Abstract
Purpose
Recently published data indicated 18F-fluorocholine to be feasible for imaging vulnerable atherosclerotic plaques in an animal model.
Methods
Five patients undergoing whole-body 18F-fluoromethylcholine-(18F-FMCH-) PET/CT for imaging of prostate cancer disease were retrospectively evaluated. Whole-body PET scans were started immediately after i.v. injection of 18F-FMCH. About 5-15 min after tracer injection, acquisition of scans of the pelvis and abdomen was performed. PET, CT, and PET/CT slices were generated for review and visual analyses of the abdominal aorta and the common iliac arteries were performed. Vascular findings in examined arteries and surrounding structures due to artifacts were excluded from further analysis. The lower threshold of 18F-FMCH uptake was set above the background activity within the examined vessels. Morphological classification of vessel wall alterations (WA) included structural wall alterations without additional calcification (SWA), structural wall alterations associated with calcifications (SWC), and solely calcified lesions (CL). They were correlated with 18F-FMCH uptake qualified as present and vice versa.
Results
A total of 31 WA were identified. Positive 18F-FMCH uptake was found in 14 lesions (SWA: n = 5; SWC: n = 9). Sixteen of 17 18F-FMCH negative lesions were identified as CL without additional structural vessel wall alteration. One SWA did not show any 18F-FMCH accumulation. None of the CLs as well as unaltered parts of the vessel wall showed 18F-FMCH uptake.
Conclusions
Our initial data in five patients with a total of 31 vessel wall alterations show promising results indicating for the first time the feasibility of 18F-FMCH for in vivo imaging of structural WA in humans.
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References
Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular disease. I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001;104:2746-53.
Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, et al. From vulnerable plaque to vulnerable patient. A call for new definitions and risk assessment strategies: Part I. Circulation 2003;108:1664-72.
Myerburg RJ, Interian A Jr, Mitrani RM, Kessler KM, Castellanos A. Frequency of sudden cardiac death and profiles of risk. Am J Cardiol 1997;80:10F-19F.
Virmani R, Kolodgie FD, Burke AP, Farb A, Schwartz SM. Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 2000;20:1262-75.
Falk E, Shah PK, Fuster V. Coronary plaque disruption. Circulation 1995;92:657-71.
Davies MJ. A macro and micro view of coronary vascular insult in ischemic heart disease. Circulation 1990;82(suppl II):II-38-II-46.
Choudhury RP, Fuster V, Fayad ZA. Molecular, cellular, and functional imaging of atherothrombosis. Nat Rev Drug Discov 2004;3:913-25.
Matter CM, Wyss MT, Meier P, Späth N, von Lukowicz T, Lohmann C, et al. 18F-choline images murine atherosclerotic plaques ex vivo. Arterioscler Thromb Vasc Biol 2006;26:584-9.
Nair A, Kuban BD, Tuzcu EM, Schoenhagen P, Nissen SE, Vince DG. Coronary plaque classification with intravascular ultrasound radiofrequency data analysis. Circulation 2002;106:2200-6.
Viles-Gonzalez JF, Poon M, Sanz J, Ruis T, Nikolaou K, Fayad ZA, et al. In vivo 16-slice, multidetector-row computed tomography for the assessment of experimental atherosclerosis: comparison with magnetic resonance imaging and histopathology. Circulation 2004;110:1467-72.
Takaya N, Yuan C, Chu B, Saam T, Polissar NL, Jarvik GP, et al. Presence of intraplaque hemorrhage stimulates progression of carotid atherosclerotic plaques: a high-resolution magnetic resonance imaging study. Circulation 2005;111:2768-75.
Ogawa M, Ishino S, Mukai T, Asano D, Teramoto N, Watabe H, et al. 18F-FDG accumulation in atherosclerotic plaques: immunohistochemical and PET imaging study. J Nucl Med 2004;45:1245-50.
Rudd JH, Warburton EA, Fryer TD, Jones HA, Clark JC, Antoun N, et al. Imaging atherosclerotic plaque inflammation with 18-F-fluorodeoxyglucose positron emission tomography. Circulation 2002;105:2708-11.
Ross R. Atherosclerosis—an inflammatory disease. N Engl J Med 1999;340:115-26.
Glass CK, Witztum JL. Atherosclerosis. The road ahead. Cell 2001;104:503-16.
Ben-Haim S, Kupzov E, Tamir A, Israel O. Evaluation of 18-F-FDG uptake and arterial wall calcifications using 18-F-FDG PET/CT. J Nucl Med 2004;45:1245-50.
Tatsumi M, Cohade C, Nakamoto Y, Wahl RL. Fluorodeoxyglucose uptake in the aortic wall at PET/CT: possible finding for active atherosclerosis. Radiology 2003;229:831-7.
Laitinen I, Marjamäki P, Haaparanta M, Savisto N, Laine VJO, Soini SL, et al. Non-specific binding of 18-F-FDG to calcifications in atherosclerotic plaques: experimental study of mouse and human arteries. Eur J Nucl Med Mol Imaging 2006;33:1461-7.
Yoshimoto M, Waki A, Obata A, Furukawa T, Yonekura Y, Fujibayashi Y. Radiolabeled choline as a proliferation marker: comparison with radiolabeled acetate. Nucl Med Biol 2004;31:859-65.
Schmid DT, John H, Zweifel R, Cservenyak T, Westra G, Goerres GE, et al. Fluorocholine PET/CT in patients with prostate cancer: initial experience. Radiology 2005;235:623-8.
Haeffner EW. Studies on choline permeation through the plasma membrane and its incorporation into phosphatidyl choline of Ehrlich-Lettre-ascites tumor cells in vitro. Eur J Biochem 1975;51:219-28.
Katz-Brull R, Degani H. Kinetics of choline transport and phosphorylation in human breast cancer cells; NMR application of the zero trans method. Anticancer Res 1996;16:1375-80.
Boggs KP, Rock CO, Jackowski S. Lysophosphatidylcholine and 1-O-octadecyl-2-O-methyl-rac-glycero-3-phosphocholine inhibit the CDP-choline pathway of phosphatidylcholine synthesis at the CTP:phosphocholine cytidylyltransferase step. J Biol Chem 1995;270:7757-64.
Ramirez de Molina A, Gutierrez R, Ramos MA, Silva JM, Silva J, Bonilla F, et al. Increased choline kinase activity in human breast carcinomas: clinical evidence for a potential novel antitumor strategy. Oncogene 2002;21:4317-22.
Wyss MT, Weber B, Honer M, Spath N, Ametamey SM, Westera G, et al. 18F-choline in experimental soft tissue infection assessed with autoradiography and high-resolution PET. Eur J Nucl Med Mol Imaging 2004;31:312-6.
Spaeth N, Wyss MT, Weber B, Scheidegger S, Lutz A, Verwey J, et al. Uptake of 18F-fluorocholine, 18F-fluoroethyl-l-tyrosine, and 18F-FDG in acute cerebral radiation injury in the rat: implications for separation of radiation necrosis from tumor recurrence. J Nucl Med 2004;45:1931-8.
DeGrado TR, Coleman RE, Wang S, Baldwin SW, Orr MD, Robertson CN, et al. Synthesis and evaluation of 18F-labeled choline as an oncologic tracer for positron emission tomography: initial findings in prostate cancer. Cancer Res 2001;61:110-7.
Henriksen G, Herz M, Hauser A, Schwaiger M, Wester HJ. Synthesis and preclinical evaluation of the choline transport tracer deshydroxy-[18F]fluorocholine ([18F]dOC). Nucl Med Biol 2004;31:851-8.
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Bucerius, J., Schmaljohann, J., Böhm, I. et al. Feasibility of 18F-fluoromethylcholine PET/CT for imaging of vessel wall alterations in humans—first results. Eur J Nucl Med Mol Imaging 35, 815–820 (2008). https://doi.org/10.1007/s00259-007-0685-x
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DOI: https://doi.org/10.1007/s00259-007-0685-x