Abstract 19815: Staging Atherosclerotic Disease and Vessel Remodeling with [18F]-Sodium Fluoride, a Novel Biomarker of Active Calcification: Sub-study of the Canadian Atherosclerosis Imaging Network (CAIN-2)
Bibliographic record
Abstract
Background: [18F]-sodium fluoride (NaF) positron emission tomography (PET) uptake may serve as a marker of active calcification. Osteopontin regulates active calcification within plaque. Positive vessel remodeling is a marker of vulnerable plaque. We hypothesized that active calcification within carotid plaque, as determined by NaF PET/CT uptake, is associated with osteopontin expression and positive vessel remodeling. Methods: Eleven patients (69±5 years, 3 females) scheduled for carotid endarterectomy were prospectively recruited for NaF PET/CT imaging of the carotids. The bifurcation of the common carotid was used as the reference point; maximum NaF uptake normalized to blood (tissue to blood ratio - TBR) was measured at every PET slice extending 2 cm above and below the bifurcation. Using NASCET criteria, cross-sectional vessel area was measured and related to proximal and distal segments, generating a vessel remodeling index (RI) for every PET slice. Regions with a RI ≤ 1.0 were classified as positive remodeling. Excised plaque was immunostained for osteopontin and whole-slide digitized images were used to quantify osteopontin expression. Pathology was co-registered with PET. Results: Immunohistology was available for 8 plaques. As a result of intraplaque clustering, a meta-analysis was performed and demonstrated that NaF uptake was related to intraplaque osteopontin expression (r=0.37, p=0.03) (Figure 1). NaF uptake was greater in regions with positive vessel remodeling (TBR=2.6±0.9 with positive (n=185) vs. 1.6±0.6 (n=46) without positive remodeling, p Conclusion: Atherosclerosis is a progressive disease. Along this continuum, we have found that there is inter-plaque variability in calcific activity and NaF uptake correlated with osteopontin expression. NaF uptake is directly related to vessel remodeling. Thus, NaF is a novel biomarker of active calcification and may serve as a tool to stage atherosclerosis.
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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 | 0.005 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".