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OBJECTIVES: This study aimed to assess the association between increased lesion peri-coronary adipose tissue (PCAT) density and coronary 18F-sodium fluoride (18F-NaF) uptake on positron emission tomography (PET) in stable patients with high-risk coronary plaques (HRPs) shown on coronary computed tomography angiography (CTA). BACKGROUND: Coronary 18F-NaF uptake reflects the rate of calcification of coronary atherosclerotic plaque. Increased PCAT density is associated with vascular inflammation. Currently, the relationship between increased PCAT density and 18F-NaF uptake in stable patients with HRPs on coronary CTA has not been characterized. METHODS: Patients who underwent coronary CTA were screened for HRP, which was defined by 3 concurrent plaque features: positive remodeling; low attenuation plaque (LAP) (<30 Hounsfield units [HU]) and spotty calcification; and obstructive coronary stenosis ≥50% (plaque volume >100 mm3). Patients with HRPs were recruited to undergo 18F-NaF PET/CT. In lesions with stenosis ≥25%, quantitative plaque analysis, mean PCAT density, maximal coronary motion-corrected 18F-NaF standard uptake values (SUVmax), and target-to-background ratios (TBR) were measured. RESULTS: Forty-one patients (age 65 ± 6 years; 68% men) were recruited. Fifty-one lesions in 23 patients (56%) showed increased coronary 18F-NaF activity. Lesions with 18F-NaF uptake had higher surrounding PCAT density than those without 18F-NaF uptake (-73 HU; interquartile range -79 to -68 HU vs. -86 HU; interquartile range -94 to -80 HU; p < 0.001). 18F-NaF TBR and SUVmax were correlated with PCAT density (r = 0.63 and r = 0.68, respectively; all p 

Original publication




Journal article


Jacc cardiovasc imaging

Publication Date





2000 - 2010


(18)F-sodium fluoride, PET/CT, coronary computed tomography angiography, coronary imaging, high-risk plaque, peri-coronary adipose tissue density, Adipose Tissue, Adiposity, Aged, Computed Tomography Angiography, Coronary Angiography, Coronary Artery Disease, Coronary Stenosis, Coronary Vessels, Female, Fluorine Radioisotopes, Humans, Los Angeles, Male, Middle Aged, Multidetector Computed Tomography, Plaque, Atherosclerotic, Positron Emission Tomography Computed Tomography, Predictive Value of Tests, Radiopharmaceuticals, Reproducibility of Results, Risk Assessment, Risk Factors, Rupture, Spontaneous, Seoul, Sodium Fluoride