue de la Côte de Nacre, 104009 CEDEX 1 Caen, France
| | - Christopher Übleis
- Department of Clinical Radiology, Ludwig-Maximilians Universität München, Marchioninistrasse 15, 81377 Munich, Germany
| | - Roberto Sciagrà
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Riemer H Slart
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, University of Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.,Department of Biomedical Photonic Imaging, University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands
| | - S Richard Underwood
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, Sydney Street, SW3 6NP, London, UK
| | - Fabien Hyafil
- Department of Nuclear Medicine, Bichat University Hospital, DHU FIRE, Inserm 1148, University of Paris Diderot, 46 rue Henri Huchard, 75018 Paris, France
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Hein J Verberne
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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25
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Nensa F, Bamberg F, Rischpler C, Menezes L, Poeppel TD, Fougère CL, Beitzke D, Rasul S, Loewe C, Nikolaou K, Bucerius J, Kjaer A, Gutberlet M, Prakken NH, Vliegenthart R, Slart RHJA, Nekolla SG, Lassen ML, Pichler BJ, Schlosser T, Jacquier A, Quick HH, Schäfers M, Hacker M. Hybrid cardiac imaging using PET/MRI: a joint position statement by the European Society of Cardiovascular Radiology (ESCR) and the European Association of Nuclear Medicine (EANM). Eur J Hybrid Imaging 2018. [DOI: 10.1186/s41824-018-0032-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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26
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Peeters FECM, van Mourik MJW, Meex SJR, Bucerius J, Schalla SM, Gerretsen SC, Mihl C, Dweck MR, Schurgers LJ, Wildberger JE, Crijns HJGM, Kietselaer BLJH. Bicuspid Aortic Valve Stenosis and the Effect of Vitamin K2 on Calcification Using 18F-Sodium Fluoride Positron Emission Tomography/Magnetic Resonance: The BASIK2 Rationale and Trial Design. Nutrients 2018; 10:E386. [PMID: 29561783 PMCID: PMC5946171 DOI: 10.3390/nu10040386] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/08/2018] [Accepted: 03/19/2018] [Indexed: 01/07/2023] Open
Abstract
BASIK2 is a prospective, double-blind, randomized placebo-controlled trial investigating the effect of vitamin K2 (menaquinone-7;MK7) on imaging measurements of calcification in the bicuspid aortic valve (BAV) and calcific aortic valve stenosis (CAVS). BAV is associated with early development of CAVS. Pathophysiologic mechanisms are incompletely defined, and the only treatment available is valve replacement upon progression to severe symptomatic stenosis. Matrix Gla protein (MGP) inactivity is suggested to be involved in progression. Being a vitamin K dependent protein, supplementation with MK7 is a pharmacological option for activating MGP and intervening in the progression of CAVS. Forty-four subjects with BAV and mild-moderate CAVS will be included in the study, and baseline 18F-sodiumfluoride (18F-NaF) positron emission tomography (PET)/ magnetic resonance (MR) and computed tomography (CT) assessments will be performed. Thereafter, subjects will be randomized (1:1) to MK7 (360 mcg/day) or placebo. During an 18-month follow-up period, subjects will visit the hospital every 6 months, undergoing a second 18F-NaF PET/MR after 6 months and CT after 6 and 18 months. The primary endpoint is the change in PET/MR 18F-NaF uptake (6 months minus baseline) compared to this delta change in the placebo arm. The main secondary endpoints are changes in calcium score (CT), progression of the left ventricularremodeling response and CAVS severity (echocardiography). We will also examine the association between early calcification activity (PET) and later changes in calcium score (CT).
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Affiliation(s)
- Frederique E C M Peeters
- Department of Cardiology, Maastricht University Medical Center+ and CARIM, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
| | - Manouk J W van Mourik
- Department of Cardiology, Maastricht University Medical Center+ and CARIM, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
| | - Steven J R Meex
- Department of Clinical Chemistry, Maastricht University Medical Center+, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
| | - Jan Bucerius
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ and CARIM, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
- Department of Nuclear Medicine University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
| | - Simon M Schalla
- Departments of Cardiology and Radiology, Maastricht University Medical Center+ and CARIM, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
| | - Suzanne C Gerretsen
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ and CARIM, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
| | - Casper Mihl
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ and CARIM, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
| | - Marc R Dweck
- Centre for Cardiovascular Science, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
| | - Leon J Schurgers
- Department of Biochemistry, Maastricht University and CARIM, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Joachim E Wildberger
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ and CARIM, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
| | - Harry J G M Crijns
- Department of Cardiology, Maastricht University Medical Center+ and CARIM, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
| | - Bas L J H Kietselaer
- Department of Cardiology, Maastricht University Medical Center+ and CARIM, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
- Department of Cardiology, Zuyderland Medisch Centrum Heerlen/Sittard, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands.
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27
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Herkel C, Joe AY, Altehoefer C, Finke J, Moser E, Reinhardt MJ, Bucerius J. 18F-FDG PET and conventional imaging for assessment of Hodgkin’s disease and non Hodgkin’s lymphoma. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1625326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThe aim of this study was to assess the diagnostic value of FDG-PET and conventional imaging (CI) in a large series of patient with Hodgkin’s disease (HD) or non-Hodgkin’s lymphoma (NHL) at three time points during their course of disease. Patients, methods: 169 consecutive lymphoma patients (69 HD; 100 NHL) were included. 193 FDG-PET studies were performed for staging at baseline in 42 cases, for post-therapeutic monitoring in 103, and for diagnosis of recurrence in 48 cases. Performance indices of sensitivity, specificity, positive (PPV) and negative predictive value (NPV), and accuracy of metabolic FDG-PET and morphological CI were calculated. Differences in staging and diagnosis of residual or recurrent lymphoma were compared. Results: FDG-PET changed staging in 36% of cases for staging at baseline, in 52% of cases for monitoring response to treatment, and in 29% for diagnosis of recurrence. FDG-PET staging results were confirmed in 80% for staging at baseline, in 74% for monitoring response to treatment, and in 50% for diagnosis of recurrence. FDGPET and CI differed significantly at monitoring response to treatment for sensitivity (0.91 versus 0.69; p<0.02), specificity (0.90 versus 0.38; p<0.00001), PPV (0.77 versus 0.42; p<0.001), and accuracy (0.83 versus 0.55; p<0.02). Conclusion: FDG-PET should be considered as the diagnostic modality of choice for post-therapeutic assessment of lymphoma patients and may be a reliable alternative to CI for staging at baseline and diagnosis of recurrence.
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28
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Naubereit A, Joe AY, Ezziddin S, Biermann K, Risse J, Palmedo H, Oldenburg J, Biersack HJ, Bucerius J. Subclinical hyperthyroidism seems not to have a significant impact on systemic anticoagulation in patients with coumarin therapy. Thromb Haemost 2017. [DOI: 10.1160/th07-12-0733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryThere is little data regarding the impact of subclinical hyperthyroidism on coagulation metabolism in patients undergoing systemic anticoagulation therapy with coumarin derivates. In this retrospective analysis we studied 233 patients with benign thyroid disorders receiving therapeutic iodine-131, as well as concomitant systemic anticoagulation therapy (subclinical hyperthyroidism: n=178; overt hyperthyroidism: n=15; euthyroidism: n=40). Multivariate regression analyses were performed in the total study population as well as in the subgroup of patients with subclinical hyperthyroidism to identify the possible impact of several variables on anticoagulation therapy, large enough to push the International Normalized Ratio (INR) level out of the therapeutic range (INR <2.0 or >3.0).Therapy with antibiotics or nitrates was significantly associated with INR-values >3.0 in the total population, while ACE inhibitors were associated with lower incidence of INR-values <2.0. In patients with subclinical hyperthyroidism, therapy with antibiotics was predictive of INR-values >3.0, whereas therapy with thyroid suppressive drugs or TSH-values <0.1 mU/l was associated with INR-values <2.0. Moreover, in a subgroup of 40 patients with the positive history of both subclinical hyperthyroidism and euthyroidism intraindividual comparison with regard to the possible impact on anticoagulation therapy was performed which failed to show any significant differences in INR-values between the two thyroid metabolic conditions. In conclusion, subclinical hyperthyroidism seems to have no significant impact on coagulation metabolism in patients receiving anticoagulation therapy.
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29
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Slart RHJA, Glaudemans AWJM, Lancellotti P, Hyafil F, Blankstein R, Schwartz RG, Jaber WA, Russell R, Gimelli A, Rouzet F, Hacker M, Gheysens O, Plein S, Miller EJ, Dorbala S, Donal E, Sciagra R, Bucerius J, Verberne HJ, Lindner O, Übleis C, Agostini D, Signore A, Edvardsen T, Neglia D, Beanlands RS, Di Carli M, Chareonthaitawee P, Dilsizian V, Soman P, Habib G, Delgado V, Cardim N, Cosyns B, Flachskampf F, Gerber B, Haugaa K, Lombardi M, Masci PG. A joint procedural position statement on imaging in cardiac sarcoidosis: from the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine, the European Association of Cardiovascular Imaging, and the American Society of Nuclear Cardiology. Eur Heart J Cardiovasc Imaging 2017; 18:1073-1089. [DOI: 10.1093/ehjci/jex146] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/16/2017] [Indexed: 12/15/2022] Open
Affiliation(s)
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands
- Department of Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands
| | - Patrizio Lancellotti
- Department of Cardiology, GIGA-Cardiovascular Sciences, University Hospital Sart Tilman, Liège, Belgium
- Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Fabien Hyafil
- Department of Nuclear Medicine, Centre Hospitalier Universitaire Bichat, Département Hospitalo-Universitaire FIRE, Inserm 1148, Assistance Publique - Hôpitaux de Paris, Université Paris Diderot, Paris, France
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Ron Blankstein
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Ronald G Schwartz
- Cardiology Division, Department of Medicine, University of Rochester Medical Center, Box 679, Rochester, NY, USA
- Nuclear Medicine Division, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Wael A Jaber
- Cleveland Clinic Lerner College of Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, USA
| | - Raymond Russell
- Cardiovascular Institute, Rhode Island Hospital, Alpert School of Medicine of Brown University, Providence, RI, USA
| | | | - François Rouzet
- Department of Nuclear Medicine, Centre Hospitalier Universitaire Bichat, Département Hospitalo-Universitaire FIRE, Inserm 1148, Assistance Publique - Hôpitaux de Paris, Université Paris Diderot, Paris, France
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria
| | - Olivier Gheysens
- Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Belgium and Department of Imaging and Pathology, KU Leuven, Belgium
| | - Sven Plein
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Edward J Miller
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Sharmila Dorbala
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Erwan Donal
- Service de Cardiologie, et CIC-IT INSERM 1414, - CHU Rennes, - Rennes, France
- LTSI, Université de Rennes 1 - INSERM, UMR 1099, - Rennes, France
| | - Roberto Sciagra
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Jan Bucerius
- Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Hein J Verberne
- Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Oliver Lindner
- Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - Christopher Übleis
- Department of Clinical Radiology, Ludwig-Maximilians Universität München, München, Germany
| | - Denis Agostini
- Department of Nuclear Medicine, CHU Cote de Nacre, CAEN, France
| | - Alberto Signore
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, ‘Sapienza’ University of Roma, Rome, Italy
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet and University of Oslo, Oslo, Norway
| | - Danilo Neglia
- Fondazione Toscana/CNR Gabriele Monasterio, Pisa, Italy
| | - Rob S Beanlands
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Canada
| | - Marcelo Di Carli
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Vasken Dilsizian
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Prem Soman
- Division of Cardiology, Heart and Vascular Institute, University of Pittsburgh Medical Center, A-429 Scaife Hall, 200 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Gilbert Habib
- Department of Cardiology, Aix-Marseille Université, Marseille 13284, France La Timone Hospital, 13005, Marseille, France
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Bucerius J, Barthel H, Tiepolt S, Werner P, Sluimer JC, Wildberger JE, Patt M, Hesse S, Gertz HJ, Biessen EAL, Mottaghy FM, Sabri O. Feasibility of in vivo 18F-florbetaben PET/MR imaging of human carotid amyloid-β. Eur J Nucl Med Mol Imaging 2017; 44:1119-1128. [PMID: 28321471 PMCID: PMC5434137 DOI: 10.1007/s00259-017-3651-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 02/08/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE Amyloid-beta (Aβ) peptides are involved in the inflammatory pathology of atherosclerosis. 18F-Florbetaben is a PET tracer for clinical imaging of cerebral Aβ plaques in Alzheimer's disease (AD). We sought to determine whether specific uptake of 18F-florbetaben in the carotid arteries can be identified using a fully integrated hybrid PET/MRI system and whether this uptake is associated with clinical cardiovascular disease (CVD) risk factors. METHODS Carotid 18F-florbetaben uptake was quantified as the mean of the maximum target-to-background ratio (meanTBRmax) in 40 cognitively impaired subjects (age 68.2 ± 9.5 years) undergoing 18F-florbetaben PET/MRI to diagnose AD. Associations between carotid 18F-florbetaben uptake and several CVD risk factors were assessed by univariate analysis followed by a multivariate linear regression analysis. Furthermore, carotid 18F-florbetaben uptake was compared between patients with and without a positive cerebral Aβ PET scan. RESULTS 18F-Florbetaben uptake was clearly visualized in the carotid arteries. Values of meanTBRmax corrected for the blood pool activity of the tracer showed specific 18F-florbetaben uptake in the carotid wall. Male gender was associated with carotid 18F-florbetaben uptake in the univariate analysis, and was found to be an independent predictor of 18F-florbetaben uptake in the multivariate regression analysis (standardized regression coefficient β = 0.407, p = 0.009). Carotid 18F-florbetaben meanTBRmax in patients with a positive cerebral Aβ scan did not differ from that in patients without cerebral Aβ deposits. CONCLUSION Specific 18F-florbetaben uptake in human carotid arteries was detected. Male gender was identified as an independent clinical risk factor. Therefore, 18F-florbetaben PET/MRI might provide new insights into the pathophysiological process in atherosclerosis.
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Affiliation(s)
- Jan Bucerius
- Department of Radiology/Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands.
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands.
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany.
- Department of Nuclear Medicine/Radiology and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University Medical Centre, Leipzig, Germany
| | - Solveig Tiepolt
- Department of Nuclear Medicine, Leipzig University Medical Centre, Leipzig, Germany
| | - Peter Werner
- Department of Nuclear Medicine, Leipzig University Medical Centre, Leipzig, Germany
| | - Judith C Sluimer
- Department of Pathology, Experimental Vascular Pathology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Joachim E Wildberger
- Department of Radiology/Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Marianne Patt
- Department of Nuclear Medicine, Leipzig University Medical Centre, Leipzig, Germany
| | - Swen Hesse
- Department of Nuclear Medicine, Leipzig University Medical Centre, Leipzig, Germany
- Integrated Treatment and Research Centre (IFB) Adiposity Diseases, Leipzig University Medical Centre, Leipzig, Germany
| | - Hermann-Josef Gertz
- Department of Psychiatry, Leipzig University Medical Centre, Leipzig, Germany
| | - Erik A L Biessen
- Department of Pathology, Experimental Vascular Pathology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Felix M Mottaghy
- Department of Radiology/Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, Leipzig University Medical Centre, Leipzig, Germany
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Smulders MW, Jaarsma C, Nelemans PJ, Bekkers SC, Bucerius J, Leiner T, Crijns HJ, Wildberger JE, Schalla S. Comparison of the prognostic value of negative non-invasive cardiac investigations in patients with suspected or known coronary artery disease–a meta-analysis. Eur Heart J Cardiovasc Imaging 2017; 18:980-987. [DOI: 10.1093/ehjci/jex014] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 01/17/2017] [Indexed: 01/06/2023] Open
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Agostini D, Marie PY, Ben-Haim S, Rouzet F, Songy B, Giordano A, Gimelli A, Hyafil F, Sciagrà R, Bucerius J, Verberne HJ, Slart RHJA, Lindner O, Übleis C, Hacker M. Erratum to: Performance of cardiac cadmium-zinc-telluride gamma camera imaging in coronary artery disease: a review from the cardiovascular committee of the European Association of Nuclear Medicine (EANM). Eur J Nucl Med Mol Imaging 2016; 44:176. [PMID: 27714422 DOI: 10.1007/s00259-016-3540-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Denis Agostini
- Department of Nuclear Medicine, CHU Caen and Normandy University, EA 4650, Caen, France.
- Normandy University, EA 4650, Caen, France.
| | - Pierre-Yves Marie
- Nancyclotep Experimental Imaging Platform, Faculty of Medicine, INSERM, U1116, University of Lorraine, Nancy, F-54000, France
- CHU Nancy, Department of Nuclear Medicine, Faculty of Medicine, INSERM, U1116, University of Lorraine, Nancy, F-54000, France
- Faculty of Medicine, INSERM, U1116, University of Lorraine, Nancy, F-54000, France
| | - Simona Ben-Haim
- Institute of Nuclear Medicine, University College London, University College Hospital, London, UK
- Department of Nuclear Medicine, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - François Rouzet
- Department of Nuclear Medicine, University Hospital of Paris-Bichat, UMR 1148, Inserm and Paris Diderot-Paris 7 University Paris, Paris, France
- UMR 1148, Inserm and Paris Diderot-Paris 7 University Paris, Paris, France
| | | | - Alessandro Giordano
- Department of Bioimages and Radiological Sciences, Institute of Nuclear Medicine, Catholic University of Sacred Heart, Largo A. Gemelli, Rome, Italy
| | | | - Fabien Hyafil
- Department of Nuclear Medicine, Bichat University Hospital, Assistance Publique - Hôpitaux de Paris, UMR 1148, Inserm and Paris Diderot-Paris 7 University, Paris, France
| | - Roberto Sciagrà
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Jan Bucerius
- Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Hein J Verberne
- Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
- Faculty of Science and Technology, Department of Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands
| | - Oliver Lindner
- Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - Christopher Übleis
- Department of Clinical Radiology, Ludwig-Maximilians Universität München, Munich, Germany
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria
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Bucerius J. Monitoring Vasculitis with 18F-FDG PET. Q J Nucl Med Mol Imaging 2016; 60:219-235. [PMID: 27280732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Whereas in the past the term "vasculitis" was most frequently used in context with systemic vasculitides, such as the large vessel vasculitides (LVV) Takayasa arteritis and giant cell arteritis, characterized by inflammation of blood vessel walls, it nowadays comprises also inflammatory changes of the vessel wall as a substantial part of the atherosclerotic disease process. Implementing non-invasive imaging techniques, such as computed tomography angiography (CTA), magnetic resonance angiography (MRA) as well as positron emission tomography (PET) in the diagnostic algorithm of atherosclerosis and LVV, depicts a promising step towards an earlier detection with a, consecutively, improved therapeutic approach and potentially prognostic benefit in patients suffering from vasculitis. Mainly molecular imaging with 18F-fluorodeoxyglucose (FDG) PET seems to be promising in offering an early and sensitive identification of inflammatory changes in both, atherosclerosis and LVV. This review will therefore provide an overview on the diagnostic performance and clinical relevance of FDG-PET in monitoring vasculitis in atherosclerosis and LVV, with a focus on LVV.
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Affiliation(s)
- Jan Bucerius
- Department of Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands -
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Smulders MW, Kietselaer BL, Schalla S, Bucerius J, Jaarsma C, van Dieijen-Visser MP, Mingels AM, Rocca HPBL, Post M, Das M, Crijns HJ, Wildberger JE, Bekkers SC. Acute chest pain in the high-sensitivity cardiac troponin era: A changing role for noninvasive imaging? Am Heart J 2016; 177:102-11. [PMID: 27297855 DOI: 10.1016/j.ahj.2016.03.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 03/30/2016] [Indexed: 02/07/2023]
Abstract
Management of patients with acute chest pain remains challenging. Cardiac biomarker testing reduces the likelihood of erroneously discharging patients with acute myocardial infarction (AMI). Despite normal contemporary troponins, physicians have still been reluctant to discharge patients without additional testing. Nowadays, the extremely high negative predictive value of current high-sensitivity cardiac troponin (hs-cTn) assays challenges this need. However, the decreased specificity of hs-cTn assays to diagnose AMI poses a new problem as noncoronary diseases (eg, pulmonary embolism, myocarditis, cardiomyopathies, hypertension, renal failure, etc) may also cause elevated hs-cTn levels. Subjecting patients with noncoronary diseases to unnecessary pharmacological therapy or invasive procedures must be prevented. Attempts to improve the positive predictive value to diagnose AMI by defining higher initial cutoff values or dynamic changes over time inherently lower the sensitivity of troponin assays. In this review, we anticipate a potential changing role of noninvasive imaging from ruling out myocardial disease when troponin values are normal toward characterizing myocardial disease when hs-cTn values are (mildly) abnormal.
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Abstract
During the past years, non-neuronal vascular nicotinic acetylcholine receptors (nAChRs) increasingly have gained interest in cardiovascular research, as they are known to mediate the deleterious effects of nicotine and nitrosamines, components of tobacco smoke, on the vasculature. Because smoking is a major risk factor for the development of atherosclerosis, it is obvious that understanding the pathophysiologic role of nAChRs in the atherosclerotic disease process, as well as in the development of new diagnostic and therapeutic nAChR-related options, has become more important. Accordingly, we briefly summarize the pathophysiologic role of vascular nAChRs in the atherosclerotic disease process. We also provide an overview of currently available nAChR positron emission tomography (PET) tracers and their performance in the noninvasive imaging of vascular nAChRs, as well as potential nAChR PET tracers that might be an option for vascular nAChR PET imaging in the future.
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Affiliation(s)
- Matthias Bauwens
- Department of Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
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Joshi FR, Rajani NK, Abt M, Woodward M, Bucerius J, Mani V, Tawakol A, Kallend D, Fayad ZA, Rudd JH. Does Vascular Calcification Accelerate Inflammation? J Am Coll Cardiol 2016; 67:69-78. [DOI: 10.1016/j.jacc.2015.10.050] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 10/07/2015] [Indexed: 11/28/2022]
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Demirev A, Brans B, Vanmolkot F, De Graaf R, Mottaghy F, Bucerius J. Diagnosis of Brachiocephalic Thrombophlebitis as the Cause of Fever of Unknown Origin by 18F-FDG-PET/CT. Mol Imaging Radionucl Ther 2015; 24:25-8. [PMID: 25800595 PMCID: PMC4372769 DOI: 10.4274/mirt.47966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Fever of unknown origin (FUO) represents a challenge in diagnosis and treatment. The role of 18Ffluorodeoxyglucose positron emission tomography (FDG-PET) / computed tomography (CT) in the differential diagnosis of this entity is presently well established. We report the case of a patient with infectious/inflammatory symptoms but no evident localization and subsequent relapse, in which PET/CT showed its ability to not only determine the exact localization of a thrombophlebitic focus as cause of FUO, but also to monitor and determine the success of treatment. After performing a FDG-PET/CT and detecting a thrombophlebitis in the brachiocephalic vein, low molecular heparins were introduced in the course of therapy. Soon (about 24 hours) thereafter, clinical symptoms significantly decreased and could no longer be observed. After continuing the antibiotic and anticoagulant therapy for 4 weeks, a follow-up PET/CT scan was performed. That scan no longer showed abnormal uptake in the previous intravascular localization. Consequently, we suggest that PET/CT is a diagnostic modality feasible to identify and monitor therapy response of intravascular thrombophlebitic foci.
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Affiliation(s)
- Anastas Demirev
- Maastricht University Faculty of Medicine, Department of Nuclear Medicine, Maastricht, Netherlands. E-mail:
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Kemna MJ, Bucerius J, Drent M, Vöö S, Veenman M, van Paassen P, Tervaert JWC, van Kroonenburgh MJPG. Aortic ¹⁸F-FDG uptake in patients suffering from granulomatosis with polyangiitis. Eur J Nucl Med Mol Imaging 2015; 42:1423-9. [PMID: 25994308 PMCID: PMC4502318 DOI: 10.1007/s00259-015-3081-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 04/29/2015] [Indexed: 11/01/2022]
Abstract
PURPOSE The objective of the study was to systematically assess aortic inflammation in patients with granulomatosis with polyangiitis (GPA) using (18)F-2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) positron emission tomography (PET)/CT. METHODS Aortic inflammation was studied in PET/CT scans obtained from 21 patients with GPA; 14 patients with sarcoidosis were included as disease controls, 7 patients with stage I or II head and neck carcinoma ascertained during routine clinical practice were used as healthy controls (HC) and 5 patients with large vessel vasculitis (LVV) were used as positive controls. Aortic (18)F-FDG uptake was expressed as the blood-normalized maximum standardized uptake value (SUVmax), known as the target to background ratio (mean TBRmax). RESULTS The mean TBRmax (interquartile range) of the aorta in patients with GPA, sarcoidosis, HC and LVV were 1.75 (1.32-2.05), 1.62 (1.54-1.74), 1.29 (1.22-1.52) and 2.03 (1.67-2.45), respectively. The mean TBRmax was significantly higher in patients suffering from GPA or LVV compared to HC (p < 0.05 and p < 0.005, respectively) and tended to be higher in patients suffering from sarcoidosis, but this did not reach statistical significance (p = 0.098). The mean TBRmax of the most diseased segment was significantly higher compared to HC [1.57 (1.39-1.81)] in LVV patients [2.55 (2.22-2.82), p < 0.005], GPA patients [2.17 (1.89-2.83), p < 0.005] and patients suffering from sarcoidosis [2.04 (1.88-2.20), p < 0.05]. In GPA patients, the mean TBRmax of the aorta was significantly higher in patients with previous renal involvement [2.01 (1.69-2.53)] compared to patients without renal involvement in the past [1.60 (1.51-1.80), p < 0.05]. Interrater reproducibility with a second reader was high (all intraclass correlation coefficients >0.9). CONCLUSION Patients suffering from GPA show marked aortic FDG uptake.
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Affiliation(s)
- Michael J. Kemna
- />Department of Nephrology and Clinical Immunology, Maastricht University Medical Center, Maastricht, The Netherlands
- />Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Jan Bucerius
- />Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- />Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- />Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Marjolein Drent
- />Department of Pharmacology and Toxicology, Maastricht University, Maastricht, The Netherlands
| | - Stefan Vöö
- />Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- />Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Martine Veenman
- />Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Pieter van Paassen
- />Department of Nephrology and Clinical Immunology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan Willem Cohen Tervaert
- />Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- />Noordoever Academy, Sint Franciscus Gasthuis, Rotterdam, The Netherlands
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Bucerius J, Vijgen GHEJ, Brans B, Bouvy ND, Bauwens M, Rudd JHF, Havekes B, Fayad ZA, van Marken Lichtenbelt WD, Mottaghy FM. Impact of bariatric surgery on carotid artery inflammation and the metabolic activity in different adipose tissues. Medicine (Baltimore) 2015; 94:e725. [PMID: 25997038 PMCID: PMC4602867 DOI: 10.1097/md.0000000000000725] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In this study, we unravel a molecular imaging marker correlated with the known reduction of cardiovascular events (most commonly related to vulnerable plaques) in morbidly obese patients after bariatric surgery (BaS).We prospectively imaged 10 morbidly obese subjects with F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography before and 1 year after BaS. F-FDG uptake-which is enhanced in inflamed, atherosclerotic vessels and in metabolically active adipose tissues-was quantified in the carotids, pericardial adipose tissue (PAT), visceral adipose tissue (VAT), as well as brown adipose tissue (BAT). The degree of carotid inflammation was compared to lean and overweight controls.Carotid inflammation significantly declined leading to an F-FDG uptake comparable to the 2 control groups. Metabolic activity significantly decreased in PAT and VAT and increased in BAT.BaS leads to a normalization of carotid artery inflammation and a beneficial impact on the metabolic activity in PAT, VAT, and BAT that is related to the metabolic syndrome observed in this patient group.
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Affiliation(s)
- Jan Bucerius
- From the Department of Nuclear Medicine (JB, BB, MB, FMM); Cardiovascular Research Institute Maastricht (CARIM) (JB), Maastricht University Medical Center, Maastricht, The Netherlands; Department of Nuclear Medicine (JB, FMM), University Hospital, RWTH Aachen, Aachen, Germany; Department of Human Biology (GHEJV, MB, BH, WDVML), School for Nutrition, Toxicology, and Metabolism (NUTRIM); Department of General Surgery (GHEJV, NDB), Maastricht University Medical Center, Maastricht, The Netherlands; Division of Cardiovascular Medicine (JHFR), University of Cambridge, Cambridge, UK; Division of Endocrinology (BH), Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands; Translational and Molecular Imaging Institute (ZAF); Department of Radiology (ZAF); and Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute, and Marie-Josée and Henry R. Kravis Cardiovascular Health Center (ZAF), Icahn School of Medicine at Mount Sinai, New York, USA
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Rötering S, Deuther-Conrad W, Cumming P, Donat CK, Scheunemann M, Fischer S, Xiong G, Steinbach J, Peters D, Sabri O, Bucerius J, Brust P. Imaging of α7 nicotinic acetylcholine receptors in brain and cerebral vasculature of juvenile pigs with [(18)F]NS14490. EJNMMI Res 2014; 4:43. [PMID: 25136512 PMCID: PMC4129469 DOI: 10.1186/s13550-014-0043-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 07/17/2014] [Indexed: 11/21/2022] Open
Abstract
Background The α7 nicotinic acetylcholine receptor (nAChR) is an important molecular target in neuropsychiatry and oncology. Development of applicable highly specific radiotracers has been challenging due to comparably low protein expression. To identify novel ligands as candidates for positron emission tomography (PET), a library of diazabicyclononane compounds was screened regarding affinity and specificity towards α7 nAChRs. From these, [18F]NS14490 has been shown to yield reliable results in organ distribution studies; however, the radiosynthesis of [18F]NS14490 required optimization and automation to obtain the radiotracer in quantities allowing dynamic PET studies in piglets. Methods Automated radiosynthesis of [18F]NS14490 has been performed by [18F]fluorination with the tosylate precursor in the TRACERlab™ FX F-N synthesis module (Waukesha, WI, USA). After optimization, the radiochemical yield of [18F]NS14490 was consistently approximately 35%, and the total synthesis time was about 90 min. The radiotracer was prepared with >92% radiochemical purity, and the specific activity at the end of the synthesis was 226 ± 68 GBq μmol−1. PET measurements were performed in young pigs to investigate the metabolic stability and cerebral binding of [18F]NS14490 without and with administration of the α7 nAChR partial agonist NS6740 in baseline and blocking conditions. Results The total distribution volume relative to the metabolite-corrected arterial input was 3.5 to 4.0 mL g−1 throughout the telencephalon and was reduced to 2.6 mL g−1 in animals treated with NS6740. Assuming complete blockade, this displacement indicated a binding potential (BPND) of approximately 0.5 in the brain of living pigs. In addition, evidence for specific binding in major brain arteries has been obtained. Conclusion [18F]NS14490 is not only comparable to other preclinically investigated PET radiotracers for imaging of α7 nAChR in brain but also could be a potential PET radiotracer for imaging of α7 nAChR in vulnerable plaques of diseased vessels.
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Affiliation(s)
- Sven Rötering
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Permoserstr. 15, Leipzig 04318, Germany
| | - Winnie Deuther-Conrad
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Permoserstr. 15, Leipzig 04318, Germany
| | - Paul Cumming
- Department of Nuclear Medicine, Friedrich-Alexander-Universität, Ulmenweg 18, Erlangen 91054, Germany ; Department of Pharmacology and Neuroscience, Copenhagen University, Blegdamsvej 3B, Copenhagen 2200, Denmark
| | - Cornelius K Donat
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Permoserstr. 15, Leipzig 04318, Germany
| | - Matthias Scheunemann
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Permoserstr. 15, Leipzig 04318, Germany
| | - Steffen Fischer
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Permoserstr. 15, Leipzig 04318, Germany
| | - Guoming Xiong
- Department of Nuclear Medicine, Ludwig-Maximilians-Universität, Marchioninistr. 15, Munich 83177, Germany
| | - Jörg Steinbach
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Permoserstr. 15, Leipzig 04318, Germany
| | - Dan Peters
- DanPET AB, Rosenstigen 7, Malmö SE-21619, Sweden
| | - Osama Sabri
- Department of Nuclear Medicine, Universität Leipzig, Liebigstr. 18, Leipzig 04103, Germany
| | - Jan Bucerius
- Department of Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, Maastricht 6229, The Netherlands ; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, P. Debeylaan 25, Maastricht 6229, The Netherlands ; Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelstr. 30, Aachen 52074, Germany
| | - Peter Brust
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Permoserstr. 15, Leipzig 04318, Germany
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Bauwens M, Wierts R, van Royen B, Bucerius J, Backes W, Mottaghy F, Brans B. Molecular imaging of brown adipose tissue in health and disease. Eur J Nucl Med Mol Imaging 2014; 41:776-91. [PMID: 24509875 DOI: 10.1007/s00259-013-2611-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 10/07/2013] [Indexed: 12/25/2022]
Abstract
PURPOSE Brown adipose tissue (BAT) has transformed from an interfering tissue in oncological (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) to an independent imaging research field. This review takes the perspective from the imaging methodology on which human BAT research has come to rely on heavily. METHODS This review analyses relevant PubMed-indexed publications that discuss molecular imaging methods of BAT. In addition, reported links between BAT and human diseases such as obesity are discussed, and the possibilities for imaging in these fields are highlighted. Radiopharmaceuticals aiming at several different biological mechanisms of BAT are discussed and evaluated. RESULTS Prospective, dedicated studies allow visualization of BAT function in a high percentage of human subjects. BAT dysfunction has been implicated in obesity, linked with diabetes and associated with cachexia and atherosclerosis. Presently, (18)F-FDG PET/CT is the most useful tool for evaluating therapies aiming at BAT activity. In addition to (18)F-FDG, other radiopharmaceuticals such as (99m)Tc-sestamibi, (123)I-metaiodobenzylguanidine (MIBG), (18)F-fluorodopa and (18)F-14(R,S)-[(18)F]fluoro-6-thia-heptadecanoic acid (FTHA) may have a potential for visualizing other aspects of BAT activity. MRI methods are under continuous development and provide the prospect of functional imaging without ionizing radiation. CONCLUSION Molecular imaging of BAT can be used to quantitatively assess different aspects of BAT metabolic activity.
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Affiliation(s)
- Matthias Bauwens
- Department of Medical Imaging, Division of Nuclear Medicine, MUMC, Maastricht, Netherlands
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Mani V, Woodward M, Samber D, Bucerius J, Tawakol A, Kallend D, Rudd JHF, Abt M, Fayad ZA. Predictors of change in carotid atherosclerotic plaque inflammation and burden as measured by 18-FDG-PET and MRI, respectively, in the dal-PLAQUE study. Int J Cardiovasc Imaging 2014; 30:571-82. [PMID: 24458953 DOI: 10.1007/s10554-014-0370-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 01/15/2014] [Indexed: 12/17/2022]
Abstract
Baseline predictors of response to treatment of patients with coronary heart disease (CHD) with respect to vascular inflammation and atherosclerotic plaque burden are poorly understood. From post hoc analysis of the dal-PLAQUE study (NCT00655473), 18F-fluorodeoxyglucose-positron emission tomography (18-FDG-PET) imaging and carotid black blood magnetic resonance imaging (MRI) were used to track changes in these vascular parameters. Baseline demographics, imaging, and biomarkers were collected/measured in 130 patients with CHD or CHD risk-equivalents, and imaging follow-up at 6 months (PET) and 24 months (MRI) was performed. Using stepwise linear regression, predictors of change in carotid plaque inflammation by PET [target-to-background ratio (TBR), n = 92] and plaque burden by MRI [wall area (WA) and total vessel area (TVA), n = 89] were determined. Variables with p < 0.05 in multivariable models were considered independently significant. Interleukin-6, systolic blood pressure and standard deviation of wall thickness (WT) at baseline were independently positively associated with 18-FDG uptake (mean of maximum [MeanMax] TBR change over 6 months). Mean of mean TBR, phospholipase A2, apolipoprotein A-I, and high-sensitivity C-reactive protein at baseline were independently negatively associated with MeanMax TBR change over 6 months. Mean WT and plasminogen activator inhibitor-1 (PAI-1) activity at baseline, and age, were independently associated with change in WA over 24 months. For TVA changes; mean WA and PAI-1 activity at baseline, age, and female gender were independent predictors. These findings may help determine patients most suitable for clinical trials employing plaque inflammation or burden changes as endpoints.
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Affiliation(s)
- Venkatesh Mani
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA,
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Bucerius J, Mani V, Moncrieff C, Machac J, Fuster V, Farkouh ME, Tawakol A, Rudd JHF, Fayad ZA. Optimizing 18F-FDG PET/CT imaging of vessel wall inflammation: the impact of 18F-FDG circulation time, injected dose, uptake parameters, and fasting blood glucose levels. Eur J Nucl Med Mol Imaging 2013; 41:369-83. [PMID: 24271038 DOI: 10.1007/s00259-013-2569-6] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 08/30/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE (18)F-FDG PET is increasingly used for imaging of vessel wall inflammation. However, limited data are available on the impact of methodological variables, i.e. prescan fasting glucose, FDG circulation time and injected FDG dose, and of different FDG uptake parameters, in vascular FDG PET imaging. METHODS Included in the study were 195 patients who underwent vascular FDG PET/CT of the aorta and the carotids. Arterial standardized uptake values (meanSUVmax), target-to-background ratios (meanTBRmax) and FDG blood-pool activity in the superior vena cava (SVC) and the jugular veins (JV) were quantified. Vascular FDG uptake values classified according to the tertiles of prescan fasting glucose levels, the FDG circulation time, and the injected FDG dose were compared using ANOVA. Multivariate regression analyses were performed to identify the potential impact of all variables described on the arterial and blood-pool FDG uptake. RESULTS Tertile analyses revealed FDG circulation times of about 2.5 h and prescan glucose levels of less than 7.0 mmol/l, showing a favorable relationship between arterial and blood-pool FDG uptake. FDG circulation times showed negative associations with aortic meanSUVmax values as well as SVC and JV FDG blood-pool activity, but positive correlations with aortic and carotid meanTBRmax values. Prescan glucose levels were negatively associated with aortic and carotid meanTBRmax and carotid meanSUVmax values, but were positively correlated with SVC blood-pool uptake. The injected FDG dose failed to show any significant association with vascular FDG uptake. CONCLUSION FDG circulation times and prescan blood glucose levels significantly affect FDG uptake in the aortic and carotid walls and may bias the results of image interpretation in patients undergoing vascular FDG PET/CT. The injected FDG dose was less critical. Therefore, circulation times of about 2.5 h and prescan glucose levels less than 7.0 mmol/l should be preferred in this setting.
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Affiliation(s)
- Jan Bucerius
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, P.O. Box 1234, New York, NY, 10029, USA
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Truijman MTB, Kwee RM, van Hoof RHM, Hermeling E, van Oostenbrugge RJ, Mess WH, Backes WH, Daemen MJ, Bucerius J, Wildberger JE, Kooi ME. Combined 18F-FDG PET-CT and DCE-MRI to assess inflammation and microvascularization in atherosclerotic plaques. Stroke 2013; 44:3568-70. [PMID: 24114456 DOI: 10.1161/strokeaha.113.003140] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND PURPOSE Hallmarks of vulnerable atherosclerotic plaques are inflammation that can be assessed with 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography, and increased neovascularization that can be evaluated by dynamic contrast-enhanced-MRI. It remains unclear whether these parameters are correlated or represent independent imaging parameters. This study determines whether there is a correlation between inflammation and neovascularization in atherosclerotic carotid plaques. METHODS A total of 58 patients with transient ischemic attack or minor stroke in the carotid territory and ipsilateral carotid artery stenosis of 30% to 69% were included. All patients underwent positron emission tomography/computed tomography and dynamic contrast-enhanced-MRI of the carotid plaque. 18Fluorine-fluorodeoxyglucose standard uptake values with target/background ratio were determined. Neovascularization was quantified by the mean (leakage) volume transfer constant Ktrans. Spearman rank correlation coefficients between target/background ratio and Ktrans were calculated. RESULTS Images suitable for further analysis were obtained in 49 patients. A weak but significant positive correlation between target/background ratio and mean Ktrans (Spearman ρ=0.30 [P=0.035]) and 75th percentile Ktrans (Spearman ρ=0.29 [P=0.041]) was found. CONCLUSIONS There is a weak but significant positive correlation between inflammation on positron emission tomography/computed tomography and neovascularization as assessed with dynamic contrast-enhanced-MRI. Future studies should investigate which imaging modality has the highest predictive value for recurrent stroke, as these are not interchangeable. CLINICAL TRIAL REGISTRATION URL http://www.clinicaltrials.gov. Unique identifier: NCT00451529.
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Affiliation(s)
- Martine T B Truijman
- From the Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands (M.T.B.T., R.H.M.v.H., E.H., R.J.v.O., J.B., J.E.W., M.E.K.); Departments of Radiology (M.T.B.T., R.M.K., R.H.M.v.H., E.H., W.H.B., J.E.W., M.E.K.), Clinical Neurophysiology (M.T.B.T., W.H.M.), Neurology (R.J.v.O.), Nuclear Medicine (J.B.), Maastricht University Medical Center, Maastricht, The Netherlands; and Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands (M.J.D.)
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De Saint-Hubert M, Bauwens M, Deckers N, Drummen M, Douma K, Granton P, Hendrikx G, Kusters D, Bucerius J, Reutelingsperger CPM, Mottaghy FM. In Vivo Molecular Imaging of Apoptosisand Necrosis in Atherosclerotic PlaquesUsing MicroSPECT-CT and MicroPET-CT Imaging. Mol Imaging Biol 2013; 16:246-54. [DOI: 10.1007/s11307-013-0677-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Calcagno C, Ramachandran S, Izquierdo-Garcia D, Mani V, Millon A, Rosenbaum D, Tawakol A, Woodward M, Bucerius J, Moshier E, Godbold J, Kallend D, Farkouh ME, Fuster V, Rudd JHF, Fayad ZA. The complementary roles of dynamic contrast-enhanced MRI and 18F-fluorodeoxyglucose PET/CT for imaging of carotid atherosclerosis. Eur J Nucl Med Mol Imaging 2013; 40:1884-93. [PMID: 23942908 DOI: 10.1007/s00259-013-2518-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 07/11/2013] [Indexed: 12/15/2022]
Abstract
PURPOSE Inflammation and neovascularization in vulnerable atherosclerotic plaques are key features for severe clinical events. Dynamic contrast-enhanced (DCE) MRI and FDG PET are two noninvasive imaging techniques capable of quantifying plaque neovascularization and inflammatory infiltrate, respectively. However, their mutual role in defining plaque vulnerability and their possible overlap has not been thoroughly investigated. We studied the relationship between DCE-MRI and (18)F-FDG PET data from the carotid arteries of 40 subjects with coronary heart disease (CHD) or CHD risk equivalent, as a substudy of the dal-PLAQUE trial (NCT00655473). METHODS The dal-PLAQUE trial was a multicenter study that evaluated dalcetrapib, a cholesteryl ester transfer protein modulator. Subjects underwent anatomical MRI, DCE-MRI and (18)F-FDG PET. Only baseline imaging and biomarker data (before randomization) from dal-PLAQUE were used as part of this substudy. Our primary goal was to evaluate the relationship between DCE-MRI and (18)F-FDG PET data. As secondary endpoints, we evaluated the relationship between (a) PET data and whole-vessel anatomical MRI data, and (b) DCE-MRI and matching anatomical MRI data. All correlations were estimated using a mixed linear model. RESULTS We found a significant inverse relationship between several perfusion indices by DCE-MRI and (18)F-FDG uptake by PET. Regarding our secondary endpoints, there was a significant relationship between plaque burden measured by anatomical MRI with several perfusion indices by DCE-MRI and (18)F-FDG uptake by PET. No relationship was found between plaque composition by anatomical MRI and DCE-MRI or (18)F-FDG PET metrics. CONCLUSION In this study we observed a significant, weak inverse relationship between inflammation measured as (18)F-FDG uptake by PET and plaque perfusion by DCE-MRI. Our findings suggest that there may be a complex relationship between plaque inflammation and microvascularization during the different stages of plaque development. (18)F-FDG PET and DCE-MRI may have complementary roles in future clinical practice in identifying subjects at high risk of cardiovascular events.
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Affiliation(s)
- Claudia Calcagno
- Translational and Molecular Imaging Institute, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1234, New York, NY, 10029, USA
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de Pont C, Halders S, Bucerius J, Mottaghy F, Brans B. 124I PET/CT in the pretherapeutic staging of differentiated thyroid carcinoma: comparison with posttherapy 131I SPECT/CT. Eur J Nucl Med Mol Imaging 2013; 40:693-700. [DOI: 10.1007/s00259-012-2331-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 12/18/2012] [Indexed: 01/22/2023]
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Bucerius J, Manka C, Schmaljohann J, Mani V, Gündisch D, Rudd JHF, Bippus R, Mottaghy FM, Wüllner U, Fayad ZA, Biersack HJ. Feasibility of [18F]-2-Fluoro-A85380-PET imaging of human vascular nicotinic acetylcholine receptors in vivo. JACC Cardiovasc Imaging 2012; 5:528-36. [PMID: 22595161 DOI: 10.1016/j.jcmg.2011.11.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 10/20/2011] [Accepted: 11/28/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this feasibility study was to evaluate [(18)F]-2-Fluoro-A85380 for in vivo imaging of arterial nicotinic acetylcholine receptors (nAChRs) in humans. Furthermore, potentially different vascular uptake patterns of this new tracer were evaluated in healthy volunteers and in patients with neurodegenerative disorders. BACKGROUND [(18)F]-2-Fluoro-A85380 was developed for in vivo positron emission tomography (PET) imaging of nAChR subunits in the human brain. These nAChRs are also found in arteries and seem to mediate the deleterious effects of nicotine as a part of tobacco smoke in the vasculature. It has been previously shown that uptake patterns of the radiotracer in the brain differs in patients with neurodegenerative disorders compared with healthy controls. METHODS [(18)F]-2-Fluoro-A85380 uptake was quantified in the ascending and descending aorta, the aortic arch, and the carotids in 5 healthy volunteers and in 6 patients with either Parkinson's disease or multiple system atrophy, respectively, as the maximum target-to-background ratio. The maximal standardized uptake value values, the single hottest segment, and the percent active segments of the [(18)F]-2-Fluoro-A85380 uptake in the arteries were also assessed. RESULTS [(18)F]-2-Fluoro-A85380 uptake was clearly visualized and maximum target-to-background ratio uptake values corrected for the background activity of the tracer showed specific tracer uptake in the arterial walls. Significantly higher uptake values were found in the descending aorta. Comparison between volunteers and patients revealed significant differences, with lower [(18)F]-2-Fluoro-A85380 uptake in the patient group when comparing single arterial territories but not when all arterial territories were pooled together. CONCLUSIONS [(18)F]-2-Fluoro-A85380 can provide specific information on the nAChR distribution in human arteries. Vascular nAChR density seems to be lower in patients with Parkinson's disease or multiple system atrophy. Once confirmed in larger study populations and in the experimental setting, this approach might provide insights into the pathogenic role of nAChRs in the human vasculature.
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Affiliation(s)
- Jan Bucerius
- Translational and Molecular Imaging Institute, Mount Sinai School of Medicine, New York, New York 10029, USA.
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Bucerius J, Mani V, Moncrieff C, Rudd JHF, Machac J, Fuster V, Farkouh ME, Fayad ZA. Impact of noninsulin-dependent type 2 diabetes on carotid wall 18F-fluorodeoxyglucose positron emission tomography uptake. J Am Coll Cardiol 2012; 59:2080-8. [PMID: 22651864 DOI: 10.1016/j.jacc.2011.11.069] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 11/26/2011] [Accepted: 11/29/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVES In this study, the impact of noninsulin-dependent type 2 diabetes mellitus on carotid wall (18)F-fluorodeoxyglucose (FDG) uptake in patients with documented or suspected cardiovascular disease was evaluated. BACKGROUND Inflammation is a pivotal process in the progression of atherosclerosis, which can be noninvasively imaged by FDG positron emission tomography (FDG-PET). METHODS Carotid artery wall FDG uptake was quantified in 134 patients (age 60.2 ± 9.7 years; diabetic subjects, n = 43). The pre-scan glucose (gluc) level corrected mean of the maximum standardized uptake value (SUV) values ((mean)SUV(gluc)), mean of the maximum target-to-background ratio ((mean)TBR(gluc)), and single hottest segment (SHS(gluc)) of FDG uptake in the artery wall were calculated. Associations between FDG uptake, the presence of risk factors for atherosclerosis, and diabetes were then assessed by multiple regression analysis with backward elimination. RESULTS The study demonstrated a significant association between diabetes and FDG uptake in the arterial wall (diabetes (mean)SUV(gluc) β = 0.324, (mean)TBR(gluc) β = 0.317, and SHS(gluc) β = 0.298; for all, p < 0.0001). In addition, in diabetic patients, both body mass index ≥ 30 kg/m(2) ((mean)SUV(gluc) β = 0.4, (mean)TBR(gluc) β = 0.357, and SHS(gluc) β = 0.388; for all, p < 0.015) and smoking ((mean)TBR(gluc), β = 0.312; SHS(gluc), β = 0.324; for all, p < 0.04) were significantly associated with FDG uptake. CONCLUSIONS Type 2 diabetes was significantly associated with carotid wall FDG uptake in patients with known or suspected cardiovascular disease. In diabetic patients, obesity and smoking add to the risk of increased FDG uptake values.
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Affiliation(s)
- Jan Bucerius
- Translational and Molecular Imaging Institute, Mount Sinai School of Medicine, New York, New York 10029, USA
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