Aortic Uptake of 18F-NaF and 18F-FDG and Calcification Predict the Development of Abdominal Aortic Aneurysms and Is Attenuated by Drug Therapy

Arterioscler Thromb Vasc Biol. 2024 Sep;44(9):1975-1985. doi: 10.1161/ATVBAHA.124.321110. Epub 2024 Jul 25.

Abstract

Background: Abdominal aortic aneurysms expand over time and increase the risk of fatal ruptures. To predict expansion, the isolated assessment of 18F-fluorodeoxyglucose (FDG) and sodium fluoride (NaF) uptake or calcification volume in aneurysms has been investigated with variability in results. We systematically evaluated whether 18F-FDG and 18F-NaF uptake was predictive of abdominal aortic aneurysm expansion.

Methods: Seventy-four male Sprague-Dawley rat abdominal aortic aneurysm models were imaged using positron emission tomography-computed tomography with 18F-FDG and 18F-NaF at 1, 2, 4, 6, and 8 weeks after CaCl2 or saline stimulation. In the 1-week cohort (n=25), the correlation between 18F-FDG or 18F-NaF uptake and pathological markers was investigated. In the time course cohort (n=49), animals received either atorvastatin, losartan, aldactone, or risedronate to assess the effect of these drugs, and the relationship between aortic size and sequential 18F-FDG and 18F-NaF uptake or calcification volume was examined.

Results: In the 1-week cohort, the maximum standard unit value of 18F-FDG and 18F-NaF uptake correlated with CD68- (r=0.82; P=0.001) and von Kossa staining-positive areas (r=0.89; P<0.001), respectively. In the time course cohort, 18F-FDG and 18F-NaF uptake changed in a time-dependent manner and drugs attenuated this uptake. Specifically, 18F-FDG showed high uptake at weeks 1 and 2, whereas a high 18F-NaF uptake was noted throughout the study period. Atorvastatin and risedronate showed a decreased and increased aortic size, respectively. The final aortic area correlated well with 18F-FDG and 18F-NaF uptake and calcification volume, especially at 1 and 2 weeks (18F-NaF [1 week]: r=0.61, 18F-FDG [2 weeks]: r=0.51, calcification volume [1 week]: r=0.59; P<0.001). Multiple linear regression analysis showed that the combination of these factors predicted the final aortic size, with 18F-NaF uptake at 1 week being the strongest predictor.

Conclusions: The uptake of 18F-NaF and 18F-FDG and the calcification volume at appropriate times correlated with the development of abdominal aortic aneurysms, with 18F-NaF uptake being the strongest predictor.

Keywords: aortic aneurysm; fluorodeoxyglucose F18; inflammation; positron-emission tomography; rats; sodium fluoride; vascular calcification.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Aorta, Abdominal* / diagnostic imaging
  • Aorta, Abdominal* / drug effects
  • Aorta, Abdominal* / metabolism
  • Aorta, Abdominal* / pathology
  • Aortic Aneurysm, Abdominal* / chemically induced
  • Aortic Aneurysm, Abdominal* / diagnostic imaging
  • Aortic Aneurysm, Abdominal* / metabolism
  • Aortic Aneurysm, Abdominal* / pathology
  • Disease Models, Animal*
  • Disease Progression
  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18* / pharmacokinetics
  • Male
  • Positron Emission Tomography Computed Tomography*
  • Predictive Value of Tests
  • Radiopharmaceuticals*
  • Rats
  • Rats, Sprague-Dawley*
  • Sodium Fluoride*
  • Time Factors
  • Vascular Calcification* / diagnostic imaging
  • Vascular Calcification* / metabolism
  • Vascular Calcification* / pathology

Substances

  • Fluorodeoxyglucose F18
  • Sodium Fluoride
  • Radiopharmaceuticals
  • Fluorine Radioisotopes