Abstract 18028: [18F]-fluorodeoxyglucose is a Stronger Correlate of Intraplaque Inflammatory Burden in Human Carotid Plaque Than C-Reactive Protein: A Sub-Study of the Canadian Atherosclerosis Imaging Network (CAIN)
Bibliographic record
Abstract
Background and Purpose: Inflammation triggers and contributes to the progression of atherosclerosis. C-reactive protein (CRP), a circulating marker of inflammation, is a putative risk factor for cardiovascular disease, but this is not borne out in Mendelian randomization studies. Inflammation in carotid arteries can be imaged with hybrid [18F]-fluorodeoxyglucose (18FDG) positron emission tomography (PET) computed tomography (CT) imaging. In this investigation, circulating levels of CRP and 18FDG uptake in carotid vasculature were directly compared with intraplaque inflammatory burden, using macrophage-specific CD68 immunohistology. Methods: Nineteen prospectively recruited patients (66 ± 11 years, 15 male) scheduled for carotid endarterectomy underwent 18FDG-PET and CT angiography of carotids. CRP levels were assessed. Maximum 18FDG uptake in both internal carotids was quantified and normalized to blood (tissue:blood ratio, TBR). Following endarterectomy, excised plaque was fixed, sectioned and immunostained for CD68. CD68 expression was quantified. Results: Carotid endarterectomy was performed in 19 patients; one received a 2 nd carotid endarterectomy due to bilateral disease. The direct burden of inflammation, as quantified by CD68 immunohistology, correlated with maximum 18FDG uptake (r=0.716, p<0.001). There was no evidence of a correlation between CRP and CD68 (r=0.159, p=0.50), nor with maximum 18FDG uptake (r=0.238, p=0.31). Furthermore, 18FDG and CRP are different correlations where FDG is more strongly correlated with CD68 than CRP (p=0.02, Hoteling Williams test). Conclusion: 18FDG uptake is more strongly related to the extent of inflammatory burden within high-risk carotid plaque than CRP. CRP may not be an accurate criterion for assessing vulnerable carotid plaque (based on histopathology nor 18FDG uptake). Prospective outcomes-based trials are needed to establish 18FDG as a direct biomarker of vulnerable carotid plaque.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".