Quantification of Skeletal Muscle Perfusion in Peripheral Artery Disease Using 18 F‐Sodium Fluoride Positron Emission Tomography Imaging

作者：Ting‐Heng Chou, Mahboubeh Nabavinia, Nguyen K. Tram, Eleanor T. Rimmerman, Surina A. Patel, Kumudha Narayana Musini, Susan Natalie Eisert, Tatiana Wolfe, Molly K. Wynveen, Yuichi Matsuzaki, Takahiro Kitsuka, Ryuma Iwaki, Sarah Janse, Adam J. Bobbey, Christopher K. Breuer, Laurie Goodchild, Raphael A. Malbrue, Toshiharu Shinoka, Said A. Atway, Michael R. Go, Mitchel R. Stacy · 发表于：Journal of the American Heart Association · 年份：2024 · DOI：10.1161/jaha.123.031823 · 被引用次数：10 · 研究领域：Peripheral Artery Disease Management、Cerebrovascular and Carotid Artery Diseases、Cardiac Imaging and Diagnostics

Background Perfusion deficits contribute to symptom severity, morbidity, and death in peripheral artery disease (PAD); however, no standard method for quantifying absolute measures of skeletal muscle perfusion exists. This study sought to preclinically test and clinically translate a positron emission tomography (PET) imaging approach using an atherosclerosis‐targeted radionuclide, fluorine‐18‐sodium fluoride ( 18 F‐NaF), to quantify absolute perfusion in PAD. Methods and Results Eight Yorkshire pigs underwent unilateral femoral artery ligation and dynamic 18 F‐NaF PET/computed tomography imaging on the day of and 2 weeks after occlusion. Following 2‐week imaging, calf muscles were harvested to quantify microvascular density. PET methodology was validated with microspheres in 4 additional pig studies and translated to patients with PAD (n=39) to quantify differences in calf perfusion across clinical symptoms/stages and perfusion responses in a case of revascularization. Associations between PET perfusion, ankle‐brachial index, toe‐brachial index, and toe pressure were assessed in relation to symptoms. 18 F‐NaF PET/computed tomography quantified significant deficits in calf perfusion in pigs following arterial occlusion and perfusion recovery 2 weeks after occlusion that coincided with increased muscle microvascular density. Additional studies confirmed that PET‐derived perfusion measures agreed with microsphere‐derived perfusion measures. Translation of imaging methods demons...