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

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 (SUVA/V ) and subtraction of background venous blood pool activity from SUV of target arterial activity (SUVA-V ) of carotid arteries with atherosclerotic plaques using 18 F-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 18 F-FDG PET/CT were enrolled retrospectively and classified patients who developed cerebrovascular events (CVEs) within 5 years after 18 F-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 SUVA/V and SUVA-V using measurements of SUVmax of carotid arteries and mean SUV of superior vena cava (SVC).

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

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