18F-Fluoride Positron Emission Tomographic Imaging of Penile Arteries and Erectile Dysfunction

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:73

Article

Nakahara, Takehiro^1,2,3  Narula, Jagat¹  Tijssen, Jan G. P.⁴  Agarwal, Sunil¹  Chowdhury, Mohammed M.⁵  Coughlin, Patrick A.⁵  Dweck, Marc R.⁶  Rudd, James H. F.⁷  Jinzaki, Masahiro³  Mulhall, John⁸  Strauss, H. William^1,2 

[1] Icahn Sch Med Mt Sinai, Mt Sinai Heart, One Guggenheim Pavil,1190 Fifth Ave,N-126, New York, NY 10029 USA

[2] Mem Sloan Kettering Canc Ctr, Mol Imaging & Therapy Serv, 1275 York Ave, New York, NY 10021 USA

[3] Keio Univ, Sch Med, Dept Diagnost Radiol, Shinjuku Ku, Tokyo, Japan

[4] Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Amsterdam, Netherlands

[5] Univ Cambridge, Dept Vasc Surg, Cambridge, England

[6] Univ Edinburgh, BHF Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland

[7] Univ Cambridge, Div Cardiovasc Med, Cambridge, England

[8] Mem Sloan Kettering Canc Ctr, Sexual & Reprod Med Program, 1275 York Ave, New York, NY 10021 USA

关键词: atherosclerosis;    calcification;    erectile dysfunction;    NaF;    sodium fluoride;   

DOI  :  10.1016/j.jacc.2018.10.076

来源: Elsevier

【 摘 要 】

BACKGROUND Fluorine-18 sodium fluoride (NaF), a bone-seeking radiopharmaceutical used to detect osseous metastases, localizes in regions of microcalcification in atherosclerosis. OBJECTIVES To determine if atherosclerosis of penile arteries plays a role in erectile dysfunction (ED), this study analyzed NaF images in prostate cancer patients. METHODS NaF positron emission tomography-computed tomography bone scans were evaluated in 437 prostate cancer patients (age 66.6 +/- 8.7 years). Their urologic histories were reviewed for prevalent ED (diagnosed before the scan date) or incident ED (no ED at first scan, but developed during 1-year follow-up); patients with no ED (neither before the scan nor during follow-up) were included as a control group. A semicircular region of interest was set on the dorsal one-half of the penis (to avoid residual excreted activity in the urethra) on 5 contiguous slices at the base of the penis on positron emission tomography-computed tomography coronal reconstructions, and the average standardized uptake value (SUVmax) was described as NaF uptake. RESULTS Of 437 patients, 336 (76.9%) had prevalent ED, 60 incident ED (13.7%), and 41 had no ED (9.4%). SUVmax in patients with prevalent (median 1.88; interquartile range [IQR]: 1.67 to 2.16) or incident (median 1.86; IQR: 1.72 to 2.08) ED was significantly higher than no ED (median 1.42; IQR: 1.25 to 1.54) patients (p < 0.001). After adjustment for other risk factors, the odds ratio of prevalent or incident ED was 25.2 (95% confidence interval: 9.5 to 67.0) for every 0.5-U increment in SUVmax with receptor operating characteristic area of 0.91 (95% confidence interval: 0.88 to 0.94). CONCLUSIONS NaF uptake in penile vessels suggests that atherosclerosis is associated with ED in prostate cancer patients. The importance of NaF uptake needs to be tested in noncancer subjects and cause-effect relationship needs to be established. (c) 2019 Published by Elsevier on behalf of the American College of Cardiology Foundation.

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