18FDG PET/CT & arterial inflammation: predicting cardiovascular events in lung cancer

QJM. 2019 Jun 1;112(6):401-407. doi: 10.1093/qjmed/hcz036.

Abstract

Background: 18F-FDG PET/CT predicts cardiovascular disease. To analyze the predictive value of cardiovascular events from inflammation and arterial calcification in patients who underwent an 18F-FDG PET/CT for lung cancer.

Methods: A retrospective study of 274 patients with primary lung neoplasia. We determined: (i) TBR (target-to-background ratio), and (ii) the calcium score, at eight common arterial segments. We took as arteriosclerosis, a TBR ≥1.6 and ≥15 Calcium Score sum. We registered cardiovascular risk factors, comorbidities, histology, stage, treatment, status at the last clinical review, cause of death and cardiovascular event during the follow-up.

Results: The territory presenting the greatest uptake of 18F-FDG, was the thoracic aorta with an average of 1.77 (± 0.27 TBR) in the aortic arch, while the greatest degree of calcification was obtained in the abdominal aorta (52% with a Calcium Score ≥ 3). 24% of the patients presented a sum Calcium Score ≥15, and 17% a TBR ≥1.6. Patients with high TBR, (17%), had not a higher frequency of cardiovascular comorbidities beforehand, nor did they in the follow-up. However, those with a sum Calcium Score ≥15 (24%), were older, had more cardiovascular risk factors and ischemic events during follow-up. The calcium score, but not the TBR, predicted the emergence of a cardiovascular event (HR 4.9 IC95% 2.1-9.1, P < 0.05).

Conclusion: In our cohort, a high Calcium Score was an independent predictor for developing cardiovascular events.

MeSH terms

  • Aged
  • Aorta, Abdominal / diagnostic imaging
  • Aorta, Thoracic / diagnostic imaging
  • Arteritis / physiopathology*
  • Atherosclerosis / complications
  • Atherosclerosis / diagnosis
  • Calcinosis / complications
  • Calcinosis / diagnosis
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / diagnosis
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnostic imaging*
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors

Substances

  • Fluorodeoxyglucose F18