Carotid Plaque Inflammation Assessed with 18F-FDG PET/CT is Higher in Symptomatic Compared with Asymptomatic Patients

BackgroundCarotid artery plaque inflammation is thought to be an important marker of plaque vulnerability and increased stroke risk.AimThe main aim of this study was to assess the level of agreement between 2-deoxy-2-[18F] fluoro-D-glucose (18F-FDG) uptake on PET (positron emission tomography) scan in carotid plaques, with cerebrovascular symptoms, carotid plaque ultrasound echogenicity and histological assessments of plaque inflammation.MethodsThirty-six patients with ≥70% carotid stenosis scheduled for carotid endarterectomy underwent a Colour Duplex ultrasound, 18F-FDG PET/CT and blood tests less than 24 h prior to surgery. Plaques were defined as symptomatic when associated with ipsilateral cerebral ischemic symptoms within 30 days prior to inclusion. Plaques were assessed histologically following endarterectomy. The level of agreement between 18F-FDG uptake (mean SUVmax and SUVmax), and target-to-background ratio, symptoms, plaque echolucency, and histological evidence of inflammation was assessed.Re...