[18F]FDG PET/CT is a quantitative tool to probe vascular inflammation and immune system metabolic activation in atherosclerotic nonhuman primates

Atherosclerosis is a major global health concern, necessitating advanced research models to better understand pathophysiology and inform potential interventions. Due to their physiological similarities to humans, nonhuman primates (NHPs), particularly crab-eating macaques, are valuable models to study the development and progression of atherosclerosis. This retrospective study utilized quantitative 2-deoxy-2-[fluorine-18]fluoro-D-glucose ([18F]FDG) positron emission tomography–computed tomography (PET/CT) to characterize a cohort of crab-eating macaques with diet-induced atherosclerosis. We evaluated [18F]FDG uptake in the vasculature, bone marrow, spleen, and adipose tissues from macaques fed an atherogenic diet compared with those fed a regular chow diet. [18F]FDG uptake was significantly higher in the vasculature, bone marrow, and adipose tissues of macaques on the atherogenic diet, along with increased vascular calcification. Correlation analyses demonstrated moderate to strong associations among vascular inflammation, calcification, and metabolic activity in the bone marrow and adipose tissues. We provide a robust methodology for quantitative PET/CT imaging analysis of atherosclerosis in an established NHP model. Our work adds to the research toolkit and highlights the translational potential of imaging in NHP models to investigate systemic cardiovascular disease, including of fundamental pathobiology and of targeted interventions.