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

Author

Listed:
  • Agnese Irkle

    (University of Cambridge)

  • Alex T. Vesey

    (Centre for Cardiovascular Science, University of Edinburgh)

  • David Y. Lewis

    (Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre)

  • Jeremy N. Skepper

    (Development and Neuroscience, Multi-Imaging Centre, University of Cambridge)

  • Joseph L. E. Bird

    (University of Cambridge)

  • Marc R. Dweck

    (Centre for Cardiovascular Science, University of Edinburgh)

  • Francis R. Joshi

    (University of Cambridge)

  • Ferdia A. Gallagher

    (Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre
    Box 218 Level 5, University of Cambridge)

  • Elizabeth A. Warburton

    (University of Cambridge)

  • Martin R. Bennett

    (University of Cambridge)

  • Kevin M. Brindle

    (Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre)

  • David E. Newby

    (Centre for Cardiovascular Science, University of Edinburgh)

  • James H. Rudd

    (University of Cambridge)

  • Anthony P. Davenport

    (University of Cambridge)

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 18F-sodium fluoride (18F-NaF) has the potential to identify pathologically high-risk nascent microcalcification. However, the precise molecular mechanism of 18F-NaF vascular uptake is still unknown. Here we use electron microscopy, autoradiography, histology and preclinical and clinical PET/CT to analyse 18F-NaF binding. We show that 18F-NaF adsorbs to calcified deposits within plaque with high affinity and is selective and specific. 18F-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 18F-NaF may foster new approaches to developing treatments for vascular calcification.

Suggested Citation

  • Agnese Irkle & Alex T. Vesey & David Y. Lewis & Jeremy N. Skepper & Joseph L. E. Bird & Marc R. Dweck & Francis R. Joshi & Ferdia A. Gallagher & Elizabeth A. Warburton & Martin R. Bennett & Kevin M. B, 2015. "Identifying active vascular microcalcification by 18F-sodium fluoride positron emission tomography," Nature Communications, Nature, vol. 6(1), pages 1-11, November.
    • Handle: RePEc:nat:natcom:v:6:y:2015:i:1:d:10.1038_ncomms8495
    DOI: 10.1038/ncomms8495
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