Prognostic Value of Arterial 18F-FDG PET Imaging - The PIAF Trial

In order to define distinct and reliable arterial 18 Fluor Desoxyglucose (FDG) thresholds identifying patients at risk for cardiovascular events, patients with a history of myocardial infarction and elevated high-sensitivity C-reactive protein (hsCRP) will be included in this international multicentre trial. Non-enhanced whole-body FDG PET/CT will be performed in all patients and the arterial FDG uptake in the carotid arteries as well as the aorta will be quantified by calculating different uptake parameters. In addition FDG uptake in hematopoietic tissues (spleen, bone marrow), visceral adipose tissue (VAT) as well as different brain regions (e. g. amygdala).Furthermore, specific blood biomarkers including genetic biomarkers, which are linked to atherosclerotic disease with predictive power for future cardiovascular events will be analysed. Within a 4-year follow-up period, cardiovascular events (acute coronary syndrome, non-fatal ischemic stroke, ischemic cardiac death, other causes of death, coronary/vascular revascularization, new-onset of angina, symptomatic peripheral arterial disease and heart failure) will be recorded. The predictive value of the arterial, hematopoietic and cerebral FDG uptake parameters as well as of the specific blood and genetic biomarkers will be determined. Based on those results, a novel diagnostic algorithm in patients at risk for atherosclerosis and consequently emerging cardiovascular events including FDG PET/CT scan imaging will be defined.