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Advances in Radiotherapy
& Nuclear Medicine 18 F-FDG uptake and hypercholesterolemia

inflammation and largest calcium density in this present Acknowledgments
study (Figure 3), where MRGlu values for the HC group at
the K4 cluster of calcium density were statistically higher The author wishes to thank Dr. M. Bentourkia, Dr. Éric
than those for the CL group at the same cluster (p<0.05). Turcotte, Éric Lavallee, and the clinical team at the
Sherbrooke Molecular Imaging Centre, Université de
Calcium area was shown to be statistically higher in Sherbrooke, for their technical assistance.
terms of MRGlu values for the HC group at the A2 cluster
(area ratio >20%, according to the mean value of calcium Funding
area ratio), as illustrated in Figure 4, with reference to both None.
CL and SA groups (p<0.05).
Calcium area has been reported to be a positive Conflict of interest
predictor of CVD. 47,48 In addition, calcium volume was The author declares no conflicts of interest.
associated with HC in other studies. 47,49 The incidence
of vascular calcium burden increases with age, and its Author contributions
presence usually represents advanced atherosclerosis.
50
Calcium burden progression has been linked to metabolic This is a single-authored article.
disorders, among which is hypercholesterolemia. 51,52 Ethics approval and consent to participate
Moreover, hypercholesterolemia and age are among several
factors known to contribute effectively to ASCVD. 11,53-55 The current prospective study was approved by the
Hypercholesterolemia has been also shown to be involved Research Ethics Committee of the Faculty of Medicine and
in the subclinical progression of atherosclerosis. 56 Health Sciences, University of Sherbrooke, Canada (2019-
3145). All participants provided written informed consent
This positive correlation of MRGlu values and 18
calcium burden in hypercholesterolemia patients for scanning with F-Fluorodeoxyglucose positron
demonstrated in this study highlights the need for calcium emission tomography/CT.
burden consideration in risk stratification models for Consent for publication
hypercholesterolemia patients.
Patients consented on the publication of their data.
In this study, there were some limitations. One
limitation is the relatively small number of participants. The Availability of data
second limitation is the cross-sectional design; therefore,
a longitudinal study design is necessary to confirm the The data supporting the findings of this study are available
findings of this study. The third limitation is that the within the article.
study did not consider sex in the analysis, particularly References
for calcium density, where a recent study suggested that
lower calcium density in women is tightly associated with 1. Wong ND, Budoff MJ, Ferdinand K, et al. Atherosclerotic
ASCVD mortality risk, while the situation in men is the cardiovascular disease risk assessment: An American Society
reverse (higher calcium density); however, for calcium for Preventive Cardiology clinical practice statement. Am J
area, both sexes show a strong association between higher Prev Cardiol. 2022;10:100335.
calcium area and ASCVD mortality risk. 57 doi: 10.1016/j.ajpc.2022.100335
5. Conclusion 2. Frąk W, Wojtasińska A, Lisińska W, Młynarska E,
Franczyk B, Rysz J. Pathophysiology of cardiovascular
Hypercholesterolemia is associated with regional glucose diseases: New insights into molecular mechanisms of
metabolism, as identified by the MRGlu on F-FDG PET/ atherosclerosis, arterial hypertension, and coronary artery
18
CT, and it reflects inflammatory activities at the arterial disease. Biomedicines. 2022;10(8):1938.
walls in hypercholesterolemia patients. Calcium burden doi: 10.3390/biomedicines10081938
at arterial wall regions – identified by area and density –
in these patients is coupled with inflammatory activities. 3. Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart disease and
stroke statistics-2017 update: A report from the American
The results suggest that vascular calcium burden may Heart Association. Circulation. 2017;135(10):e146-e603.
be accelerated by hypercholesterolemia and could be a
target of cholesterol-lowering medications. Therefore, doi: 10.1161/CIR.0000000000000485
incorporating calcium burden consideration into risk 4. Yan L, Ye X, Fu L, Hou W, Lin S, Su H. Construction of
stratification models may improve risk assessment in vulnerable plaque prediction model based on multimodal
patients with hypercholesterolemia. vascular ultrasound parameters and clinical risk factors. Sci

Volume 3 Issue 2 (2025) 57 doi: 10.36922/arnm.8540