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Fluorodeoxyglucose Uptake in the Aortic Wall at PET/CT: Possible Finding for Active Atherosclerosis¹

¹ From the Russell H. Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine, Johns Hopkins Medical Institutions, 601 N Caroline St, Rm 3223A, Baltimore, MD 21287-0817. Received September 13, 2002; revision requested November 20; final revision received May 15, 2003; accepted May 20. Address correspondence to R.L.W. (e-mail: rwahl@jhmi.edu).

View larger version (39K): [in a new window]   Figure 1a. (a) Coronal CT (left), PET (middle), and fused PET/CT (right) images. Linear and bandlike positive FDG uptake is observed in the middle (grade 1, arrow) and lower (grade 3, arrowhead) descending aorta, respectively. No calcification is observed at CT. The intensity of the golden color on the fused PET/CT image corresponds to the gray scale on the PET image. (b) Transaxial CT (upper left), PET (CT attenuation correction, upper right), fused PET/CT (lower left), and non-attenuation-corrected PET (lower right) images at the lower descending aorta level (same patient as in a). FDG uptake is clearly demonstrated in the aortic wall (arrowhead). No calcification is observed. The intensity of the golden color on the fused PET/CT image (lower left) corresponds to the gray scale on the PET images (upper and lower right).

View larger version (85K): [in a new window]   Figure 1b. (a) Coronal CT (left), PET (middle), and fused PET/CT (right) images. Linear and bandlike positive FDG uptake is observed in the middle (grade 1, arrow) and lower (grade 3, arrowhead) descending aorta, respectively. No calcification is observed at CT. The intensity of the golden color on the fused PET/CT image corresponds to the gray scale on the PET image. (b) Transaxial CT (upper left), PET (CT attenuation correction, upper right), fused PET/CT (lower left), and non-attenuation-corrected PET (lower right) images at the lower descending aorta level (same patient as in a). FDG uptake is clearly demonstrated in the aortic wall (arrowhead). No calcification is observed. The intensity of the golden color on the fused PET/CT image (lower left) corresponds to the gray scale on the PET images (upper and lower right).

View larger version (20K): [in a new window]   Figure 2a. Bar graphs depict (a) the number of positive FDG uptake areas and (b) the number of calcifications in each aortic site. White, gray, and black bars represent grades 1, 2, and 3, respectively, of the FDG uptake or calcification. Asc = ascending aorta, Arc = aortic arch, Up = upper third of descending aorta, Mid = middle third of descending aorta, Low = lower third of descending aorta.

View larger version (19K): [in a new window]   Figure 2b. Bar graphs depict (a) the number of positive FDG uptake areas and (b) the number of calcifications in each aortic site. White, gray, and black bars represent grades 1, 2, and 3, respectively, of the FDG uptake or calcification. Asc = ascending aorta, Arc = aortic arch, Up = upper third of descending aorta, Mid = middle third of descending aorta, Low = lower third of descending aorta.

View larger version (51K): [in a new window]   Figure 3. Coronal CT (left), PET (middle), and fused PET/CT (right) images. Thick calcification is seen in the aortic arch (arrow). No focal FDG uptake is observed that corresponds to the sites of calcification. The intensity of the golden color on the fused PET/CT image corresponds to the gray scale on the PET image.

View larger version (45K): [in a new window]   Figure 4. Transaxial CT (left), PET (middle), and fused PET/CT (right) images. Aortic wall FDG uptake (grade 2) with calcification is demonstrated on the medial side of the lower descending aorta (arrow). FDG uptake (grade 3) is also seen on the lateral side of the aorta (arrowhead). This uptake is accompanied by small calcifications. The intensity of the golden color on the fused PET/CT image (right) corresponds to the gray scale on the PET image (middle).

View larger version (19K): [in a new window]   Figure 5a. (a) Scatterplot demonstrates no correlation between age and FDG uptake score in 50 patients with positive uptake. (b) Scatterplot demonstrates a relationship between the calcification score and age.

View larger version (23K): [in a new window]   Figure 5b. (a) Scatterplot demonstrates no correlation between age and FDG uptake score in 50 patients with positive uptake. (b) Scatterplot demonstrates a relationship between the calcification score and age.