Coronary fluorine-18-sodium fluoride uptake is increased in healthy adults with an unfavorable cardiovascular risk profile: results from the CAMONA study

Nucl Med Commun. 2017 Nov;38(11):1007-1014. doi: 10.1097/MNM.0000000000000734.


Objective: Coronary artery fluorine-18-sodium fluoride (F-NaF) uptake reflects coronary artery calcification metabolism and is considered to be an early prognostic marker of coronary heart disease. This study evaluated the relationship between coronary artery F-NaF uptake and cardiovascular risk in healthy adults at low cardiovascular risk.

Participants and methods: Study participants underwent blood pressure measurements, blood analyses, and coronary artery F-NaF PET/CT imaging. In addition, the 10-year risk for the development of cardiovascular disease, on the basis of the Framingham Risk Score, was estimated. Multivariable linear regression evaluated the dependence of coronary artery F-NaF uptake on cardiovascular risk factors.

Results: We recruited 89 (47 men, 42 women) healthy adults aged 21-75 years. Female sex (0.34 kBq/ml; P=0.009), age (0.16 kBq/ml per SD; P=0.002), and BMI (0.42 kBq/ml per SD; P<0.001) were independent determinants of increased coronary artery F-NaF uptake (adjusted R=0.21; P<0.001). Coronary artery F-NaF uptake increased linearly according to the number of cardiovascular risk factors present (P<0.001 for a linear trend). The estimated 10-year risk for the development of cardiovascular disease was on average 2.4 times higher in adults with coronary artery F-NaF uptake in the highest quartile compared with those in the lowest quartile of the distribution (8.0 vs. 3.3%, P<0.001).

Conclusion: Our findings indicate that coronary artery F-NaF PET/CT imaging is feasible in healthy adults at low cardiovascular risk and that an unfavorable cardiovascular risk profile is associated with a marked increase in coronary artery F-NaF uptake.

MeSH terms

  • Adult
  • Aged
  • Biological Transport
  • Cardiovascular Diseases / epidemiology*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / metabolism*
  • Female
  • Fluorine Radioisotopes*
  • Healthy Volunteers*
  • Humans
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography
  • Risk
  • Sodium Fluoride / metabolism*
  • Young Adult


  • Fluorine Radioisotopes
  • Sodium Fluoride
  • Fluorine-18