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Background  Integrin alpha-V-beta-3 (αvβ3) pathway is involved in intraplaque angiogenesis and inflammation and represents a promising target for molecular imaging in cardiovascular diseases such as atherosclerosis. The aim of this study was to assess the clinical correlates of arterial wall accumulation of  68 Ga-NODAGA-RGD, a specific α v β 3  integrin ligand for PET.    Materials and methods  The data of 44 patients who underwent  68 Ga-NODAGA-RGD PET/CT scans were retrospectively analyzed. Tracer accumulation in the vessel wall of major arteries was analyzed semi-quantitatively by blood-pool-corrected target-to-background ratios. Tracer uptake was compared with clinically documented atherosclerotic cardiovascular disease, cardiovascular risk factors and calcified plaque burden. Data were compared using the Mann–Whitney  U  test, Pearson correlation and Spearman correlation.    Results   68 Ga-NODAGA-RGD arterial uptake was significantly higher in patients with previous clinically documented atherosclerotic cardiovascular disease (mean TBR 2.44 [2.03–2.55] vs. 1.81 [1.56–1.96],  p  = 0.001) and showed a significant correlation with prior cardiovascular or cerebrovascular event ( r  = 0.33,  p  = 0.027), BMI ( ρ  = 0.38,  p  = 0.01), plaque burden ( ρ  = 0.31,  p  = 0.04) and hypercholesterolemia ( r  = 0.31,  p  = 0.04).    Conclusions   68 Ga-NODAGA-RGD holds promise as a non-invasive marker of disease activity in atherosclerosis, providing information about intraplaque angiogenesis.

ejnmmi research

Imaging angiogenesis in atherosclerosis in large arteries with 68Ga-NODAGA-RGD PET/CT: relationship with clinical atherosclerotic cardiovascular disease