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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

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