NUCLEAR CARDIOLOGY BULLET
Fusion of positron emission tomography and
coronary computed tomographic angiography
identifies fluorine 18 fluorodeoxyglucose uptake in
the left main coronary artery soft plaque
Erick Alexanderson, Mi
® Piotr Slomka, PhD.‘ Victor Cheng, MD.‘
‘Aloha Meave, MD,*° Yolanda Saldafa, MD,* Leonardo Garcia-Rojas, MD,* and
Daniel Berman, MD“
Case report. A 71 year-old man underwent F-18
FDG-PET scanning with noncontat computed tomog.
raphy (CT) for attenuation and anatomic correction
(PETICT) 1 year afer surgical reseetion with diverting
colostomy and adjuvant chemotherapy and radiotherapy
for colonie adenocarcinoma, A PETICT sesn was done
after 10 hours of fasting, 9 minutes ater FDG injec
His medical history included type 2 ciahetes. mellitus
conuolled with metformin and glibenclamide, eigacete
smoking for IS years (8-10 cigaetes per day), conic
heavy alcohol wse, and esophageal varices. The
erie any allergies. chest pin, oF previous heart
FDG-PETICT showed focal hypermetatolic activity
in the rocurn and its acighboring fatty tissue, liver, and
multiple lymph nodes in the mediastinum and neck. In
dition, noticeable FDG upake was presenti the aot,
most consistent with aortic aheroselerotic plague, and in
4 strcture that appeared t9 be within of adjacent to the
left main coronary artery (Figure 1)
‘To further investigate the later finding, cetrospee:
tively gated 64-slice CCTA was performed on the
same day with the Siemens HI-REZ Biograph 64 hybrid
PEDCT scanner (Siemens Medical Solutions, Malyem,
Pa). Analysis of the reconstucted 3