Incidence of focal myocardial 18F-FDG uptake and correlation with coronary calcifications by PET/CT

Objective

To evaluate the incidence of ¹⁸F-FDG focal uptake in the myocardium as well as its correlation with coronary vessel calcifications.

Material and methods

A total of 130 patients who underwent an oncological PET/CT study were reviewed retrospectively. Sixty-five had undergone a myocardial perfusion study because of clinical suspicion of coronary artery disease (group 1). There were no significant differences in age and gender regarding another group of the same series (n = 65; group 2). Focal myocardial ¹⁸F-FDG uptake and the presence of coronary vessel calcifications were identified by 2 independent observers.

Results

Group 1: in 18 out of 65 patients (28%) focal myocardial ¹⁸F-FDG uptake was identified (5 had 2 foci; total: 23 foci). In 43 out of 65 studies (66%), calcification was identified in the coronary vessels. Group 2: in 6 out of 65 patients (9%) focal myocardial ¹⁸F-FDG uptake was identified (1 had 2 foci; total: 7 foci). In 17 out of 65 studies (26%), calcification was identified in the coronary vessels.

Comparative analysis: focal myocardial ¹⁸F-FDG uptake and coronary vessel calcifications were more frequent in the group 1 patients (p < 0.01).

There was no correlation between the presence of coronary vessel calcifications and focal myocardial ¹⁸ F-FDG uptake in individual patients in both groups (group 1: p = 0.7; group 2: p = 0.163).

Conclusions

PET/CT allows simultaneous assessment of focal myocardial ¹⁸F-FDG uptake and myocardial vessel calcifications. Patients with clinical suspicion of coronary artery disease have a higher incidence of focal myocardial ¹⁸F-FDG uptake and coronary calcifications. However, ¹⁸F-FDG focal uptake is often observed in sites remote from those with calcification.