Vulnerable plaque detection: The role of 18-fluorine fluorodeoxyglucose in identifying high risk patients

Available online 22 July 2013

Peer review under responsibility of Alexandria University Faculty of Medicine.

Figures & data

Table 1 Descriptive patient characteristics (n = 30).

Characteristic	N (n = 30)	Percentage (%)
Age group (years)
<30	1	3.3
31–40	4	13.3
41–50	9	30
51–60	6	20
>60	10	33.30
BMI (kg/m^2)
15.00–18.49 (underweight)	2	6.67
18.50–24.99 (normal)	16	53.3
25.00–29.99 (overweight)	9	30
30.00–34.99 (obese)	3	10
Gender
Male	19	63.3
Female	11	36.7
Ethnicity
Chinese	13	41.9
Malay	12	38.7
Indian	5	16.1
Risk factors
Smoking status
Smoker	10	32.3
Non-smoker	20	64.5
Hypertension	11	35.5
Diabetes mellitus	4	13.3
Hyperlipidemia	7	22.6
Family history
Heart disease	6	19.4
Hypertension	12	38.7
Diabetes mellitus	9	29

Figure 1 A foci of calcification within vascular wall with CT value of 550 HU (hard plaque) at 10 o’clock position.

Figure 2 Control sites demonstrated in grey scale. Region of interest drawn at three sites (2 o’clock, 4 o’clock and 8 o’clock) within similar level of plaque localization.

Figure 3 Inflamed vascular plaque at 10 o’clock position with CT value of 43 (mean HU) and metabolic activity of SUVmax: 3.34.

Table 3 The relationship of plaque area (HUmax) and risk factors in developing vulnerable plaque by using independent t test for variable <2 group and ANOVA test for variable >2 group.

Variable (Risk factor)	N (n: 30)	Mean ± S.D (plaque area)	P value (plaque area)
Gender
Male	19	187.9 ± 137.6
Female	11	184.9 ± 116.8	0.014•
Age
<30	1	144.2 ± 11.67
31–40	4	155.9 ± 46.50
41–50	9	171.9 ± 94.52	0.0001•
51–60	6	178.9 ± 81.54
>60	10	221.5 ± 190.1
BMI (kg/m^2)
15.00–18.49 (underweight)	2	144.9 ± 46.9
18.50–24.99 (normal)	16	178 ± 107.6
25.00–29.99 (overweight)	9	212.6 ± 173.7	0.0001•
30.00–34.99 (obese)	3	169.7 ± 60.6
Ethnicity
Chinese	13	207.9 ± 172.4
Malay	12	173.4 ± 82.54	0.0001•
Indian	5	170.8 ± 106.0
Smoking status
Smoker	10	180.7 ± 113.9	0.944
Non-smoker	20	190.3 ± 138.9
Hypertension
Yes	11	215.2 ± 180.6	0.0001•
No	19	167.8 ± 75.47
Diabetes mellitus
Yes	4	198.1 ± 149.9	0.83
No	26	184.5 ± 126.0
Hyperlipidemia
Yes	7	205.4 ± 167.8	0.0001•
No	23	180 ± 113.1
Family history of heart disease
Yes	6	194.3 ± 101.8	0.566
No	24	184.9 ± 136.5
Hypertension
Yes	12	195.8 ± 163.7	0.0001•
No	18	180.8 ± 101.9
Diabetes mellitus
Yes	9	208.3 ± 180.5	0.0001•
No	21	176.0 ± 94.24

Table 2 The relationship between SUVmax and HUmax, with patient demographics and risk factors by using an independent t-test for < 2 variables and ANOVA for > 2 variables.

Variables (Risk factors)	n	Vulnerable plaque (SUVmax)		Calcified plaque area
		Mean ± S.D	p-value	Mean ± S.D	p-value
Gender
Male	19	1.86 ± 0.41		187.9 ± 137.6
Female	11	1.79 ± 0.37	0.486	184.9 ± 116.8	0.014•
Age
<30	1	–		144.2 ± 11.67
31–40	4	2.17 ± 0.45		155.9 ± 46.50
41–50	9	1.66 ± 0.32	0.073	171.9 ± 94.52	0.0001•
51–60	6	1.87 ± 0.49		178.9 ± 81.54
>60	10	1.85 ± 0.37		221.5 ± 190.1
BMI (kg/m^2)
Underweight	2	1.05		144.9 ± 46.9
Normal	16	1.77 ± 0.38		178 ± 107.6
Overweight	9	1.87 ± 0.38	0.031•	212.6 ± 173.7	0.0001•
Obese	3	2.17 ± 0 .45		169.7 ± 60.6
Ethnic
Chinese	13	1.77 ± 0.32		207.9 ± 172.4
Malay	12	1.88 ± 0.38	0.126	173.4 ± 82.54	0.0001•
Indian	5	2.00 ± 0 .61		170.8 ± 106.0
Smoking status
Smoker	10	1.90 ± 0.39	0.176	180.7 ± 113.9	0.944
Non-smoker	20	1.79 ± 0.41		190.3 ± 138.9	Non-smoker
Hypertension
Yes	11	1.78 ± 0.33	0.089	215.2 ± 180.6	0.0001•
No	19	1.96 ± 0.51		167.8 ± 75.47	No
Diabetes mellitus
Yes	4	1.91 ± 0.37	0.296	198.1 ± 149.9	0.83
No	26	1.81 ± 0.41		184.5 ± 126.0	No
Hyperlipidemia
Yes	7	1.80 ± 0.32	0.524	205.4 ± 167.8	0.0001•
No	23	1.86 ± 0.44		180 ± 113.1
Family history of heart disease
Yes	6	1.96 ± 0.36	0.103	194.3 ± 101.8	0.566
No	24	1.80 ± 0.40		184.9 ± 136.5	No
Hypertension
Yes	12	1.83 ± 0.35	0.81	195.8 ± 163.7	0.0001•
No	18	1.85 ± 0.44		180.8 ± 101.9	No
Diabetes mellitus
Yes	9	1.86 ± 0.386	0.554	208.3 ± 180.5	0.0001•
No	21	1.81 ± 0.416		176.0 ± 94.24	No

Significant at p value <0.05•.

Figure 4 Scatter plot correlating the relationship of SUVmax and CT value in log transformed HU (log₁₀).