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Article

The Usefulness of [18F]F-Fluorodeoxyglucose and [18F]F-Sodium Fluoride Positron Emission Tomography Imaging in the Assessment of Early-Stage Aortic Valve Degeneration after Transcatheter Aortic Valve Implantation (TAVI)—Protocol Description and Preliminary Results

by
Danuta Sorysz
1,*,
Rafał Januszek
1,2,*,
Anna Sowa-Staszczak
3,4,
Anna Grochowska
5,
Marta Opalińska
3,
Maciej Bagieński
1,
Barbara Zawiślak
1,
Artur Dziewierz
1,6,
Tomasz Tokarek
1,
Agata Krawczyk-Ożóg
1,
Stanisław Bartuś
1,6 and
Dariusz Dudek
1,6
1
Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
2
Department of Clinical Rehabilitation, University of Physical Education, 31-571 Kraków, Poland
3
Nuclear Medicine Unit, Department of Endocrinology, University Hospital, 31-501 Kraków, Poland
4
Department of Endocrinology, University Hospital, Jagiellonian University Medical College, 31-501 Kraków, Poland
5
Department of Radiology, University Hospital, Jagiellonian University Medical College, 31-501 Kraków, Poland
6
Department of Cardiology, Jagiellonian University Medical College, 31-008 Kraków, Poland
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(3), 431; https://doi.org/10.3390/jcm10030431
Submission received: 6 December 2020 / Revised: 9 January 2021 / Accepted: 19 January 2021 / Published: 22 January 2021
(This article belongs to the Section Cardiology)
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Abstract

Transcatheter aortic valve implantation (TAVI) is now a well-established treatment for severe aortic stenosis. As the number of procedures and indications increase, the age of patients decreases. However, their durability and factors accelerating the process of degeneration are not well-known. The aim of the study was to verify the possibility of using [18F]F-sodium fluoride ([18F]F-NaF) and [18F]F-fluorodeoxyglucose ([18F]F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing the intensity of TAVI valve degenerative processes. In 73 TAVI patients, transthoracic echocardiography (TTE) at initial (before TAVI), baseline (after TAVI), and during follow-up, as well as transesophageal echocardiography (TEE) and PET/CT, were performed using [18F]F-NaF and [18F]F-FDG at the six-month follow-up (FU) visit as a part of a two-year FU period. The morphology of TAVI valve leaflets were assessed in TEE, transvalvular gradients and effective orifice area (EOA) in TTE. Calcium scores and PET tracer activity were counted. We assessed the relationship between [18F]F-NaF and [18F]F-FDG PET/CT uptake at the 6 = month FU with selected indices e.g.,: transvalvular gradient, valve type, EOA and insufficiency grade at following time points after the TAVI procedure. We present the preliminary PET/CT ([18F]F-NaF, [18F]F-FDG) results at the six-month follow-up period as are part of an ongoing study, which will last two years FU. We enrolled 73 TAVI patients with the mean age of 82.49 ± 7.11 years. A significant decrease in transvalvular gradient and increase of effective orifice area and left ventricle ejection fraction were observed. At six months, FU valve thrombosis was diagnosed in four patients, while 7.6% of patients refused planned controls due to the COVID-19 pandemic. We noticed significant correlations between valve types, EOA and transaortic valve gradients, as well as [18F]F-NaF and [18F]F-FDG uptake in PET/CT. PET/CT imaging with the use of [18F]F-FDG and [18F]F-NaF is intended to be feasible, and it practically allows the standardized uptake value (SUV) to differentiate the area containing the TAVI leaflets from the SUV directly adjacent to the ring calcifications and the calcified native leaflets. This could become the seed for future detection and evaluation capabilities regarding the progression of even early degenerative lesions to the TAVI valve, expressed as local leaflet inflammation and microcalcifications.
Keywords: degeneration; PET/CT imaging; TAVI durability degeneration; PET/CT imaging; TAVI durability

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MDPI and ACS Style

Sorysz, D.; Januszek, R.; Sowa-Staszczak, A.; Grochowska, A.; Opalińska, M.; Bagieński, M.; Zawiślak, B.; Dziewierz, A.; Tokarek, T.; Krawczyk-Ożóg, A.; et al. The Usefulness of [18F]F-Fluorodeoxyglucose and [18F]F-Sodium Fluoride Positron Emission Tomography Imaging in the Assessment of Early-Stage Aortic Valve Degeneration after Transcatheter Aortic Valve Implantation (TAVI)—Protocol Description and Preliminary Results. J. Clin. Med. 2021, 10, 431. https://doi.org/10.3390/jcm10030431

AMA Style

Sorysz D, Januszek R, Sowa-Staszczak A, Grochowska A, Opalińska M, Bagieński M, Zawiślak B, Dziewierz A, Tokarek T, Krawczyk-Ożóg A, et al. The Usefulness of [18F]F-Fluorodeoxyglucose and [18F]F-Sodium Fluoride Positron Emission Tomography Imaging in the Assessment of Early-Stage Aortic Valve Degeneration after Transcatheter Aortic Valve Implantation (TAVI)—Protocol Description and Preliminary Results. Journal of Clinical Medicine. 2021; 10(3):431. https://doi.org/10.3390/jcm10030431

Chicago/Turabian Style

Sorysz, Danuta, Rafał Januszek, Anna Sowa-Staszczak, Anna Grochowska, Marta Opalińska, Maciej Bagieński, Barbara Zawiślak, Artur Dziewierz, Tomasz Tokarek, Agata Krawczyk-Ożóg, and et al. 2021. "The Usefulness of [18F]F-Fluorodeoxyglucose and [18F]F-Sodium Fluoride Positron Emission Tomography Imaging in the Assessment of Early-Stage Aortic Valve Degeneration after Transcatheter Aortic Valve Implantation (TAVI)—Protocol Description and Preliminary Results" Journal of Clinical Medicine 10, no. 3: 431. https://doi.org/10.3390/jcm10030431

APA Style

Sorysz, D., Januszek, R., Sowa-Staszczak, A., Grochowska, A., Opalińska, M., Bagieński, M., Zawiślak, B., Dziewierz, A., Tokarek, T., Krawczyk-Ożóg, A., Bartuś, S., & Dudek, D. (2021). The Usefulness of [18F]F-Fluorodeoxyglucose and [18F]F-Sodium Fluoride Positron Emission Tomography Imaging in the Assessment of Early-Stage Aortic Valve Degeneration after Transcatheter Aortic Valve Implantation (TAVI)—Protocol Description and Preliminary Results. Journal of Clinical Medicine, 10(3), 431. https://doi.org/10.3390/jcm10030431

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