Identifying active vascular microcalcification by (18)F-sodium fluoride positron emission tomography

Nat Commun. 2015 Jul 7;6:7495. doi: 10.1038/ncomms8495.

Abstract

Vascular calcification is a complex biological process that is a hallmark of atherosclerosis. While macrocalcification confers plaque stability, microcalcification is a key feature of high-risk atheroma and is associated with increased morbidity and mortality. Positron emission tomography and X-ray computed tomography (PET/CT) imaging of atherosclerosis using (18)F-sodium fluoride ((18)F-NaF) has the potential to identify pathologically high-risk nascent microcalcification. However, the precise molecular mechanism of (18)F-NaF vascular uptake is still unknown. Here we use electron microscopy, autoradiography, histology and preclinical and clinical PET/CT to analyse (18)F-NaF binding. We show that (18)F-NaF adsorbs to calcified deposits within plaque with high affinity and is selective and specific. (18)F-NaF PET/CT imaging can distinguish between areas of macro- and microcalcification. This is the only currently available clinical imaging platform that can non-invasively detect microcalcification in active unstable atherosclerosis. The use of (18)F-NaF may foster new approaches to developing treatments for vascular calcification.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Atherosclerosis / diagnosis*
  • Atherosclerosis / pathology
  • Carotid Arteries / pathology*
  • Female
  • Fluorine Radioisotopes
  • Humans
  • Male
  • Positron-Emission Tomography / methods*
  • Sodium Fluoride / chemistry*
  • Vascular Calcification / diagnosis*

Substances

  • Fluorine Radioisotopes
  • Sodium Fluoride