SPECT/CT imaging of inflammation and calcification in human carotid atherosclerosis to identify the plaque at risk of rupture

SPECT/CT imaging of inflammation and calcification in human carotid atherosclerosis to identify the plaque at risk of rupture

Van der Heiden, K. (Erasmus MC)
Barrett, H. E. (Erasmus MC)
van Gaalen, K.C. (Erasmus MC)
Krenning, B. J. (Erasmus MC)
Beekman, F.J. (TU Delft RST/Biomedical Imaging; University Medical Center Utrecht; MILabs B.V.)
Verhagen, H. J.M. (Erasmus MC)
Norenberg, J. P. (University of New Mexico)
de Jong, M. (Erasmus MC)
Gijsen, F.J.H. (Erasmus MC)

2021

Background: Calcification and inflammation are atherosclerotic plaque compositional biomarkers that have both been linked to stroke risk. The aim of this study was to evaluate their co-existing prevalence in human carotid plaques with respect to plaque phenotype to determine the value of hybrid imaging for the detection of these biomarkers. Methods: Human carotid plaque segments, obtained from endarterectomy, were incubated in [111In]In-DOTA-butylamino-NorBIRT ([111In]In-Danbirt), targeting Leukocyte Function-associated Antigen-1 (LFA-1) on leukocytes. By performing SPECT/CT, both inflammation from DANBIRT uptake and calcification from CT imaging were assessed. Plaque phenotype was classified using histology. Results: On a total plaque level, comparable levels of calcification volume existed with different degrees of inflammation and vice versa. On a segment level, an inverse relationship between calcification volume and inflammation was evident in highly calcified segments, which classify as fibrocalcific, stable plaque segments. In contrast, segments with little or no calcification presented with a moderate to high degree of inflammation, often coinciding with the more dangerous fibrous cap atheroma phenotype. Conclusion: Calcification imaging alone can only accurately identify highly calcified, stable, fibrocalcific plaques. To identify high-risk plaques, with little or no calcification, hybrid imaging of calcification and inflammation could provide diagnostic benefit.

calcification
human carotid plaque
inflammation
SPECT/CT
vulnerable plaque

http://resolver.tudelft.nl/uuid:bdc0c89f-ca60-41c0-9186-2c5e619e04a3

https://doi.org/10.1007/s12350-021-02745-0

1071-3581

Journal of Nuclear Cardiology, 29 (5), 2487-2496

Institutional Repository

journal article

© 2021 K. Van der Heiden, H. E. Barrett, K.C. van Gaalen, B. J. Krenning, F.J. Beekman, H. J.M. Verhagen, J. P. Norenberg, M. de Jong, F.J.H. Gijsen, More Authors