Comparison of SUVA/V and SUVA-V for Evaluating Atherosclerotic Inflammation in 18F-FDG PET/CT.

Abstract

Purpose: This study aimed to compare the clinical significance of two parameters, division of standardized uptake value (SUV) of target arterial activity by background venous blood pool activity (SUV_A/V) and subtraction of background venous blood pool activity from SUV of target arterial activity (SUV_A-V) of carotid arteries with atherosclerotic plaques using ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT).

Methods: Patients aged 50 years or more who were diagnosed with carotid artery stenosis of 50% or more with carotid Doppler ultrasonography and had torso ¹⁸F-FDG PET/CT were enrolled retrospectively and classified patients who developed cerebrovascular events (CVEs) within 5 years after ¹⁸F-FDG PET/CT scan as the active group and patients who did not experience the CVE within 5 years as an inactive group. We calculated SUV_A/V and SUV_A-V using measurements of SUV_max of carotid arteries and mean SUV of superior vena cava (SVC).

Results: SUV_A-V, SUV_{A-V_high}, and SUV_{A-V_low} were significantly higher in the active group than in the inactive group, but neither SUV_A/V, SUV_{A/V_high}, nor SUV_{A/V_low} showed significant differences between the active and inactive groups. The difference in rank between groups of SUV_{A/V_high} and SUV_{A/V_low} was greater than the difference in rank between groups of SUV_{A-V_high} and SUV_{A-V_low}. The CVE incidence differed between SUV_{A/V_high} and SUV_{A/V_low} of high carotid FDG uptake, but the CVE incidence did not differ between SUV_{A-V_high} and SUV_{A-V_low} of high carotid FDG uptake.

Conclusion: SUV_A-V may be a more rational solution than SUV_A/V for evaluating atherosclerotic plaque inflammation on ¹⁸F-FDG PET/CT.