Quantifying sodium [18F]fluoride uptake in abdominal aortic aneurysms

Samuel Debono; Jennifer Nash; Alexander J  Fletcher; Maaz Syed; Scott I  Semple; Edwin J R  van Beek; Alison Fletcher; Sebastien Cadet; Michelle C Williams; Damini Dey; Piotr J Slomka; Rachael O Forsythe; Marc R Dweck; David E Newby

doi:10.1186/s13550-022-00904-z

Quantifying sodium [18F]fluoride uptake in abdominal aortic aneurysms

Samuel Debono, Jennifer Nash, Alexander J Fletcher , Maaz Syed, Scott I Semple, Edwin J R van Beek, Alison Fletcher, Sebastien Cadet, Michelle C Williams, Damini Dey, Piotr J Slomka, Rachael O Forsythe, Marc R Dweck, David E Newby

Research output: Contribution to journal › Article › peer-review

Abstract

Background
Aortic microcalcification activity is a recently described method of measuring aortic sodium [ F]fluoride uptake in the
thoracic aorta on positron emission tomography. In this study, we aimed to compare and to modify this method for use within
the infrarenal aorta of patients with abdominal aortic aneurysms.
Methods
Twenty-five patients with abdominal aortic aneurysms underwent an sodium [ F]fluoride positron emission tomography and
computed tomography scan. Maximum and mean tissue-to-background ratios (TBR) and abdominal aortic microcalcification
activity were determined following application of a thresholding and variable radius method to correct for vertebral sodium
[ F]fluoride signal spill-over and the nonlinear changes in aortic diameter, respectively. Agreement between the methods, and
repeatability of these approaches were assessed.
Results
The aortic microcalcification activity method was much quicker to perform than the TBR method (14 versus 40 min, p <
0.001). There was moderate-to-good agreement between TBR and aortic microcalcification activity measurements for
maximum (interclass correlation co-efficient, 0.67) and mean (interclass correlation co-efficient, 0.88) values. These
correlations sequentially improved with the application of thresholding (intraclass correlation coefficient 0.93, 95% confidence
interval 0.89–0.95) and variable diameter (intraclass correlation coefficient 0.97, 95% confidence interval 0.94–0.99)
techniques. The optimised method had good intra-observer (mean 1.57 ± 0.42, bias 0.08, co-efficient of repeatability 0.36 and
limits of agreement − 0.43 to 0.43) and inter-observer (mean 1.57 ± 0.42, bias 0.08, co-efficient of repeatability 0.47 and limits
of agreement − 0.53 to 0.53) repeatability.
Conclusions
Aortic microcalcification activity is a quick and simple method which demonstrates good intra-observer and inter-observer
repeatabilities and provides measures of sodium [ F]fluoride uptake that are comparable to established methods.

Original language	English
Journal	EJNMMI research
Early online date	6 Jun 2022
DOIs	https://doi.org/10.1186/s13550-022-00904-z
Publication status	E-pub ahead of print - 6 Jun 2022

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1 Active
5 Finished

Incidental coronary calcification on thoracic computed tomography
Williams, M. (Principal Investigator), Mills, N. (Co-investigator) & Newby, D. (Co-investigator)
UK-based charities
1/02/21 → 31/01/26
Project: Research
Myocardial fibrosis activity in cardiovascular disease
Dweck, M. (Principal Investigator)
UK-based charities
1/12/21 → 30/11/24
Project: Research
Predicting Endoleaks Following Endovascular Aortic Aneurysm Repair
Forsythe, R. (Principal Investigator), Lichten, C. (Co-investigator) & Newby, D. (Co-investigator)
UK-based charities
1/04/21 → 31/03/24
Project: Research

Edinburgh Imaging Facility
Grant, A. (Manager), van Beek, E. (Manager) & Semple, S. (Manager)
Deanery of Clinical Sciences
Facility/equipment: Facility

Cite this

@article{ee93272e01734d00bdf6cc8081e86699,

title = "Quantifying sodium [18F]fluoride uptake in abdominal aortic aneurysms",

abstract = "BackgroundAortic microcalcification activity is a recently described method of measuring aortic sodium [ F]fluoride uptake in thethoracic aorta on positron emission tomography. In this study, we aimed to compare and to modify this method for use withinthe infrarenal aorta of patients with abdominal aortic aneurysms.MethodsTwenty-five patients with abdominal aortic aneurysms underwent an sodium [ F]fluoride positron emission tomography andcomputed tomography scan. Maximum and mean tissue-to-background ratios (TBR) and abdominal aortic microcalcificationactivity were determined following application of a thresholding and variable radius method to correct for vertebral sodium[ F]fluoride signal spill-over and the nonlinear changes in aortic diameter, respectively. Agreement between the methods, andrepeatability of these approaches were assessed.ResultsThe aortic microcalcification activity method was much quicker to perform than the TBR method (14 versus 40 min, p <0.001). There was moderate-to-good agreement between TBR and aortic microcalcification activity measurements formaximum (interclass correlation co-efficient, 0.67) and mean (interclass correlation co-efficient, 0.88) values. Thesecorrelations sequentially improved with the application of thresholding (intraclass correlation coefficient 0.93, 95% confidenceinterval 0.89–0.95) and variable diameter (intraclass correlation coefficient 0.97, 95% confidence interval 0.94–0.99)techniques. The optimised method had good intra-observer (mean 1.57 ± 0.42, bias 0.08, co-efficient of repeatability 0.36 andlimits of agreement − 0.43 to 0.43) and inter-observer (mean 1.57 ± 0.42, bias 0.08, co-efficient of repeatability 0.47 and limitsof agreement − 0.53 to 0.53) repeatability.ConclusionsAortic microcalcification activity is a quick and simple method which demonstrates good intra-observer and inter-observerrepeatabilities and provides measures of sodium [ F]fluoride uptake that are comparable to established methods.",

author = "Samuel Debono and Jennifer Nash and Fletcher, {Alexander J} and Maaz Syed and Semple, {Scott I} and {van Beek}, {Edwin J R} and Alison Fletcher and Sebastien Cadet and Williams, {Michelle C} and Damini Dey and Slomka, {Piotr J} and Forsythe, {Rachael O} and Dweck, {Marc R} and Newby, {David E}",

note = "Funding Information: SD, AJF, MBJS, MCW, ROF, MRD and DEN are supported by the British Heart Foundation (PG/21/10461, FS/19/15/34155, FS/18/31/33676, FS/ICRF/20/26002, RE/18/5/34216, FS/SCRF/21/32010). MRD is the recipient of the Sir Jules Thorn Award for Biomedical Research 2015 (15/JTA). DEN is the recipient of a Wellcome Trust Senior Investigator Award (WT103782AIA). EJRVB is supported by SINAPSE ( www.sinapse.ac.uk ). PS, SC and FusionQuant Development is supported by the National Institute of Health Grant HL135557 (PI: Piotr Slomka). Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = jun,

day = "6",

doi = "10.1186/s13550-022-00904-z",

language = "English",

journal = "EJNMMI research",

issn = "2191-219X",

publisher = "Springer",

}

TY - JOUR

T1 - Quantifying sodium [18F]fluoride uptake in abdominal aortic aneurysms

AU - Debono, Samuel

AU - Nash, Jennifer

AU - Fletcher , Alexander J

AU - Syed, Maaz

AU - Semple, Scott I

AU - van Beek, Edwin J R

AU - Fletcher, Alison

AU - Cadet, Sebastien

AU - Williams, Michelle C

AU - Dey, Damini

AU - Slomka, Piotr J

AU - Forsythe, Rachael O

AU - Dweck, Marc R

AU - Newby, David E

N1 - Funding Information: SD, AJF, MBJS, MCW, ROF, MRD and DEN are supported by the British Heart Foundation (PG/21/10461, FS/19/15/34155, FS/18/31/33676, FS/ICRF/20/26002, RE/18/5/34216, FS/SCRF/21/32010). MRD is the recipient of the Sir Jules Thorn Award for Biomedical Research 2015 (15/JTA). DEN is the recipient of a Wellcome Trust Senior Investigator Award (WT103782AIA). EJRVB is supported by SINAPSE ( www.sinapse.ac.uk ). PS, SC and FusionQuant Development is supported by the National Institute of Health Grant HL135557 (PI: Piotr Slomka). Publisher Copyright: © 2022, The Author(s).

PY - 2022/6/6

Y1 - 2022/6/6

N2 - BackgroundAortic microcalcification activity is a recently described method of measuring aortic sodium [ F]fluoride uptake in thethoracic aorta on positron emission tomography. In this study, we aimed to compare and to modify this method for use withinthe infrarenal aorta of patients with abdominal aortic aneurysms.MethodsTwenty-five patients with abdominal aortic aneurysms underwent an sodium [ F]fluoride positron emission tomography andcomputed tomography scan. Maximum and mean tissue-to-background ratios (TBR) and abdominal aortic microcalcificationactivity were determined following application of a thresholding and variable radius method to correct for vertebral sodium[ F]fluoride signal spill-over and the nonlinear changes in aortic diameter, respectively. Agreement between the methods, andrepeatability of these approaches were assessed.ResultsThe aortic microcalcification activity method was much quicker to perform than the TBR method (14 versus 40 min, p <0.001). There was moderate-to-good agreement between TBR and aortic microcalcification activity measurements formaximum (interclass correlation co-efficient, 0.67) and mean (interclass correlation co-efficient, 0.88) values. Thesecorrelations sequentially improved with the application of thresholding (intraclass correlation coefficient 0.93, 95% confidenceinterval 0.89–0.95) and variable diameter (intraclass correlation coefficient 0.97, 95% confidence interval 0.94–0.99)techniques. The optimised method had good intra-observer (mean 1.57 ± 0.42, bias 0.08, co-efficient of repeatability 0.36 andlimits of agreement − 0.43 to 0.43) and inter-observer (mean 1.57 ± 0.42, bias 0.08, co-efficient of repeatability 0.47 and limitsof agreement − 0.53 to 0.53) repeatability.ConclusionsAortic microcalcification activity is a quick and simple method which demonstrates good intra-observer and inter-observerrepeatabilities and provides measures of sodium [ F]fluoride uptake that are comparable to established methods.

AB - BackgroundAortic microcalcification activity is a recently described method of measuring aortic sodium [ F]fluoride uptake in thethoracic aorta on positron emission tomography. In this study, we aimed to compare and to modify this method for use withinthe infrarenal aorta of patients with abdominal aortic aneurysms.MethodsTwenty-five patients with abdominal aortic aneurysms underwent an sodium [ F]fluoride positron emission tomography andcomputed tomography scan. Maximum and mean tissue-to-background ratios (TBR) and abdominal aortic microcalcificationactivity were determined following application of a thresholding and variable radius method to correct for vertebral sodium[ F]fluoride signal spill-over and the nonlinear changes in aortic diameter, respectively. Agreement between the methods, andrepeatability of these approaches were assessed.ResultsThe aortic microcalcification activity method was much quicker to perform than the TBR method (14 versus 40 min, p <0.001). There was moderate-to-good agreement between TBR and aortic microcalcification activity measurements formaximum (interclass correlation co-efficient, 0.67) and mean (interclass correlation co-efficient, 0.88) values. Thesecorrelations sequentially improved with the application of thresholding (intraclass correlation coefficient 0.93, 95% confidenceinterval 0.89–0.95) and variable diameter (intraclass correlation coefficient 0.97, 95% confidence interval 0.94–0.99)techniques. The optimised method had good intra-observer (mean 1.57 ± 0.42, bias 0.08, co-efficient of repeatability 0.36 andlimits of agreement − 0.43 to 0.43) and inter-observer (mean 1.57 ± 0.42, bias 0.08, co-efficient of repeatability 0.47 and limitsof agreement − 0.53 to 0.53) repeatability.ConclusionsAortic microcalcification activity is a quick and simple method which demonstrates good intra-observer and inter-observerrepeatabilities and provides measures of sodium [ F]fluoride uptake that are comparable to established methods.

U2 - 10.1186/s13550-022-00904-z

DO - 10.1186/s13550-022-00904-z

M3 - Article

SN - 2191-219X

JO - EJNMMI research

JF - EJNMMI research

ER -

Quantifying sodium [18F]fluoride uptake in abdominal aortic aneurysms

Abstract

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Projects

Incidental coronary calcification on thoracic computed tomography

Myocardial fibrosis activity in cardiovascular disease

Predicting Endoleaks Following Endovascular Aortic Aneurysm Repair

Equipment

Edinburgh Imaging Facility

Cite this