Dual Quantification of Skeletal Muscle Perfusion and Metabolism in a Porcine Model of Peripheral Artery Disease Using Multiparametric 18F-FDG PET Imaging

BACKGROUND: F)-fluorodeoxyglucose (FDG) for the quantification of skeletal muscle perfusion and metabolism in a porcine model of PAD. METHODS: F-FDG PET imaging under resting conditions immediately following unilateral surgical ligation of the femoral artery and 2 weeks after arterial occlusion. Calf muscle perfusion was computed using 1-compartment modeling of the first 2.5 min of PET data acquisition, and the metabolic rate of glucose (MRGlu) was computed using 3-compartment modeling of the entire 60-min dataset. Two weeks after arterial occlusion, the gastrocnemius muscle was harvested to compare microvascular density between ischemic and control hindlimbs. RESULTS: Calf perfusion and MRGlu were significantly reduced following peripheral artery occlusion and recovered to control levels 2 weeks later. Recovery of perfusion and metabolism in calf skeletal muscle coincided with a significant increase in calf muscle capillary density 2 weeks after arterial occlusion. CONCLUSIONS: F-FDG PET/CT imaging for quantifying ischemia-induced alterations in skeletal muscle perfusion and metabolism, providing a unique comprehensive approach for evaluating PAD pathophysiology and creating opportunities for monitoring treatment responses to emerging therapeutics.