Carotid Plaque Inflammation Assessed by 18F-FDG PET/CT and Lp-PLA2 Is Higher in Symptomatic Patients

Carotid plaque inflammation assessed by 2-deoxy-2-[ 18 F]fluoro-D-glucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) and lipoprotein-associated phospholipase A2 (Lp-PLA 2 ) levels are higher in symptomatic patients. The aim of this study was to assess correlations between 18 F-FDG uptake on PET scan of carotid artery plaques, plasma levels of Lp-PLA 2 , and cerebrovascular symptoms. The study included 45 consecutive patients (22 symptomatic, 23 asymptomatic) with >70% carotid stenosis. Patients were examined by hybrid PET/CT, and maximum standardized uptake values (SUV max ) were recorded. Blood samples were obtained, and plasma was stored at −80 °C for subsequent Lp-PLA 2 analysis. Symptomatic and asymptomatic patients showed no significant difference in classical cardiovascular risk factors. Asymptomatic carotid stenosis patients more frequently had a history of coronary artery disease ( P = .025) and peripheral artery disease ( P = .012). The symptomatic group had higher 18 F-FDG uptake in carotid plaques ( P < .001), higher plasma Lp-PLA 2 ( P < .01), and higher high-sensitive C-reactive protein ( P = .022). 2-Deoxy-2-[ 18 F]fluoro-D-glucose uptake on PET/CT and plasma Lp-PLA 2 show a statistically significant association with the symptomatic status of carotid plaques.