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The Sodium Fluoride Aortic Gradient: Insights From the ROPPET-NAF Study
Session:
SESSÃO DE POSTERS 16 - DIAGNÓSTICO E PROGNÓSTICO NA ESTENOSE AÓRTICA
Speaker:
Mafalda de Oliveira Griné
Congress:
CPC 2025
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.4 Nuclear Imaging
Session Type:
Cartazes
FP Number:
---
Authors:
Mafalda Griné; Manuel Oliveira-Santos; João Borges-Rosa; Rudolfo Silva; Andreia Gomes; Antero Abrunhosa; Miguel Castelo-Branco; Lino Gonçalves; Maria João Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Introduction:</strong> 18F-NaF PET-CT (Positron Emission Tomography-Computed Tomography using 18F-sodium fluoride) detects active microcalcification, an indicator of plaque instability. Variations in 18F-NaF uptake across the coronary, carotid, and aortic territories have been noted. We aimed to explore regional differences in 18F-NaF uptake specifically within the Aorta of individuals at high cardiovascular (CV) risk.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods</strong>: We conducted a sub-analysis of a prospective study of high-risk individuals without prior CV events using 18F-NaF PET-CT (ROPPET-NAF, NCT 03233243). The uptake of 18F-NaF in the aortic wall was quantified via tissue-to-background ratio (TBR), calculated by dividing the maximum standard uptake value of a region of interest by the baseline blood pool activity in the atria.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results</strong>: We included 30 participants in this analysis (mean age 63.7 ± 9.5 years; 70.0% male), most of whom had diabetes and hypertension (93.3%). The estimated 10-year CV event risk was 10.5% (range: 6.5–15.5) by SCORE2/SCORE-OP and 32.2 ± 18.6% by the ASCVD equation. The Abdominal Aorta showed significantly higher 18F-NaF uptake compared to other aortic segments [p<0.001; TBR: 1.84 (1.56–2.21) in the Abdominal Aorta vs. 1.63 (1.51–1.84) in the Descending Thoracic Aorta, 1.68 ± 0.25 in the Aortic Arch, and 1.65 (1.43–1.78) in the Ascending Aorta]. No other regional differences were significant. Males exhibited higher Abdominal Aorta TBR compared to females [1.95 (1.68–2.62) vs. 1.56 (1.51–1.79), p=0.014]. Abdominal Aorta TBR was positively correlated with estimated 10-year CV event risk by both SCORE2/SCORE-OP (R=0.49, p=0.006) and ASCVD (R=0.43, p=0.017) systems. No significant associations were found between other baseline characteristics and Abdominal Aorta TBR.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusions</strong>: In this high-risk cohort, the Abdominal Aorta demonstrated significantly greater 18F-NaF activity compared to other aortic segments. This increased uptake was more pronounced in males and correlated with higher predicted CV risk. Further large-scale studies are needed to confirm these findings and to establish the role of 18F-NaF PET-CT in CV disease research and management.</span></span></span></p>
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