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Identifying active vascular microcalcification by (18)F-sodium fluoride positron emission tomography

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  • Agnese Irkle
  • Alex T Vesey
  • David Y Lewis
  • Jeremy N Skepper
  • Joseph L E Bird
  • Marc R Dweck
  • Francis R Joshi
  • Ferdia A Gallagher
  • Elizabeth A Warburton
  • Martin R Bennett
  • Kevin M Brindle
  • David E Newby
  • James H Rudd
  • Anthony P Davenport

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Original languageEnglish
Pages (from-to)7495
JournalNature Communications
Volume6
DOIs
Publication statusPublished - 7 Jul 2015

Abstract

Vascular calcification is a complex biological process that is a hallmark of atherosclerosis. While macrocalcification confers plaque stability, microcalcification is a key feature of high-risk atheroma and is associated with increased morbidity and mortality. Positron emission tomography and X-ray computed tomography (PET/CT) imaging of atherosclerosis using (18)F-sodium fluoride ((18)F-NaF) has the potential to identify pathologically high-risk nascent microcalcification. However, the precise molecular mechanism of (18)F-NaF vascular uptake is still unknown. Here we use electron microscopy, autoradiography, histology and preclinical and clinical PET/CT to analyse (18)F-NaF binding. We show that (18)F-NaF adsorbs to calcified deposits within plaque with high affinity and is selective and specific. (18)F-NaF PET/CT imaging can distinguish between areas of macro- and microcalcification. This is the only currently available clinical imaging platform that can non-invasively detect microcalcification in active unstable atherosclerosis. The use of (18)F-NaF may foster new approaches to developing treatments for vascular calcification.

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