High-Resolution [18]Fluorodeoxyglucose-Positron Emission Tomography and Coregistered Magnetic Resonance Imaging of Atherosclerotic Plaque From a Patient Undergoing Carotid Endarterectomy

In this Institutional Review Board-approved investigation, an 82-year-old male underwent carotid endarterectomy for a >80% asymptomatic carotid stenosis. Six weeks prior, the subject had undergone carotid endarterectomy of the contralateral carotid artery for a symptomatic >70% stenosis. Approximately 1 hour before surgery, the patient was injected with 7.9 mCi [18]Fluorodeoxyglucose (FDG). After resection of the plaque using a surgical technique that maintained its integrity, the specimen was imaged using micro-positron emission tomography (PET) (Siemens Inveon) and magnetic resonance imaging (3T Philips Achieva). Subsequently, the specimen was fixed in formalin, sectioned at 1 mm intervals, and stained with hematoxylin and eosin. Immunocytochemistry was performed using antibodies to detect macrophages (HAM-56, Dako, 1:100), leukocytes (CD-45, Dako, 1:200), and smooth muscle cell actin (anti–σ-actin Sigma, 1:100).The …