Page 60 - ARNM-3-2

Advances in Radiotherapy &

Nuclear Medicine

ORIGINAL RESEARCH ARTICLE
18 F-FDG uptake in patients with

hypercholesterolemia using a standard
compartmental modeling approach

Mamdouh S. Al-enezi*

Department of Diagnostic Radiology, College of Applied Medical Science, University of Hail, Hail,
Saudi Arabia

Abstract

Hypercholesterolemia is a major risk factor of atherosclerotic cardiovascular disease.
However, current risk stratification models lack consideration of calcium burden. This study
aimed to examine the association between calcium burden and inflammatory response
in hypercholesterolemia patients. Eighteen participants were prospectively scheduled
for 18F-fluorodeoxyglucose ( F-FDG) PET/CT examination. They were classified into
18
a control group (CL, n=4), a hypercholesteremia group (HC, n=8), and a stable angina
group (SA, n=6). Arterial calcium was defined at attenuation ≥130 Hounsfield units in
arterial regions of interest (ROIs), and calcium density was divided into four groups based
on the Agatston strategy. Calcium area was defined by at least two adjoining pixels and
normalized to artery area, forming two groups based on the mean area. The metabolic
*Corresponding author: rate of glucose (MRGlu) was estimated using a two-tissue compartment model. For all
Mamdouh S. Al-enezi ROIs, MRGlu was significantly higher in both HC and SA groups compared to CL (p<0.05).
(ms.alenezi@uoh.edu.sa)
Among no-calcium groups (CL, HC, and SA), no statistical significance was observed
Citation: Al-enezi, MS. (p>0.05). In with-calcium groups, MRGlu in HC was significantly higher than in CL and
18 F-FDG uptake in patients with
hypercholesterolemia using a SA (p<0.05). At the highest calcium density cluster, the difference between CL and HC
standard compartmental modeling was also significant (p<0.05). CL and SA showed a similar pattern of decreasing MRGlu
approach. Adv Radiother Nucl Med. with increasing calcium area (p<0.05 when compared with no-calcium), while the HC
2025;3(2):52-60.
doi: 10.36922/arnm.8540 group showed a marked increase in MRGlu with higher calcium area (p<0.05) compared
to CL and AS. Hypercholesterolemia is associated with increased glucose metabolism.
Received: January 15, 2025
Higher calcium area and density in hypercholesterolemia patients appear metabolically
1st revised: February 25, 2025 active. The results suggest that incorporating calcium burden in hypercholesterolemia
2nd revised: April 20, 2025 risk stratification models may enhance risk assessment.
Accepted: April 23, 2025
Keywords: Hypercholesterolemia; Atherosclerosis; Calcium; Inflammation;
Published online: May 6, 2025
Computed tomography; Positron emission tomography; Fluorodeoxyglucose;
Copyright: © 2025 Author(s). Compartmental modeling
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium, 1. Introduction
provided the original work is
properly cited. Cardiovascular disease (CVD) refers to all pathologies that affect the blood circulatory
Publisher’s Note: AccScience system. It encompasses a set of heterogeneous diseases, with the most common being
Publishing remains neutral with atherosclerotic cardiovascular disease (ASCVD). ASCVD is the main CVD subtype
1,2
regard to jurisdictional claims in 3
published maps and institutional responsible for both mortality and morbidity. Older adults are at high risk of ASCVD
affiliations. and its complications. 4-6

Volume 3 Issue 2 (2025) 52 doi: 10.36922/arnm.8540