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. 2014 Sep;11(3):259–273. doi: 10.11909/j.issn.1671-5411.2014.03.005

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Institute of Geriatric Cardiology

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License, which allows readers to alter, transform, or build upon the article and then distribute the resulting work under the same or similar license to this one. The work must be attributed back to the original author and commercial use is not permitted without specific permission.

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Figure 4. — Patient with acute ST-segment elevation myocardial infarction with (A): proximal occlusion (red arrow) of the left anterior descending artery on invasive coronary angiography and (B): intense focal ¹⁸F-fluoride [¹⁸F-NaF, tissue-to-background ratios, culprit 2.27 vs. reference segment 1.09 (108% increase)] uptake (yellow-red) at the site of the culprit plaque (red arrow) on the combined positron emission and computed tomogram (PET-CT). (C): Corresponding ¹⁸F-fluorodeoxyglucose PET-CT image showing no uptake at the site of the culprit plaque (¹⁸F-FDG, tissue-to-background ratios, 1.63 versus reference segment 1.91 (15% decrease)). Note the significant myocardial uptake overlapping with the coronary artery (yellow arrow) and uptake within the oesophagus (blue arrow). (D): Patient with anterior non-ST-segment elevation myocardial infarction with culprit (red arrow; left anterior descending artery) and bystander non-culprit (white arrow; circumflex artery) lesions on invasive coronary angiography that were both stented during the index admission. (E): Only the culprit lesion had increased ¹⁸F-NaF uptake [¹⁸F-NaF, tissue-to-background ratios, culprit 2.03 vs. reference segment 1.08 (88% increase)] on PET-CT after percutaneous coronary intervention. Corresponding ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG), PET-CT showing no uptake either at the culprit [¹⁸F-FDG, tissue-to-background ratios, culprit 1.62 vs. reference segment 1.49 (9% increase)] or the bystander stented lesion. Note intense uptake within the ascending aorta (F). Reprint with permission from reference [88].