18F-fluorodeoxyglucose (18F-FDG) PET/CT assessment of aortic inflammation and calcification in COPD

Introduction: Systemic inflammation may account for the increased risk of cardiovascular disease in COPD patients. Aim: We hypothesised that COPD patients would demonstrate higher levels of aortic inflammation and calcification compared with control groups, which could be demonstrated by 18 F-FDG PET/CT. Methods: 24 COPD patients, 10 ex-smokers (with normal spirometry) and 8 healthy volunteers underwent 18 F-FDG PET/CT. Each PET/CT was analysed on 2 separate occasions by same reader. Aortic 18 F-FDG uptake was measured as maximum standardised uptake value (SUV). Aortic calcification was calculated as sum of maximum Hounsfield unit (HU) values from whole aorta. Emphysema was expressed as % of low attenuation areas with HU of less than −950 in both lungs. Results: Aortic maximum SUV and maximum HU measurements were reproducible with intra-class correlation coefficients for intra-observer agreement greater than 0.9. Aortic maximum SUV (mean±SD) was significantly higher in COPD patients (3.77±0.40), compared with healthy volunteers (3.25±0.75) and ex-smokers (2.81±0.54, p 1 % predicted (r=-0.59, p 1 % predicted (r=-0.57, p Conclusion: 18 F-FDG PET/CT is a reproducible method for assessing aortic inflammation. 18 F-FDG PET/CT demonstrates greater aortic inflammation and calcification in COPD, which may have a role in predicting future vascular events in COPD patients.