101
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Seyres D, Cabassi A, Lambourne JJ, Burden F, Farrow S, McKinney H, Batista J, Kempster C, Pietzner M, Slingsby O, Cao TH, Quinn PA, Stefanucci L, Sims MC, Rehnstrom K, Adams CL, Frary A, Ergüener B, Kreuzhuber R, Mocciaro G, D'Amore S, Koulman A, Grassi L, Griffin JL, Ng LL, Park A, Savage DB, Langenberg C, Bock C, Downes K, Wareham NJ, Allison M, Vacca M, Kirk PDW, Frontini M. Transcriptional, epigenetic and metabolic signatures in cardiometabolic syndrome defined by extreme phenotypes. Clin Epigenetics 2022; 14:39. [PMID: 35279219 PMCID: PMC8917653 DOI: 10.1186/s13148-022-01257-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This work is aimed at improving the understanding of cardiometabolic syndrome pathophysiology and its relationship with thrombosis by generating a multi-omic disease signature. METHODS/RESULTS We combined classic plasma biochemistry and plasma biomarkers with the transcriptional and epigenetic characterisation of cell types involved in thrombosis, obtained from two extreme phenotype groups (morbidly obese and lipodystrophy) and lean individuals to identify the molecular mechanisms at play, highlighting patterns of abnormal activation in innate immune phagocytic cells. Our analyses showed that extreme phenotype groups could be distinguished from lean individuals, and from each other, across all data layers. The characterisation of the same obese group, 6 months after bariatric surgery, revealed the loss of the abnormal activation of innate immune cells previously observed. However, rather than reverting to the gene expression landscape of lean individuals, this occurred via the establishment of novel gene expression landscapes. NETosis and its control mechanisms emerge amongst the pathways that show an improvement after surgical intervention. CONCLUSIONS We showed that the morbidly obese and lipodystrophy groups, despite some differences, shared a common cardiometabolic syndrome signature. We also showed that this could be used to discriminate, amongst the normal population, those individuals with a higher likelihood of presenting with the disease, even when not displaying the classic features.
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Affiliation(s)
- Denis Seyres
- National Institute for Health Research BioResource, Cambridge University Hospitals, Cambridge Biomedical Campus, Cambridge, UK.
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
- NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK.
| | - Alessandra Cabassi
- MRC Biostatistics Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - John J Lambourne
- National Institute for Health Research BioResource, Cambridge University Hospitals, Cambridge Biomedical Campus, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK
| | - Frances Burden
- National Institute for Health Research BioResource, Cambridge University Hospitals, Cambridge Biomedical Campus, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK
| | - Samantha Farrow
- National Institute for Health Research BioResource, Cambridge University Hospitals, Cambridge Biomedical Campus, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK
| | - Harriet McKinney
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Joana Batista
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Carly Kempster
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Maik Pietzner
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Oliver Slingsby
- Department of Cardiovascular Sciences, Glenfield Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Thong Huy Cao
- Department of Cardiovascular Sciences, Glenfield Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Paulene A Quinn
- Department of Cardiovascular Sciences, Glenfield Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Luca Stefanucci
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK
- British Heart Foundation Centre of Excellence, Cambridge Biomedical Campus, Cambridge, UK
| | - Matthew C Sims
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK
- Oxford Haemophilia and Thrombosis Centre, Oxford University Hospitals NHS Foundation Trust, NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Karola Rehnstrom
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Claire L Adams
- Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Amy Frary
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Bekir Ergüener
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Roman Kreuzhuber
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK
| | - Gabriele Mocciaro
- Department of Biochemistry and the Cambridge Systems Biology Centre, University of Cambridge, The Sanger Building, 80 Tennis Court Road, Cambridge, CB2 1GA, UK
| | - Simona D'Amore
- Addenbrooke's Hospital, NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Department of Medicine, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy
- National Cancer Research Center, IRCCS Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco, 65, 70124, Bari, Italy
| | - Albert Koulman
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- MRC Elsie Widdowson Laboratory, Cambridge, UK
- National Institute for Health Research Biomedical Research Centres Core Nutritional Biomarker Laboratory, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
- National Institute for Health Research Biomedical Research Centres Core Metabolomics and Lipidomics Laboratory, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Luigi Grassi
- National Institute for Health Research BioResource, Cambridge University Hospitals, Cambridge Biomedical Campus, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK
| | - Julian L Griffin
- Department of Biochemistry and the Cambridge Systems Biology Centre, University of Cambridge, The Sanger Building, 80 Tennis Court Road, Cambridge, CB2 1GA, UK
| | - Leong Loke Ng
- Department of Cardiovascular Sciences, Glenfield Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Adrian Park
- Addenbrooke's Hospital, NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - David B Savage
- Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, CB2 0QQ, UK
| | | | - Christoph Bock
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
- Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Kate Downes
- National Institute for Health Research BioResource, Cambridge University Hospitals, Cambridge Biomedical Campus, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- East Midlands and East of England Genomic Laboratory Hub, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Michael Allison
- Addenbrooke's Hospital, NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Michele Vacca
- Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Biochemistry and the Cambridge Systems Biology Centre, University of Cambridge, The Sanger Building, 80 Tennis Court Road, Cambridge, CB2 1GA, UK
| | - Paul D W Kirk
- MRC Biostatistics Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge Biomedical Campus, Puddicombe Way, Cambridge, CB2 0AW, UK.
| | - Mattia Frontini
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
- NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK.
- British Heart Foundation Centre of Excellence, Cambridge Biomedical Campus, Cambridge, UK.
- Institute of Biomedical & Clinical Science, College of Medicine and Health, University of Exeter Medical School, RILD Building, Barrack Road, Exeter, EX2 5DW, UK.
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102
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Positron Emission Tomography in Atherosclerosis Research. METHODS IN MOLECULAR BIOLOGY (CLIFTON, N.J.) 2022; 2419:825-839. [PMID: 35238004 DOI: 10.1007/978-1-0716-1924-7_50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Positron emission tomography (PET) is a quantitative imaging technique that uses molecules labeled with positron-emitting radionuclides to visualize and measure biochemical processes in the tissues of living subjects. In recent years, different PET tracers have been evaluated for their ability to characterize the atherosclerotic process in order to study the activity of the disease. Here, we describe detailed PET methods for preclinical studies of atherosclerosis and summarize the key methodological aspects of PET imaging in clinical studies of atherosclerosis.
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103
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Tzolos E, Kwiecinski J, Berman D, Slomka P, Newby DE, Dweck MR. Latest Advances in Multimodality Imaging of Aortic Stenosis. J Nucl Med 2022; 63:353-358. [PMID: 34887339 PMCID: PMC8978201 DOI: 10.2967/jnumed.121.262304] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/06/2021] [Indexed: 11/16/2022] Open
Abstract
Aortic stenosis is a common condition associated with major morbidity, mortality, and health-care costs. Nevertheless, we currently lack any effective medical therapies that can treat or prevent disease development or progression. Modern advances in echocardiography and CT have helped improve the assessment of aortic stenosis severity and monitoring of disease progression, whereas cardiac MRI informs on myocardial health and the development of fibrosis. In a series of recent studies, 18F-NaF PET/CT has been shown to assess valvular disease activity and progression, providing mechanistic insights that can inform potential novel therapeutic approaches. This review will examine the latest advances in the imaging of aortic stenosis and bioprosthetic valve degeneration and explore how these techniques can assist patient management and potentially accelerate novel therapeutic developments.
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Affiliation(s)
- Evangelos Tzolos
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Jacek Kwiecinski
- Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland; and
| | - Daniel Berman
- Division of Nuclear Medicine, Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Piotr Slomka
- Division of Nuclear Medicine, Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - David E Newby
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom;
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104
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Khare HA, Døssing KBV, Ringgaard L, Christensen E, Urbak L, Sillesen H, Ripa RS, Binderup T, Pedersen SF, Kjaer A. In vivo detection of urokinase-type plasminogen activator receptor (uPAR) expression in arterial atherogenesis using [64Cu]Cu-DOTA-AE105 positron emission tomography (PET). Atherosclerosis 2022; 352:103-111. [DOI: 10.1016/j.atherosclerosis.2022.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/23/2022] [Accepted: 03/25/2022] [Indexed: 12/21/2022]
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105
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Canu M, Broisat A, Riou L, Vanzetto G, Fagret D, Ghezzi C, Djaileb L, Barone-Rochette G. Non-invasive Multimodality Imaging of Coronary Vulnerable Patient. Front Cardiovasc Med 2022; 9:836473. [PMID: 35282382 PMCID: PMC8907666 DOI: 10.3389/fcvm.2022.836473] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/01/2022] [Indexed: 01/07/2023] Open
Abstract
Atherosclerotic plaque rupture or erosion remain the primary mechanism responsible for myocardial infarction and the major challenge of cardiovascular researchers is to develop non-invasive methods of accurate risk prediction to identify vulnerable plaques before the event occurs. Multimodal imaging, by CT-TEP or CT-SPECT, provides both morphological and activity information about the plaque and cumulates the advantages of anatomic and molecular imaging to identify vulnerability features among coronary plaques. However, the rate of acute coronary syndromes remains low and the mechanisms leading to adverse events are clearly more complex than initially assumed. Indeed, recent studies suggest that the detection of a state of vulnerability in a patient is more important than the detection of individual sites of vulnerability as a target of focal treatment. Despite this evolution of concepts, multimodal imaging offers a strong potential to assess patient's vulnerability. Here we review the current state of multimodal imaging to identify vulnerable patients, and then focus on emerging imaging techniques and precision medicine.
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Affiliation(s)
- Marjorie Canu
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Alexis Broisat
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, LRB, Grenoble, France
| | - Laurent Riou
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, LRB, Grenoble, France
| | - Gerald Vanzetto
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, LRB, Grenoble, France
- French Alliance Clinical Trial, French Clinical Research Infrastructure Network, Paris, France
| | - Daniel Fagret
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, LRB, Grenoble, France
- Department of Nuclear Medicine, University Hospital, Grenoble Alpes, Grenoble, France
| | - Catherine Ghezzi
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, LRB, Grenoble, France
| | - Loic Djaileb
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, LRB, Grenoble, France
- Department of Nuclear Medicine, University Hospital, Grenoble Alpes, Grenoble, France
| | - Gilles Barone-Rochette
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, LRB, Grenoble, France
- French Alliance Clinical Trial, French Clinical Research Infrastructure Network, Paris, France
- *Correspondence: Gilles Barone-Rochette
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106
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Shi D, Si Z, Xu Z, Cheng Y, Lin Q, Fu Z, Fu W, Yang T, Shi H, Cheng D. Synthesis and Evaluation of 68Ga-NOTA-COG1410 Targeting to TREM2 of TAMs as a Specific PET Probe for Digestive Tumor Diagnosis. Anal Chem 2022; 94:3819-3830. [PMID: 35195007 DOI: 10.1021/acs.analchem.1c04701] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Currently, positron emission tomography/computed tomography (PET/CT) is an important method for the discovery and diagnosis of digestive system tumors. However, the shortage of specific imaging tracer limits the effectiveness of PET. Triggering receptor expressed on myeloid cells 2 (TREM2) as an M2-type macrophage biomarker is receiving much attention considering its high abundance and specificity, which could be an ideal target for PET imaging. First, the expression of TREM2 in tumors and corresponding normal tissues was analyzed using a database and was verified by tissue microarrays and murine model slices, and we found that the expression of TREM2 in tumor tissues was significantly higher than that in normal tissues and enteritis tissues. Then, we established a macrophage co-culture system to obtain tumor-associated macrophages (TAMs). Compared with M1-type macrophages and tumor cells, TAMs had a higher expression level of TREM2. The novel radioligand 68Ga-NOTA-COG1410 was successfully synthesized for TREM2 targeting PET imaging. The biodistribution and micro-PET/CT results showed high uptake of 68Ga-NOTA-COG1410 in the tumor but not in areas of inflammation. The data testified that 68Ga-NOTA-COG1410 was a specific radioligand targeting TREM2, which could be used to distinguish tumors from inflammation. Using 68Ga-NOTA-COG1410, the effectiveness of PET on digestive tumors imaging may be enhanced.
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Affiliation(s)
- Dai Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zhan Si
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zhan Xu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yuan Cheng
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Qingyu Lin
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zhequan Fu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Wenhui Fu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Tingting Yang
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Dengfeng Cheng
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.,Shanghai Institute of Medical Imaging, Shanghai 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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107
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Ge J, Chen L, Huang B, Gao Y, Zhou D, Zhou Y, Chen C, Wen L, Li Q, Zeng J, Zhong Z, Gao M. Anchoring Group-Mediated Radiolabeling of Inorganic Nanoparticles─A Universal Method for Constructing Nuclear Medicine Imaging Nanoprobes. ACS APPLIED MATERIALS & INTERFACES 2022; 14:8838-8846. [PMID: 35133124 DOI: 10.1021/acsami.1c23907] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Nuclear medicine imaging has aroused great interest in the design and synthesis of versatile radioactive nanoprobes, while most of the methods developed for radiolabeling nanoprobes are difficult to satisfy the criteria of clinical translation, including easy operation, mild labeling conditions, high efficiency, and high radiolabeling stability. Herein, we demonstrated the universality of a simple but efficient radiolabeling method recently developed for constructing nuclear imaging nanoprobes, that is, ligand anchoring group-mediated radiolabeling (LAGMERAL). In this method, a diphosphonate-polyethylene glycol (DP-PEG) decorating on the surface of inorganic nanoparticles plays an essential role. In principle, owing to the strong binding affinity to a great variety of metal ions, it can not only endow the underlying nanoparticles containing metal ions including some main group metal ions, transition metal ions, and lanthanide metal ions with excellent colloidal stability and biocompatibility but also enable efficient radiolabeling through the diphosphonate group. Based on this assumption, inorganic nanoparticles such as Fe3O4 nanoparticles, NaGdF4:Yb,Tm nanoparticles, and Cu2-xS nanoparticles, as representatives of functional inorganic nanoparticles suitable for different imaging modalities including magnetic resonance imaging (MRI), upconversion luminescence imaging (UCL), and photoacoustic imaging (PAI), respectively, were chosen to be radiolabeled with different kinds of radionuclides such as SPECT nuclides (e.g., 99mTc), PET nuclides (e.g., 68Ga), and therapeutic SPECT nuclides (e.g., 177Lu) to demonstrate the reliability of the LAGMERAL approach. The experimental results showed that the obtained nanoprobes exhibited high radiolabeling stability, and the whole radiolabeling process had negligible impacts on the physical and chemical properties of the initial nanoparticles. Through passive targeting SPECT/MRI of glioma tumor, active targeting SPECT/UCL of colorectal cancer, and SPECT/PAI of lymphatic metastasis, the outstanding potentials of the resulting radioactive nanoprobes for sensitive tumor diagnosis were demonstrated, manifesting the feasibility and efficiency of LAGMERAL.
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Affiliation(s)
- Jianxian Ge
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Lei Chen
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Baoxing Huang
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Yun Gao
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Dandan Zhou
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Yi Zhou
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Can Chen
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Ling Wen
- The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215000, China
| | - Qing Li
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Jianfeng Zeng
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
| | - Zhiyuan Zhong
- College of Chemistry, Chemical Engineering and Materials Science of Soochow University, Soochow University, Suzhou 215123, China
| | - Mingyuan Gao
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, China
- The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou 215000, China
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108
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Helgebostad R, Revheim ME, Johnsrud K, Amlie K, Alavi A, Connelly JP. Clinical Applications of Somatostatin Receptor (Agonist) PET Tracers beyond Neuroendocrine Tumors. Diagnostics (Basel) 2022; 12:diagnostics12020528. [PMID: 35204618 PMCID: PMC8870812 DOI: 10.3390/diagnostics12020528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/17/2022] Open
Abstract
Somatostatin receptor (SSTR) agonist tracers used in nuclear medicine scans are classically used for neuroendocrine tumor diagnosis and staging. SSTR are however, expressed more widely in a variety of cells as seen in the distribution of physiological tracer uptake during whole body scans. This provides opportunities for using these tracers for applications other than NETs and meningiomas. In this qualitative systematic review, novel diagnostics in SSTR-PET imaging are reviewed. A total of 70 studies comprised of 543 patients were qualitatively reviewed. Sarcoidosis, atherosclerosis and phosphaturic mesenchymal tumors represent the most studied applications currently with promising results. Other applications remain in progress where there are many case reports but a relative dearth of cohort studies. [18F]FDG PET provides the main comparative method in many cases but represents a well-established general PET technique that may be difficult to replace, without prospective clinical studies.
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Affiliation(s)
- Rasmus Helgebostad
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; (R.H.); (M.-E.R.); (K.J.); (K.A.)
| | - Mona-Elisabeth Revheim
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; (R.H.); (M.-E.R.); (K.J.); (K.A.)
- Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway
| | - Kjersti Johnsrud
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; (R.H.); (M.-E.R.); (K.J.); (K.A.)
| | - Kristine Amlie
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; (R.H.); (M.-E.R.); (K.J.); (K.A.)
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA;
| | - James Patrick Connelly
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; (R.H.); (M.-E.R.); (K.J.); (K.A.)
- Correspondence:
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109
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Molecular imaging in atherosclerosis. Clin Transl Imaging 2022. [DOI: 10.1007/s40336-022-00483-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
Purpose
As atherosclerosis is a prominent cause of morbidity and mortality, early detection of atherosclerotic plaques is vital to prevent complications. Imaging plays a significant role in this goal. Molecular imaging and structural imaging detect different phases of atherosclerotic progression. In this review, we explain the relation between these types of imaging with the physiopathology of plaques, along with their advantages and disadvantages. We also discuss in detail the most commonly used positron emission tomography (PET) radiotracers for atherosclerosis imaging.
Method
A comprehensive search was conducted to extract articles related to imaging of atherosclerosis in PubMed, Google Scholar, and Web of Science. The obtained papers were reviewed regarding precise relation with our topic. Among the search keywords utilized were "atherosclerosis imaging", "atherosclerosis structural imaging", "atherosclerosis CT scan" "positron emission tomography", "PET imaging", "18F-NaF", "18F-FDG", and "atherosclerosis calcification."
Result
Although structural imaging such as computed tomography (CT) offers essential information regarding plaque structure and morphologic features, these modalities can only detect macroscopic alterations that occur later in the disease’s progression, when the changes are frequently irreversible. Molecular imaging modalities like PET, on the other hand, have the advantage of detecting microscopic changes and allow us to treat these plaques before irreversible changes occur. The two most commonly used tracers in PET imaging of atherosclerosis are 18F-sodium fluoride (18F-NaF) and 18F-fluorodeoxyglucose (18F-FDG). While there are limitations in the use of 18F-FDG for the detection of atherosclerosis in coronary arteries due to physiological uptake in myocardium and high luminal blood pool activity of 18F-FDG, 18F-NaF PET is less affected and can be utilized to analyze the coronary arteries in addition to the peripheral vasculature.
Conclusion
Molecular imaging with PET/CT has become a useful tool in the early detection of atherosclerosis. 18F-NaF PET/CT shows promise in the early global assessment of atherosclerosis, but further prospective studies are needed to confirm its role in this area.
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110
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Stammes MA, Lee JH, Meijer L, Naninck T, Doyle-Meyers LA, White AG, Borish HJ, Hartman AL, Alvarez X, Ganatra S, Kaushal D, Bohm RP, le Grand R, Scanga CA, Langermans JAM, Bontrop RE, Finch CL, Flynn JL, Calcagno C, Crozier I, Kuhn JH. Medical imaging of pulmonary disease in SARS-CoV-2-exposed non-human primates. Trends Mol Med 2022; 28:123-142. [PMID: 34955425 PMCID: PMC8648672 DOI: 10.1016/j.molmed.2021.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 12/11/2022]
Abstract
Chest X-ray (CXR), computed tomography (CT), and positron emission tomography-computed tomography (PET-CT) are noninvasive imaging techniques widely used in human and veterinary pulmonary research and medicine. These techniques have recently been applied in studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-exposed non-human primates (NHPs) to complement virological assessments with meaningful translational readouts of lung disease. Our review of the literature indicates that medical imaging of SARS-CoV-2-exposed NHPs enables high-resolution qualitative and quantitative characterization of disease otherwise clinically invisible and potentially provides user-independent and unbiased evaluation of medical countermeasures (MCMs). However, we also found high variability in image acquisition and analysis protocols among studies. These findings uncover an urgent need to improve standardization and ensure direct comparability across studies.
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Affiliation(s)
- Marieke A Stammes
- Biomedical Primate Research Centre (BPRC), 2288 GJ, Rijswijk, The Netherlands.
| | - Ji Hyun Lee
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA
| | - Lisette Meijer
- Biomedical Primate Research Centre (BPRC), 2288 GJ, Rijswijk, The Netherlands
| | - Thibaut Naninck
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, 92260 Fontenay-aux-Roses, France
| | - Lara A Doyle-Meyers
- Tulane National Primate Research Center, Covington, LA 70433, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Alexander G White
- Department of Microbiology and Molecular Genetics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - H Jacob Borish
- Department of Microbiology and Molecular Genetics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Amy L Hartman
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pitt Public Health, Pittsburgh, PA 15261, USA
| | - Xavier Alvarez
- Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | | | - Deepak Kaushal
- Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Rudolf P Bohm
- Tulane National Primate Research Center, Covington, LA 70433, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Roger le Grand
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, 92260 Fontenay-aux-Roses, France
| | - Charles A Scanga
- Department of Microbiology and Molecular Genetics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Jan A M Langermans
- Biomedical Primate Research Centre (BPRC), 2288 GJ, Rijswijk, The Netherlands; Department Population Health Sciences, Division of Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, 3584 CL, Utrecht, The Netherlands
| | - Ronald E Bontrop
- Biomedical Primate Research Centre (BPRC), 2288 GJ, Rijswijk, The Netherlands; Department of Biology, Theoretical Biology and Bioinformatics, Utrecht University, 3584 CH, Utrecht, The Netherlands
| | - Courtney L Finch
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA
| | - JoAnne L Flynn
- Department of Microbiology and Molecular Genetics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Claudia Calcagno
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA
| | - Ian Crozier
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD 21701, USA
| | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA
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111
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Nuclear Molecular Imaging of Cardiac Remodeling after Myocardial Infarction. Pharmaceuticals (Basel) 2022; 15:ph15020183. [PMID: 35215296 PMCID: PMC8875369 DOI: 10.3390/ph15020183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 12/03/2022] Open
Abstract
The role of molecular imaging technologies in detecting, evaluating, and monitoring cardiovascular disease and their treatment is expanding rapidly. Gradually replacing the conventional anatomical or physiological approaches, molecular imaging strategies using biologically targeted markers provide unique insight into pathobiological processes at molecular and cellular levels and allow for cardiovascular disease evaluation and individualized therapy. This review paper will discuss currently available and developing molecular-based single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging strategies to evaluate post-infarction cardiac remodeling. These approaches include potential targeted methods of evaluating critical biological processes, such as inflammation, angiogenesis, and scar formation.
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112
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Li XG, Velikyan I, Viitanen R, Roivainen A. PET radiopharmaceuticals for imaging inflammatory diseases. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00075-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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113
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Haider A, Bengs S, Gebhard C. Imaging inflammation in atherosclerosis: Exploring all avenues. J Nucl Cardiol 2021; 28:2514-2517. [PMID: 32236840 DOI: 10.1007/s12350-020-02103-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Ahmed Haider
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, 8952, Schlieren, Switzerland
| | - Susan Bengs
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, 8952, Schlieren, Switzerland
| | - Catherine Gebhard
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
- Center for Molecular Cardiology, University of Zurich, 8952, Schlieren, Switzerland.
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114
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Meester EJ, Krenning BJ, de Blois E, de Jong M, van der Steen AFW, Bernsen MR, van der Heiden K. Imaging inflammation in atherosclerotic plaques, targeting SST 2 with [ 111In]In-DOTA-JR11. J Nucl Cardiol 2021; 28:2506-2513. [PMID: 32026330 PMCID: PMC8709817 DOI: 10.1007/s12350-020-02046-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/24/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Imaging Somatostatin Subtype Receptor 2 (SST2) expressing macrophages by [DOTA,Tyr3]-octreotate (DOTATATE) has proven successful for plaque detection. DOTA-JR11 is a SST2 targeting ligand with a five times higher tumor uptake than DOTATATE, and holds promise to improve plaque imaging. The aim of this study was to evaluate the potential of DOTA-JR11 for plaque detection. METHODS AND RESULTS Atherosclerotic ApoE-/- mice (n = 22) fed an atherogenic diet were imaged by SPECT/CT two hours post injection of [111In]In-DOTA-JR11 (~ 200 pmol, ~ 50 MBq). In vivo plaque uptake of [111In]In-DOTA-JR11 was visible in all mice, with a target-to-background-ratio (TBR) of 2.23 ± 0.35. Post-mortem scans after thymectomy and ex vivo scans of the arteries after excision of the arteries confirmed plaque uptake of the radioligand with TBRs of 2.46 ± 0.52 and 3.43 ± 1.45 respectively. Oil red O lipid-staining and ex vivo autoradiography of excised arteries showed [111In]In-DOTA-JR11 uptake at plaque locations. Histological processing showed CD68 (macrophages) and SST2 expressing cells in plaques. SPECT/CT, in vitro autoradiography and immunohistochemistry performed on slices of a human carotid endarterectomy sample showed [111In]In-DOTA-JR11 uptake at plaque locations containing CD68 and SST2 expressing cells. CONCLUSIONS The results of this study indicate DOTA-JR11 as a promising ligand for visualization of atherosclerotic plaque inflammation.
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Affiliation(s)
- Eric J Meester
- Department of Biomedical Engineering, Thorax Center, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | | | - Erik de Blois
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Marion de Jong
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Antonius F W van der Steen
- Department of Biomedical Engineering, Thorax Center, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Monique R Bernsen
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Kim van der Heiden
- Department of Biomedical Engineering, Thorax Center, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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115
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Osborne MT, Abbasi TA, Albaghdadi MS. Narrowing in on a PET tracer that characterizes coronary atheroma: 18F-NaF uptake is increased in stenotic coronary artery disease. J Nucl Cardiol 2021; 28:3067-3069. [PMID: 32699988 PMCID: PMC7854803 DOI: 10.1007/s12350-020-02279-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Michael T Osborne
- Cardiology Division, Department of Medicine and Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St Yawkey 5B, Boston, MA, 02114-2750, USA.
| | - Taimur A Abbasi
- Cardiology Division, Department of Medicine and Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St Yawkey 5B, Boston, MA, 02114-2750, USA
| | - Mazen S Albaghdadi
- Cardiology Division, Department of Medicine and Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St Yawkey 5B, Boston, MA, 02114-2750, USA
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116
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Raynor WY, Park PSU, Borja AJ, Sun Y, Werner TJ, Ng SJ, Lau HC, Høilund-Carlsen PF, Alavi A, Revheim ME. PET-Based Imaging with 18F-FDG and 18F-NaF to Assess Inflammation and Microcalcification in Atherosclerosis and Other Vascular and Thrombotic Disorders. Diagnostics (Basel) 2021; 11:diagnostics11122234. [PMID: 34943473 PMCID: PMC8700072 DOI: 10.3390/diagnostics11122234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 01/13/2023] Open
Abstract
Positron emission tomography (PET) imaging with 18F-fluorodeoxyglucose (FDG) represents a method of detecting and characterizing arterial wall inflammation, with potential applications in the early assessment of vascular disorders such as atherosclerosis. By portraying early-stage molecular changes, FDG-PET findings have previously been shown to correlate with atherosclerosis progression. In addition, recent studies have suggested that microcalcification revealed by 18F-sodium fluoride (NaF) may be more sensitive at detecting atherogenic changes compared to FDG-PET. In this review, we summarize the roles of FDG and NaF in the assessment of atherosclerosis and discuss the role of global assessment in quantification of the vascular disease burden. Furthermore, we will review the emerging applications of FDG-PET in various vascular disorders, including pulmonary embolism, as well as inflammatory and infectious vascular diseases.
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Affiliation(s)
- William Y. Raynor
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
| | - Peter Sang Uk Park
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA;
| | - Austin J. Borja
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA;
| | - Yusha Sun
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA;
| | - Thomas J. Werner
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
| | - Sze Jia Ng
- Department of Medicine, Crozer-Chester Medical Center, Upland, PA 19013, USA; (S.J.N.); (H.C.L.)
| | - Hui Chong Lau
- Department of Medicine, Crozer-Chester Medical Center, Upland, PA 19013, USA; (S.J.N.); (H.C.L.)
| | - Poul Flemming Høilund-Carlsen
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense C, Denmark;
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
| | - Mona-Elisabeth Revheim
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Problemveien 7, 0315 Oslo, Norway
- Correspondence: or
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117
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Molecular Imaging of Vulnerable Coronary Plaque with Radiolabeled Somatostatin Receptors (SSTR). J Clin Med 2021; 10:jcm10235515. [PMID: 34884218 PMCID: PMC8658082 DOI: 10.3390/jcm10235515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 12/25/2022] Open
Abstract
Atherosclerosis is responsible for the majority of heart attacks and is characterized by several modifications of the arterial wall including an inflammatory reaction. The silent course of atherosclerosis has made it necessary to develop predictors of disease complications before symptomatic lesions occur. Vulnerable to rupture atherosclerotic plaques are the target for molecular imaging. To this aim, different radiopharmaceuticals for PET/CT have emerged for the identification of high-risk plaques, with high specificity for the identification of the cellular components and pathophysiological status of plaques. By targeting specific receptors on activated macrophages in high-risk plaques, radiolabelled somatostatin analogues such as 68Ga-DOTA-TOC, TATE,0 or NOC have shown high relevance to detect vulnerable, atherosclerotic plaques. This PET radiopharmaceutical has been tested in several pre-clinical and clinical studies, as reviewed here, showing an important correlation with other risk factors.
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118
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Prigent K, Vigne J. Advances in Radiopharmaceutical Sciences for Vascular Inflammation Imaging: Focus on Clinical Applications. Molecules 2021; 26:molecules26237111. [PMID: 34885690 PMCID: PMC8659223 DOI: 10.3390/molecules26237111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/09/2021] [Accepted: 11/19/2021] [Indexed: 01/18/2023] Open
Abstract
Biomedical imaging technologies offer identification of several anatomic and molecular features of disease pathogenesis. Molecular imaging techniques to assess cellular processes in vivo have been useful in advancing our understanding of several vascular inflammatory diseases. For the non-invasive molecular imaging of vascular inflammation, nuclear medicine constitutes one of the best imaging modalities, thanks to its high sensitivity for the detection of probes in tissues. 2-[18F]fluoro-2-deoxy-d-glucose ([18F]FDG) is currently the most widely used radiopharmaceutical for molecular imaging of vascular inflammatory diseases such as atherosclerosis and large-vessel vasculitis. The combination of [18F]FDG and positron emission tomography (PET) imaging has become a powerful tool to identify and monitor non-invasively inflammatory activities over time but suffers from several limitations including a lack of specificity and avid background in different localizations. The use of novel radiotracers may help to better understand the underlying pathophysiological processes and overcome some limitations of [18F]FDG PET for the imaging of vascular inflammation. This review examines how [18F]FDG PET has given us deeper insight into the role of inflammation in different vascular pathologies progression and discusses perspectives for alternative radiopharmaceuticals that could provide a more specific and simple identification of pathologies where vascular inflammation is implicated. Use of these novel PET tracers could lead to a better understanding of underlying disease mechanisms and help inform the identification and stratification of patients for newly emerging immune-modulatory therapies. Future research is needed to realize the true clinical translational value of PET imaging in vascular inflammatory diseases.
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Affiliation(s)
- Kevin Prigent
- CHU de Caen Normandie, Department of Nuclear Medicine, Normandie Université, UNICAEN, 14000 Caen, France;
| | - Jonathan Vigne
- CHU de Caen Normandie, Department of Nuclear Medicine, Normandie Université, UNICAEN, 14000 Caen, France;
- CHU de Caen Normandie, Department of Pharmacy, Normandie Université, UNICAEN, 14000 Caen, France
- UNICAEN, INSERM U1237, Etablissement Français du Sang, Physiopathology and Imaging of Neurological Disorders (PhIND), Cyceron, Institut Blood and Brain @ Caen-Normandie (BB@C), Normandie University, 14000 Caen, France
- Correspondence:
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Itani M, Haq A, Amin M, Mhlanga J, Lenihan D, Iravani A, Trikalinos NA. Myocardial uptake of 68Ga-DOTATATE: correlation with cardiac disease and risk factors. Acta Radiol 2021; 63:1166-1172. [PMID: 34713716 DOI: 10.1177/02841851211054193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Myocardial uptake on 68Ga-DOTATATE PET/CT is often observed and its clinical relevance is poorly understood. PURPOSE To detect any correlation between myocardial uptake of 68Ga-DOTATATE and presence of cardiac disease or risk factors. MATERIAL AND METHODS In this institutional review board-approved retrospective study, we reviewed 68Ga-DOTATATE PET/CT scans in our institution between 1 May 2018 and 30 September 2018. A semi-quantitative score (MUS) for myocardial uptake of 68Ga-DOTATATE was developed by measuring mean standardized uptake value (SUV) in five myocardial regions, corrected by blood pool activity, and MUS was validated between two readers. We investigated the relationship between MUS and presence of cardiac disease or risk factors, including Framingham score and coronary calcification. RESULTS A total of 145 scans were included (79 women; mean age = 56.9 ± 13.7 years). Inter-reader agreement was excellent with intraclass correlation coefficient (r) = 0.964 (95% confidence interval [CI] = 0.903-0.987; P < 0.001). There was a weak but significant positive correlation between MUS and presence of coronary calcifications (Spearman rho = 0.20; P = 0.016). MUS was higher in patients with heart disease or risk factors (n = 83, mean MUS 2.03, 95% CI = 1.85-2.21) compared to those without (n = 23, mean MUS 1.40, 95% CI = 1.17-1.62; P < 0.001), although the cardiac disease group was older with a higher percentage of men (62.0 years, 57.8% men compared to 47.6 years, 13.0% men; P value <0.0001 for both comparisons). CONCLUSION For patients undergoing 68Ga-DOTATATE PET/CT scan, an elevated MUS might indicate an underlying heart disease.
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Affiliation(s)
- Malak Itani
- Mallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Adeel Haq
- Mallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Manik Amin
- Department of Medical Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Joyce Mhlanga
- Mallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Daniel Lenihan
- Division of Cardiology, Cardio-Oncology Center of Excellence, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Amir Iravani
- Mallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO, USA
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Abstract
The search for subclinical atherosclerosis is carried out in several arterial districts using ultrasonography and computed tomography (CT). Coronary calcium assessed by computerized tomography (calcium score) is a well-validated marker of atherosclerosis and able to correlate with the extent of coronary artery disease and the risk of cardiovascular events. The evaluation of carotid atherosclerosis by ultrasonography is a technically simple and low-cost solution. However, the literature does not provide a sufficient number of evidence to clarify the clinical impact of carotid atherosclerosis and in particular the risk of developing cardiac events. According to the researchers of the Progression of Early Subclinical Atherosclerosis (PESA) study, subclinical atherosclerosis research should preferably be carried out in the femoral district, which is more easily affected by atherosclerosis. Pending the data from the PESA study, which will better clarify the role of ultrasound applied in non-coronary districts, the coronary calcifications seems to be a reasonable solution. It is possible that in the future imaging techniques (CT-PET) capable of studying the extent and functional status of coronary atherosclerosis will further improve the identification of the risk of cardiovascular events.
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Affiliation(s)
- Francesco Prati
- Dipartimento Cardiovascolare, Ospedale San Giovanni Addolorata, Rome, Italy.,Centro per la Lotta contro l'Infarto-CLI Foundation, Rome, Italy.,UniCamillus-Università Medica Internazionale San Camillo di Roma, Rome, Italy
| | - Flavio Giuseppe Biccirè
- Dipartimento Cardiovascolare, Ospedale San Giovanni Addolorata, Rome, Italy.,Centro per la Lotta contro l'Infarto-CLI Foundation, Rome, Italy
| | - Simone Budassi
- Dipartimento Cardiovascolare, Ospedale San Giovanni Addolorata, Rome, Italy.,Centro per la Lotta contro l'Infarto-CLI Foundation, Rome, Italy
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121
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Kondakov A, Lelyuk V. Clinical Molecular Imaging for Atherosclerotic Plaque. J Imaging 2021; 7:jimaging7100211. [PMID: 34677297 PMCID: PMC8538040 DOI: 10.3390/jimaging7100211] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 12/14/2022] Open
Abstract
Atherosclerosis is a well-known disease leading to cardiovascular events, including myocardial infarction and ischemic stroke. These conditions lead to a high mortality rate, which explains the interest in their prevention, early detection, and treatment. Molecular imaging is able to shed light on the basic pathophysiological processes, such as inflammation, that cause the progression and instability of plaque. The most common radiotracers used in clinical practice can detect increased energy metabolism (FDG), macrophage number (somatostatin receptor imaging), the intensity of cell proliferation in the area (labeled choline), and microcalcifications (fluoride imaging). These radiopharmaceuticals, especially FDG and labeled sodium fluoride, can predict cardiovascular events. The limitations of molecular imaging in atherosclerosis include low uptake of highly specific tracers, possible overlap with other diseases of the vessel wall, and specific features of certain tracers’ physiological distribution. A common protocol for patient preparation, data acquisition, and quantification is needed in the area of atherosclerosis imaging research.
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122
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Multi-targeted 1H/ 19F MRI unmasks specific danger patterns for emerging cardiovascular disorders. Nat Commun 2021; 12:5847. [PMID: 34615876 PMCID: PMC8494909 DOI: 10.1038/s41467-021-26146-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 09/20/2021] [Indexed: 12/28/2022] Open
Abstract
Prediction of the transition from stable to acute coronary syndromes driven by vascular inflammation, thrombosis with subsequent microembolization, and vessel occlusion leading to irreversible myocardial damage is still an unsolved problem. Here, we introduce a multi-targeted and multi-color nanotracer platform technology that simultaneously visualizes evolving danger patterns in the development of progressive coronary inflammation and atherothrombosis prior to spontaneous myocardial infarction in mice. Individual ligand-equipped perfluorocarbon nanoemulsions are used as targeting agents and are differentiated by their specific spectral signatures via implementation of multi chemical shift selective 19F MRI. Thereby, we are able to identify areas at high risk of and predictive for consecutive development of myocardial infarction, at a time when no conventional parameter indicates any imminent danger. The principle of this multi-targeted approach can easily be adapted to monitor also a variety of other disease entities and constitutes a technology with disease-predictive potential.
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123
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Cardiac hybrid imaging: novel tracers for novel targets. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2021; 18:748-758. [PMID: 34659381 PMCID: PMC8501382 DOI: 10.11909/j.issn.1671-5411.2021.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Non-invasive cardiac imaging has explored enormous advances in the last few decades. In particular, hybrid imaging represents the fusion of information from multiple imaging modalities, allowing to provide a more comprehensive dataset compared to traditional imaging techniques in patients with cardiovascular diseases. The complementary anatomical, functional and molecular information provided by hybrid systems are able to simplify the evaluation procedure of various pathologies in a routine clinical setting. The diagnostic capability of hybrid imaging modalities can be further enhanced by introducing novel and specific imaging biomarkers. The aim of this review is to cover the most recent advancements in radiotracers development for SPECT/CT, PET/CT, and PET/MRI for cardiovascular diseases.
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124
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Imaging Inflammation in Patients and Animals: Focus on PET Imaging the Vulnerable Plaque. Cells 2021; 10:cells10102573. [PMID: 34685553 PMCID: PMC8533866 DOI: 10.3390/cells10102573] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/18/2021] [Accepted: 09/23/2021] [Indexed: 02/07/2023] Open
Abstract
Acute coronary syndrome (ACS) describes a range of conditions associated with the rupture of high-risk or vulnerable plaque. Vulnerable atherosclerotic plaque is associated with many changes in its microenvironment which could potentially cause rapid plaque progression. Present-day PET imaging presents a plethora of radiopharmaceuticals designed to image different characteristics throughout plaque progression. Improved knowledge of atherosclerotic disease pathways has facilitated a growing number of pathophysiological targets for more innovative radiotracer design aimed at identifying at-risk vulnerable plaque and earlier intervention opportunity. This paper reviews the efficacy of PET imaging radiotracers 18F-FDG, 18F-NaF, 68Ga-DOTATATE, 64Cu-DOTATATE and 68Ga-pentixafor in plaque characterisation and risk assessment, as well as the translational potential of novel radiotracers in animal studies. Finally, we discuss our murine PET imaging experience and the challenges encountered.
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125
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Evans NR, Tarkin JM, Walsh J, Chowdhury MM, Patterson AJ, Graves MJ, Rudd JHF, Warburton EA. Carotid Atheroinflammation Is Associated With Cerebral Small Vessel Disease Severity. Front Neurol 2021; 12:690935. [PMID: 34531813 PMCID: PMC8438317 DOI: 10.3389/fneur.2021.690935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Atherosclerosis is a systemic inflammatory disease, with common inflammatory processes implicated in both atheroma vulnerability and blood-brain barrier disruption. This prospective multimodal imaging study aimed to measure directly the association between systemic atheroma inflammation (“atheroinflammation”) and downstream chronic cerebral small vessel disease severity. Methods: Twenty-six individuals with ischemic stroke with ipsilateral carotid artery stenosis of >50% underwent 18fluoride-fluorodeoxyglucose-positron emission tomography within 2 weeks of stroke. Small vessel disease severity and white matter hyperintensity volume were assessed using 3-tesla magnetic resonance imaging also within 2 weeks of stroke. Results: Fluorodeoxyglucose uptake was independently associated with more severe small vessel disease (odds ratio 6.18, 95% confidence interval 2.1–18.2, P < 0.01 for the non-culprit carotid artery) and larger white matter hyperintensity volumes (coefficient = 14.33 mL, P < 0.01 for the non-culprit carotid artery). Conclusion: These proof-of-concept results have important implications for our understanding of the neurovascular interface and potential therapeutic exploitation in the management of systemic atherosclerosis, particularly non-stenotic disease previously considered asymptomatic, in order to reduce the burden of chronic cerebrovascular disease.
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Affiliation(s)
- Nicholas R Evans
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom.,Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Jason M Tarkin
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jessica Walsh
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | | | - Andrew J Patterson
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - James H F Rudd
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Elizabeth A Warburton
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
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126
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Balogh V, MacAskill MG, Hadoke PWF, Gray GA, Tavares AAS. Positron Emission Tomography Techniques to Measure Active Inflammation, Fibrosis and Angiogenesis: Potential for Non-invasive Imaging of Hypertensive Heart Failure. Front Cardiovasc Med 2021; 8:719031. [PMID: 34485416 PMCID: PMC8416043 DOI: 10.3389/fcvm.2021.719031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/22/2021] [Indexed: 12/11/2022] Open
Abstract
Heart failure, which is responsible for a high number of deaths worldwide, can develop due to chronic hypertension. Heart failure can involve and progress through several different pathways, including: fibrosis, inflammation, and angiogenesis. Early and specific detection of changes in the myocardium during the transition to heart failure can be made via the use of molecular imaging techniques, including positron emission tomography (PET). Traditional cardiovascular PET techniques, such as myocardial perfusion imaging and sympathetic innervation imaging, have been established at the clinical level but are often lacking in pathway and target specificity that is important for assessment of heart failure. Therefore, there is a need to identify new PET imaging markers of inflammation, fibrosis and angiogenesis that could aid diagnosis, staging and treatment of hypertensive heart failure. This review will provide an overview of key mechanisms underlying hypertensive heart failure and will present the latest developments in PET probes for detection of cardiovascular inflammation, fibrosis and angiogenesis. Currently, selective PET probes for detection of angiogenesis remain elusive but promising PET probes for specific targeting of inflammation and fibrosis are rapidly progressing into clinical use.
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Affiliation(s)
- Viktoria Balogh
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom.,Edinburgh Imaging, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Mark G MacAskill
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom.,Edinburgh Imaging, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Patrick W F Hadoke
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Gillian A Gray
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Adriana A S Tavares
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom.,Edinburgh Imaging, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
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127
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Wall C, Huang Y, Le EPV, Ćorović A, Uy CP, Gopalan D, Ma C, Manavaki R, Fryer TD, Aloj L, Graves MJ, Tombetti E, Ariff B, Bambrough P, Hoole SP, Rusk RA, Jayne DR, Dweck MR, Newby D, Fayad ZA, Bennett MR, Peters JE, Slomka P, Dey D, Mason JC, Rudd JHF, Tarkin JM. Pericoronary and periaortic adipose tissue density are associated with inflammatory disease activity in Takayasu arteritis and atherosclerosis. EUROPEAN HEART JOURNAL OPEN 2021; 1:oeab019. [PMID: 34661196 PMCID: PMC8508012 DOI: 10.1093/ehjopen/oeab019] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/26/2021] [Accepted: 08/04/2021] [Indexed: 12/20/2022]
Abstract
AIMS To examine pericoronary adipose tissue (PCAT) and periaortic adipose tissue (PAAT) density on coronary computed tomography angiography for assessing arterial inflammation in Takayasu arteritis (TAK) and atherosclerosis. METHODS AND RESULTS PCAT and PAAT density was measured in coronary (n = 1016) and aortic (n = 108) segments from 108 subjects [TAK + coronary artery disease (CAD), n = 36; TAK, n = 18; atherosclerotic CAD, n = 32; matched controls, n = 22]. Median PCAT and PAAT densities varied between groups (mPCAT: P < 0.0001; PAAT: P = 0.0002). PCAT density was 7.01 ± standard error of the mean (SEM) 1.78 Hounsfield Unit (HU) higher in coronary segments from TAK + CAD patients than stable CAD patients (P = 0.0002), and 8.20 ± SEM 2.04 HU higher in TAK patients without CAD than controls (P = 0.0001). mPCAT density was correlated with Indian Takayasu Clinical Activity Score (r = 0.43, P = 0.001) and C-reactive protein (r = 0.41, P < 0.0001) and was higher in active vs. inactive TAK (P = 0.002). mPCAT density above -74 HU had 100% sensitivity and 95% specificity for differentiating active TAK from controls [area under the curve = 0.99 (95% confidence interval 0.97-1)]. The association of PCAT density and coronary arterial inflammation measured by 68Ga-DOTATATE positron emission tomography (PET) equated to an increase of 2.44 ± SEM 0.77 HU in PCAT density for each unit increase in 68Ga-DOTATATE maximum tissue-to-blood ratio (P = 0.002). These findings remained in multivariable sensitivity analyses adjusted for potential confounders. CONCLUSIONS PCAT and PAAT density are higher in TAK than atherosclerotic CAD or controls and are associated with clinical, biochemical, and PET markers of inflammation. Owing to excellent diagnostic accuracy, PCAT density could be useful as a clinical adjunct for assessing disease activity in TAK.
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Affiliation(s)
- Christopher Wall
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Yuan Huang
- EPSRC Centre for Mathematical Imaging in Healthcare, University of Cambridge, Cambridge, UK
| | - Elizabeth P V Le
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Andrej Ćorović
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Christopher P Uy
- Vascular Sciences, National Heart & Lung Institute, Faculty of Medicine, Imperial College London, Hammersmith Campus, DuCane Road, London, W12 0HS, UK
| | - Deepa Gopalan
- Department of Radiology, Cambridge University Hospitals NHS Trust, Hills Road, Cambridge, CB2 2QQ, UK
- Department of Radiology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, W12 0HS, UK
| | - Chuoxin Ma
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Roido Manavaki
- Department of Radiology, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Tim D Fryer
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Luigi Aloj
- Department of Radiology, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Enrico Tombetti
- Department of biomedical Sciences L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Ben Ariff
- Department of Radiology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, W12 0HS, UK
| | - Paul Bambrough
- Department of Cardiology, Royal Papworth Hospital, Cambridge, UK CB2 0AY, UK
| | - Stephen P Hoole
- Department of Cardiology, Royal Papworth Hospital, Cambridge, UK CB2 0AY, UK
| | - Rosemary A Rusk
- Department of Cardiology, Cambridge University Hospitals NHS Trust, Hills Road, Cambridge, CB2 2QQ, UK
| | - David R Jayne
- Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Marc R Dweck
- Centre for Cardiovascular Science, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - David Newby
- Centre for Cardiovascular Science, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Zahi A Fayad
- BioMedical Engineering & Imaging Institute, Icahn School of Medicine at Mt Sinai, Gustave L. Levy Place, New York, NY 10029-5674, USA
| | - Martin R Bennett
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - James E Peters
- Centre for Inflammatory Diseases, Imperial College London, London, UK
| | - Piotr Slomka
- Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, USA
| | - Damini Dey
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 116 N Robertson Blvd, Los Angeles, CA, 90048, USA
| | - Justin C Mason
- Vascular Sciences, National Heart & Lung Institute, Faculty of Medicine, Imperial College London, Hammersmith Campus, DuCane Road, London, W12 0HS, UK
| | - James H F Rudd
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Jason M Tarkin
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ, UK
- Vascular Sciences, National Heart & Lung Institute, Faculty of Medicine, Imperial College London, Hammersmith Campus, DuCane Road, London, W12 0HS, UK
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Abstract
The use of PET imaging agents in oncology, cardiovascular disease, and neurodegenerative disease shows the power of this technique in evaluating the molecular and biological characteristics of numerous diseases. These agents provide crucial information for designing therapeutic strategies for individual patients. Novel PET tracers are in continual development and many have potential use in clinical and research settings. This article discusses the potential applications of tracers in diagnostics, the biological characteristics of diseases, the ability to provide prognostic indicators, and using this information to guide treatment strategies including monitoring treatment efficacy in real time to improve outcomes and survival.
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129
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MacRitchie N, Noonan J, Guzik TJ, Maffia P. Molecular Imaging of Cardiovascular Inflammation. Br J Pharmacol 2021; 178:4216-4245. [PMID: 34378206 DOI: 10.1111/bph.15654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/22/2020] [Accepted: 11/09/2020] [Indexed: 11/30/2022] Open
Abstract
Cardiovascular diseases (CVD), including atherosclerosis, are chronic inflammatory diseases characterised by a complex and evolving tissue micro-environment. Molecular heterogeneity of inflammatory responses translates into clinical outcomes. However, current medical imaging modalities are unable to reveal the cellular and molecular events at a level of detail that would allow more accurate and timely diagnosis and treatment. This is an inherent limitation of the current imaging tools which are restricted to anatomical or functional data. Molecular imaging - the visualization and quantification of molecules in the body - is already established in the clinic in the form of Positron Emitted Tomography (PET), yet the use of PET in CVD is limited. In this visual review, we will guide you through the current state of molecular imaging research, assessing the respective strengths and weaknesses of molecular imaging modalities, including those already being used in the clinic such as PET and magnetic resonance imaging (MRI) and emerging technologies at pre-clinical stage, such as photoacoustic imaging. We discuss the basic principles of each technology and provide key examples of their application in imaging inflammation in CVD and the added value into the diagnostic decision-making process. Finally, we discuss barriers for rapid successful clinical translation of these novel diagnostic modalities.
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Affiliation(s)
- Neil MacRitchie
- Centre for Immunobiology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.,Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Tomasz J Guzik
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.,Department of Internal Medicine, Jagiellonian University, Collegium Medicum, Kraków, Poland
| | - Pasquale Maffia
- Centre for Immunobiology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.,Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.,Department of Pharmacy, University of Naples Federico II, Naples, Italy
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130
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Zobel EH, Ripa RS, von Scholten BJ, Curovic VR, Diaz LJ, Hansen TW, Rossing P, Kjaer A. Effect of Liraglutide on Vascular Inflammation Evaluated by [ 64Cu]DOTATATE. Diagnostics (Basel) 2021; 11:diagnostics11081431. [PMID: 34441365 PMCID: PMC8391433 DOI: 10.3390/diagnostics11081431] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/28/2021] [Accepted: 08/04/2021] [Indexed: 01/04/2023] Open
Abstract
Quantification of vascular inflammation before and after treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may help reveal mechanistic pathways underlying the cardiovascular benefits of these drugs. We assessed change in vascular inflammation in the carotid arteries over 26 weeks by copper-64-labeled [1,4,7,10-tetraazacyclododecane-N,N′,N″,N‴-tetraacetic acid]-D-Phe1, Tyr3-octreotate ([64Cu]DOTATATE) PET in 30 participants included in a substudy of a double-blind trial where persons with type 2 diabetes (T2D) were randomized to liraglutide (n = 15) or placebo (n = 15) for 26 weeks. Mean age (SD) was 66.4 (7.2) years, HbA1c 56.4 (9.2) mmol/mol and BMI 28.9 (4.6) kg/m2. Weight and HbA1c were significantly reduced by liraglutide vs. placebo (p ≤ 0.01). The [64Cu]DOTATATE uptake (mean standardized uptake values) was significantly reduced in the liraglutide-treated group (−0.11 [95% confidence interval −0.19 to −0.03], p = 0.01) and not changed significantly in the placebo group (−0.07 [−0.14 to 0.01], p = 0.08). The mean difference between groups did not reach significance (−0.04 [−0.15 to 0.07], p = 0.44). In conclusion, [64Cu]DOTATATE uptake was reduced in persons with T2D treated with liraglutide. However, the reduction compared to placebo did not reach statistical significance, perhaps due to limited power. A reduction in vascular inflammation with liraglutide could help explain the cardiovascular protection observed with GLP-1 RAs in outcome studies but warrants further and larger studies.
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Affiliation(s)
- Emilie H. Zobel
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820 Gentofte, Denmark; (B.J.v.S.); (V.R.C.); (L.J.D.); (T.W.H.); (P.R.)
- Correspondence:
| | - Rasmus S. Ripa
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, 1165 Copenhagen, Denmark; (R.S.R.); (A.K.)
| | - Bernt J. von Scholten
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820 Gentofte, Denmark; (B.J.v.S.); (V.R.C.); (L.J.D.); (T.W.H.); (P.R.)
- Novo Nordisk A/S, 2860 Søborg, Denmark
| | - Viktor Rotbain Curovic
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820 Gentofte, Denmark; (B.J.v.S.); (V.R.C.); (L.J.D.); (T.W.H.); (P.R.)
| | - Lars Jorge Diaz
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820 Gentofte, Denmark; (B.J.v.S.); (V.R.C.); (L.J.D.); (T.W.H.); (P.R.)
| | - Tine W. Hansen
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820 Gentofte, Denmark; (B.J.v.S.); (V.R.C.); (L.J.D.); (T.W.H.); (P.R.)
| | - Peter Rossing
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820 Gentofte, Denmark; (B.J.v.S.); (V.R.C.); (L.J.D.); (T.W.H.); (P.R.)
- Department of Clinical Medicine, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, 1165 Copenhagen, Denmark; (R.S.R.); (A.K.)
- Department of Clinical Medicine, University of Copenhagen, 1165 Copenhagen, Denmark
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131
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Borchert T, Beitar L, Langer LBN, Polyak A, Wester HJ, Ross TL, Hilfiker-Kleiner D, Bengel FM, Thackeray JT. Dissecting the target leukocyte subpopulations of clinically relevant inflammation radiopharmaceuticals. J Nucl Cardiol 2021; 28:1636-1645. [PMID: 31659697 DOI: 10.1007/s12350-019-01929-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/29/2019] [Accepted: 10/01/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Leukocyte subtypes bear distinct pro-inflammatory, reparative, and regulatory functions. Imaging inflammation provides information on disease prognosis and may guide therapy, but the cellular basis of the signal remains equivocal. We evaluated leukocyte subtype specificity of characterized clinically relevant inflammation-targeted radiotracers. METHODS AND RESULTS Leukocyte populations were purified from blood- and THP-1-derived macrophages were polarized into M1-, reparative M2a-, or M2c-macrophages. In vitro uptake assays were conducted using tracers of enhanced glucose or amino acid metabolism and molecular markers of inflammatory cells. Both 18F-deoxyglucose (18F-FDG) and the labeled amino acid 11C-methionine (11C-MET) displayed higher uptake in neutrophils and monocytes compared to other leukocytes (P = 0.005), and markedly higher accumulation in pro-inflammatory M1-macrophages compared to reparative M2a-macrophages (P < 0.001). Molecular tracers 68Ga-DOTATATE targeting the somatostatin receptor type 2 and 68Ga-pentixafor targeting the chemokine receptor type 4 (CXCR4) exhibited broad uptake by leukocyte subpopulations and polarized macrophages with highest uptake in T-cells/natural killer cells and B-cells compared to neutrophils. Mitochondrial translocator protein (TSPO)-targeted 18F-flutriciclamide selectively accumulated in monocytes and pro-inflammatory M1 macrophages (P < 0.001). Uptake by myocytes and fibroblasts tended to be higher for metabolic radiotracers. CONCLUSIONS The different in vitro cellular uptake profiles may allow isolation of distinct phases of the inflammatory pathway with specific inflammation-targeted radiotracers. The pathogenetic cell population in specific inflammatory diseases should be considered in the selection of an appropriate imaging agent.
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Affiliation(s)
- Tobias Borchert
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg-Str. 1, 30625, Hannover, Germany
| | - Laura Beitar
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg-Str. 1, 30625, Hannover, Germany
| | - Laura B N Langer
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg-Str. 1, 30625, Hannover, Germany
| | - Andras Polyak
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg-Str. 1, 30625, Hannover, Germany
| | - Hans-Jürgen Wester
- Department of Radiopharmaceutical Chemistry, Technical University of Munich, Munich, Germany
| | - Tobias L Ross
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg-Str. 1, 30625, Hannover, Germany
| | | | - Frank M Bengel
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg-Str. 1, 30625, Hannover, Germany
| | - James T Thackeray
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg-Str. 1, 30625, Hannover, Germany.
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132
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Emerging Preclinical and Clinical Applications of Theranostics for Nononcological Disorders. PET Clin 2021; 16:429-440. [PMID: 34053586 DOI: 10.1016/j.cpet.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Studies in nuclear medicine have shed light on molecular imaging and therapeutic approaches for oncological and nononcological conditions. Using the same radiopharmaceuticals for diagnosis and therapeutics of malignancies, the theranostics approach, has improved clinical management of patients. Theranostic approaches for nononcological conditions are recognized as emerging topics of research. This review focuses on preclinical and clinical studies of nononcological disorders that include theranostic strategies. Theranostic approaches are demonstrated as possible in the clinical management of infections and inflammations. There is an emerging need for randomized trials to specify the factors affecting validity and efficacy of theranostic approaches in nononcological diseases.
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133
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Abstract
PURPOSE OF REVIEW To examine the use of positron emission tomography (PET) for imaging post-infarct myocardial inflammation and repair. RECENT FINDINGS Dysregulated immune responses after myocardial infarction are associated with adverse cardiac remodelling and an increased likelihood of ischaemic heart failure. PET imaging utilising novel tracers can be applied to visualise different components of the post-infarction inflammatory and repair processes. This approach could offer unique pathophysiological insights that could prove useful for the identification and risk-stratification of individuals who would ultimately benefit most from emerging immune-modulating therapies. PET imaging could also bridge the clinical translational gap as a surrogate measure of drug efficacy in early-stage clinical trials in patients with myocardial infarction. The use of hybrid PET/MR imaging, in particular, offers the additional advantage of simultaneous in vivo molecular imaging and detailed assessment of myocardial function, viability and tissue characterisation. Further research is needed to realise the true clinical translational value of PET imaging after myocardial infarction.
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Affiliation(s)
- Andrej Ćorović
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
| | - Meritxell Nus
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
| | - Ziad Mallat
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
| | - James H. F. Rudd
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
| | - Jason M. Tarkin
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
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134
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Abstract
PURPOSE OF REVIEW Current therapeutic strategies to mitigate heart failure progression after myocardial infarction involve support of endogenous repair through molecular targets. The capacity for repair varies greatly between individuals. In this review, we will assess how cardiac PET/CT enables precise characterization of early pathogenetic processes which govern ventricle remodeling and progression to heart failure. RECENT FINDINGS Inflammation in the first days after myocardial infarction predicts subsequent functional decline and can influence therapy decisions. The expansion of anti-inflammatory approaches to improve outcomes after myocardial infarction may benefit from noninvasive characterization using imaging. Novel probes also allow visualization of fibroblast transdifferentiation and activation, as a precursor to ventricle remodeling. The expanding arsenal of molecular imaging agents in parallel with new treatment options provides opportunity to harmonize diagnostic imaging with precision therapy.
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Affiliation(s)
- James T Thackeray
- Department of Nuclear Medicine, Hannover Medical School, Neuberg-Str. 1, D-30625, Hannover, Germany.
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135
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Kwiecinski J, Dey D, Cadet S, Lee SE, Tamarappoo B, Otaki Y, Huynh PT, Friedman JD, Dweck MR, Newby DE, Yun M, Chang HJ, Slomka PJ, Berman DS. Predictors of 18F-sodium fluoride uptake in patients with stable coronary artery disease and adverse plaque features on computed tomography angiography. Eur Heart J Cardiovasc Imaging 2021; 21:58-66. [PMID: 31211387 DOI: 10.1093/ehjci/jez152] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/01/2019] [Accepted: 05/24/2019] [Indexed: 01/01/2023] Open
Abstract
AIMS In patients with stable coronary artery disease (CAD) and high-risk plaques (HRPs) on coronary computed tomography angiography (CTA), we sought to define qualitative and quantitative CTA predictors of abnormal coronary 18F-sodium fluoride uptake (18F-NaF) by positron emission tomography (PET). METHODS AND RESULTS Patients undergoing coronary CTA were screened for HRP. Those who presented with ≥3 CTA adverse plaque features (APFs) including positive remodelling; low attenuation plaque (LAP, <30 HU), spotty calcification; obstructive coronary stenosis ≥50%; plaque volume >100 mm3 were recruited for 18F-NaF PET. In lesions with stenosis ≥25%, quantitative plaque analysis and maximum 18F-NaF target to background ratios (TBRs) were measured. Of 55 patients, 35 (64%) manifested coronary 18F-NaF uptake. Of 68 high-risk lesions 49 (70%) had increased PET tracer activity. Of the APFs, LAP had the highest sensitivity (39.4%) and specificity (98.3%) for predicting 18F-NaF uptake. TBR values were higher in lesions with LAP compared to those without [1.6 (1.3-1.8) vs. 1.1 (1.0-1.3), P = 0.01]. On adjusted multivariable regression analysis, LAP (both qualitative and quantitative) was independently associated with plaque TBR [LAP qualitative: β = 0.47, 95% confidence interval (CI) 0.30-0.65; P < 0.001] and (LAP volume: β = 0.20 per 10 mm3, 95% CI 0.13-0.27; P < 0.001). CONCLUSION In stable CAD patients with HRP, LAP is predictive of 18F-NaF coronary uptake, but 18F-NaF is often seen in the absence of LAP. If 18F-NaF uptake is shown to be associated with adverse outcomes and becomes clinically used, the presence of LAP may define patients who would not benefit from the added testing.
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Affiliation(s)
- Jacek Kwiecinski
- Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, USA.,Department of Interventional Cardiology and Angiology, Institute of Cardiology, Alpejska 42, Warsaw, Poland
| | - Damini Dey
- Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, USA
| | - Sebastien Cadet
- Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, USA
| | - Sang-Eun Lee
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Balaji Tamarappoo
- Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, USA
| | - Yuka Otaki
- Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, USA
| | - Phi T Huynh
- Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, USA
| | - John D Friedman
- Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, USA
| | - Mark R Dweck
- BHF Centre for Cardiovascular Science, University of Edinburgh, 49 Little France Crescent, Edinburgh, UK
| | - David E Newby
- BHF Centre for Cardiovascular Science, University of Edinburgh, 49 Little France Crescent, Edinburgh, UK
| | - Mijin Yun
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyuk-Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Piotr J Slomka
- Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, USA
| | - Daniel S Berman
- Department of Imaging (Division of Nuclear Medicine), Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, USA
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Slart RHJA, Glaudemans AWJM, Gheysens O, Lubberink M, Kero T, Dweck MR, Habib G, Gaemperli O, Saraste A, Gimelli A, Georgoulias P, Verberne HJ, Bucerius J, Rischpler C, Hyafil F, Erba PA. Procedural recommendations of cardiac PET/CT imaging: standardization in inflammatory-, infective-, infiltrative-, and innervation- (4Is) related cardiovascular diseases: a joint collaboration of the EACVI and the EANM: summary. Eur Heart J Cardiovasc Imaging 2021; 21:1320-1330. [PMID: 33245759 PMCID: PMC7695243 DOI: 10.1093/ehjci/jeaa299] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 10/13/2020] [Indexed: 01/18/2023] Open
Abstract
With this summarized document we share the standard for positron emission tomography (PET)/(diagnostic)computed tomography (CT) imaging procedures in cardiovascular diseases that are inflammatory, infective, infiltrative, or associated with dysfunctional innervation (4Is) as recently published in the European Journal of Nuclear Medicine and Molecular Imaging. This standard should be applied in clinical practice and integrated in clinical (multicentre) trials for optimal standardization of the procedurals and interpretations. A major focus is put on procedures using [18F]-2-fluoro-2-deoxyglucose ([18F]FDG), but 4Is PET radiopharmaceuticals beyond [18F]FDG are also described in this summarized document. Whilst these novel tracers are currently mainly applied in early clinical trials, some multicentre trials are underway and we foresee in the near future their use in clinical care and inclusion in the clinical guidelines. Diagnosis and management of 4Is related cardiovascular diseases are generally complex and often require a multidisciplinary approach by a team of experts. The new standards described herein should be applied when using PET/CT and PET/magnetic resonance, within a multimodality imaging framework both in clinical practice and in clinical trials for 4Is cardiovascular indications.
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Affiliation(s)
- Riemer H J A Slart
- Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands.,Faculty of Science and Technology, Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands
| | - Andor W J M Glaudemans
- Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Olivier Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Mark Lubberink
- Department of Surgical Sciences/Radiology, Uppsala University, Uppsala, Sweden
| | - Tanja Kero
- Department of Surgical Sciences/Radiology, Uppsala University, Uppsala, Sweden.,Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Gilbert Habib
- Cardiology Department, APHM, La Timone Hospital, Marseille, France.,Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | | | - Antti Saraste
- Turku PET Centre, Turku University Hospital, University of Turku, Turku, Finland.,Heart Center, Turku University Hospital, Turku, Finland
| | | | - Panagiotis Georgoulias
- Department of Nuclear Medicine, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Bucerius
- Department of Nuclear Medicine, Georg-August University Göttingen, Göttingen, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Fabien Hyafil
- Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, F75015, Paris, France.,University of Paris, PARCC, INSERM, F75007, Paris, France
| | - Paola A Erba
- Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands.,Department of Nuclear Medicine, University of Pisa, Pisa, Italy.,Department of Translational Research and New Technology in Medicine, University of Pisa, Pisa, Italy
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137
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Sultan D, Li W, Detering L, Heo GS, Luehmann HP, Kreisel D, Liu Y. Assessment of ultrasmall nanocluster for early and accurate detection of atherosclerosis using positron emission tomography/computed tomography. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2021; 36:102416. [PMID: 34147662 DOI: 10.1016/j.nano.2021.102416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/17/2021] [Accepted: 04/30/2021] [Indexed: 11/25/2022]
Abstract
The development of atherosclerosis therapy is hampered by the lack of molecular imaging tools to identify the relevant biomarkers and determine the dynamic variation in vivo. Here, we show that a chemokine receptor 2 (CCR2) targeted gold nanocluster conjugated with extracellular loop 1 inverso peptide (AuNC-ECL1i) determines the initiation, progression and regression of atherosclerosis in apolipoprotein E knock-out (ApoE-/-) mouse models. The CCR2 targeted 64Cu-AuNC-ECL1i reveals sensitive detection of early atherosclerotic lesions and progression of plaques in ApoE-/- mice. CCR2 targeting specificity was confirmed by the competitive receptor blocking studies. In a mouse model of aortic arch transplantation, 64Cu-AuNC-ECL1i accurately detects the regression of plaques. Human atherosclerotic tissues show high expression of CCR2 related to the status of the disease. This study confirms CCR2 as a useful marker for atherosclerosis and points to the potential of 64Cu-AuNC-ECL1i as a targeted molecular imaging probe for future clinical translation.
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Affiliation(s)
- Deborah Sultan
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA
| | - Wenjun Li
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Lisa Detering
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA
| | - Gyu Seong Heo
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA
| | - Hannah P Luehmann
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA
| | - Daniel Kreisel
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA; Department of Pathology and Immunology, Washington University, St. Louis, MO, USA.
| | - Yongjian Liu
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA.
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138
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Taglieri N, Ghetti G, Bruno AG, Marco V, Reggiani MLB, Bonfiglioli R, Massarelli G, Gatto L, Bruno M, Paoletti G, Fanti S, Saia F, Prati F, Galiè N. Optical coherence tomography assessment of macrophages accumulation in non-ST-segment elevation acute coronary syndromes. J Cardiovasc Med (Hagerstown) 2021; 21:860-865. [PMID: 33017123 DOI: 10.2459/jcm.0000000000001015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS To investigate in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) the prevalence and the features of optical coherence tomography (OCT)-detected macrophages accumulation in culprit plaques as compared with nonculprit plaques (NCP). METHODS The study is a post-hoc analysis of a prospective study aimed at evaluating the relationship between aortic inflammation as assessed by F-fluorodeoxyglucose-PET and features of coronary plaque vulnerability as assessed by OCT. We enrolled 32 patients with first NSTE-ACS who successfully underwent three-vessel OCT. RESULTS The median age was 65 (54-72) years and 27 patients (84%) were men. Culprit plaques were clinically defined. Overall, the rate of lipid plaques and lipid plaques containing macrophages were 6.4 and 4.2 per patient, respectively. Culprit plaques had a smaller minimal luminal area, a higher extension of lipid component and a thinner fibrous cap than NCPs. Macrophages accumulations were more likely found in culprit plaque (84 vs. 61%, P = 0.015) in which they had also a higher circumferential extension. On univariable analysis, macrophages accumulation extension had a higher association with culprit plaques (odds ratio = 4.42; 95% confidence interval; 2.54-9.15, P < 0.001) than the mere presence of macrophages accumulation (odds ratio = 3.36; 95% confidence interval; 1.30-8.66, P = 0.012). Culprit plaques with thrombus had a lower distance between macrophages accumulation and the luminal surface than culprit plaque with no thrombus (0.06 vs. 0.1 mm; P = 0.04). CONCLUSION In patients with NSTE-ACS, macrophages accumulations are more likely present in culprit plaque in which they disclose also a greater extension compared with those observed in NCP. The distance between macrophages accumulation and the luminal surface is lower in thrombotic culprit plaque than that in nonthrombotic culprit plaque.
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Affiliation(s)
- Nevio Taglieri
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna
| | - Gabriele Ghetti
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna
| | - Antonio G Bruno
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna
| | | | - Maria L Bacchi Reggiani
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna
| | - Rachele Bonfiglioli
- Dipartimento di Medicina Specialistica, Istituto di Medicina Nucleare, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna
| | - Giulia Massarelli
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna
| | - Laura Gatto
- CLI Foundation, Rome.,Dipartimento di Scienze Cardiovascolari, Ospedale San Giovanni Addolorata Roma, Roma
| | - Matteo Bruno
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna
| | | | - Stefano Fanti
- Dipartimento di Medicina Specialistica, Istituto di Medicina Nucleare, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna
| | - Francesco Saia
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna
| | - Francesco Prati
- CLI Foundation, Rome.,UniCamillus-International Medical University, Rome Italy
| | - Nazzareno Galiè
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna
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139
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Sriranjan RS, Tarkin JM, Evans NR, Le EPV, Chowdhury MM, Rudd JHF. Atherosclerosis imaging using PET: Insights and applications. Br J Pharmacol 2021; 178:2186-2203. [PMID: 31517992 DOI: 10.1111/bph.14868] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/02/2019] [Accepted: 08/16/2019] [Indexed: 12/17/2022] Open
Abstract
PET imaging is able to harness biological processes to characterise high-risk features of atherosclerotic plaque prone to rupture. Current radiotracers are able to track inflammation, microcalcification, hypoxia, and neoangiogenesis within vulnerable plaque. 18 F-fluorodeoxyglucose (18 F-FDG) is the most commonly used radiotracer in vascular studies and is employed as a surrogate marker of plaque inflammation. Increasingly, 18 F-FDG and other PET tracers are also being used to provide imaging endpoints in cardiovascular interventional trials. The evolution of novel PET radiotracers, imaging protocols, and hybrid scanners are likely to enable more efficient and accurate characterisation of high-risk plaque. This review explores the role of PET imaging in atherosclerosis with a focus on PET tracers utilised in clinical research and the applications of PET imaging to cardiovascular drug development.
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Affiliation(s)
| | - Jason M Tarkin
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
| | - Nicholas R Evans
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
| | - Elizabeth P V Le
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
| | | | - James H F Rudd
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
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140
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Kocyigit D, Scanameo A, Xu B. Multimodality imaging for the prevention of cardiovascular events: Coronary artery calcium and beyond. Cardiovasc Diagn Ther 2021; 11:840-858. [PMID: 34295709 PMCID: PMC8261752 DOI: 10.21037/cdt-19-654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 01/15/2020] [Indexed: 12/24/2022]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) has been the leading cause of death worldwide for more than a decade. Prevention is of utmost importance to reduce related mortality. The innovations in cardiovascular imaging technology, in addition to our improved understanding of coronary atherosclerosis pathogenesis, have resulted in cardiovascular imaging becoming one of the most influential tools for diagnosis and risk stratification in ASCVD. Although numerous publications have emerged on this topic, data that guide routine cardiology clinical practice currently focus on the utility of a limited number of such modalities, namely arterial ultrasonography and computed tomography. Herein, current evidence with respect to the role of multimodality cardiovascular imaging on ASCVD prevention will be reviewed.
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Affiliation(s)
- Duygu Kocyigit
- Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | - Bo Xu
- Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
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141
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Schofield R, Menezes L, Underwood SR. Nuclear cardiology: state of the art. Heart 2021; 107:954-961. [PMID: 33483353 DOI: 10.1136/heartjnl-2019-315628] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 12/04/2020] [Accepted: 12/11/2020] [Indexed: 12/11/2022] Open
Abstract
Radionuclide imaging remains an essential component of modern cardiology. There is overlap with the information from other imaging techniques, but no technique is static and new developments have expanded its role. This review focuses on ischaemic heart disease, heart failure, infection and inflammation. Radiopharmaceutical development includes the wider availability of positron emission tomography (PET) tracers such as rubidium-82, which allows myocardial perfusion to be quantified in absolute terms. Compared with alternative techniques, myocardial perfusion scintigraphy PET and single photon emission computed tomography (SPECT) have the advantages of being widely applicable using exercise or pharmacological stress, full coverage of the myocardium and a measure of ischaemic burden, which helps to triage patients between medical therapy and revascularisation. Disadvantages include the availability of expertise in some cardiac centres and the lack of simple SPECT quantification, meaning that global abnormalities can be underestimated. In patients with heart failure, despite the findings of the STICH (Surgical Treatment for Ischemic Heart Failure) trial, there are still data to support the assessment of myocardial hibernation in predicting when abolition of ischaemia might lead to improvement in ventricular function. Imaging of sympathetic innervation is well validated, but simpler markers of prognosis mean that it has not been widely adopted. There are insufficient data to support its use in predicting the need for implanted devices, but non-randomised studies are promising. Other areas where radionuclide imaging is uniquely valuable are detection and monitoring of endocarditis, device infection, myocardial inflammation in sarcoidosis, myocarditis and so on, and reliable detection of deposition in suspected transthyretin-related amyloidosis.
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Affiliation(s)
- Rebecca Schofield
- Department of Cardiology, North West Anglia NHS Foundation Trust, Peterborough, Cambridgeshire, UK
| | - Leon Menezes
- Institute of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK
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142
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Abstract
Significance: Coronary artery disease (CAD) continues to be a leading cause of morbidity and mortality across the world despite significant progress in the prevention, diagnosis, and treatment of atherosclerotic disease. Recent Advances: The focus of the cardiovascular community has shifted toward seeking a better understanding of the inflammatory mechanisms driving residual CAD risk that is not modulated by current therapies. Significant progress has been achieved in revealing both proinflammatory and anti-inflammatory mechanisms, and how shift of the balance in favor of the former can drive the development of disease. Critical Issues: Advances in the noninvasive detection of coronary artery inflammation have been forthcoming. These advances include multiple imaging modalities, with novel applications of computed tomography both with and without positron emission tomography, and experimental ultrasound techniques. These advances will enable better selection of patients for anti-inflammatory treatments and assessment of treatment response. The rapid advancement in pharmaceutical design has enabled the production of specific antibodies against inflammatory pathways of atherosclerosis, with modest success to date. The pursuit of demonstrating the efficacy and safety of novel anti-inflammatory and/or proinflammatory resolution therapies for atherosclerotic CAD has become a major focus. Future Directions: This review seeks to provide an update of the latest evidence of all three of these highly related but disparate areas of inquiry: Our current understanding of the key mechanisms by which inflammation contributes to coronary artery atherosclerosis, the evidence for noninvasive assessment of coronary artery inflammation, and finally, the evidence for targeted therapies to treat coronary inflammation for the reduction of CAD risk. Antioxid. Redox Signal. 34, 1217-1243.
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Affiliation(s)
- Henry W West
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
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143
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Abstract
Targeting residual cardiovascular risk in primary and secondary prevention, would allow deployment of novel therapeutic agents, facilitating precision medicine. For example, lowering vascular inflammation is a promising strategy to reduce the residual inflammatory cardiovascular risk in patients already receiving optimal medical therapy, but prescribing novel anti-inflammatory treatments will be problematic due to the lack of specific companion diagnostic tests, to guide their targeted use in clinical practice. Currently available tests for the detection of coronary inflammation are either non-specific for the cardiovascular system (e.g. plasma biomarkers) or expensive and not readily available (e.g. hybrid positron emission tomography imaging). Recent technological advancements in coronary computed tomography angiography (CCTA) allow non-invasive detection of high-risk plaque features (positive remodelling, spotty calcification, low attenuation plaque, and napkin-ring sign) and help identify the vulnerable patient, but they provide only indirectly information about coronary inflammation. Perivascular fat attenuation index (FAI), a novel method for assessing coronary inflammation by analysing routine CCTA, captures changes in the perivascular adipose tissue composition driven by inflammatory signals coming from the inflamed coronary artery, by analysing the three-dimensional gradients of perivascular attenuation, followed by adjustments for technical, anatomical, and biological factors. By detecting vascular inflammation, perivascular FAI enhances cardiovascular risk discrimination which could aid more cost-effective deployment of novel therapeutic agents. In this article, we present the existing non-invasive modalities for the detection of coronary inflammation and provide a practical guide for their use in clinical practice.
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Affiliation(s)
- Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK
| | - Alexios S Antonopoulos
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK
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Yuvaraj J, Cheng K, Lin A, Psaltis PJ, Nicholls SJ, Wong DTL. The Emerging Role of CT-Based Imaging in Adipose Tissue and Coronary Inflammation. Cells 2021; 10:1196. [PMID: 34068406 PMCID: PMC8153638 DOI: 10.3390/cells10051196] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/30/2021] [Accepted: 05/07/2021] [Indexed: 12/15/2022] Open
Abstract
A large body of evidence arising from recent randomized clinical trials demonstrate the association of vascular inflammatory mediators with coronary artery disease (CAD). Vascular inflammation localized in the coronary arteries leads to an increased risk of CAD-related events, and produces unique biological alterations to local cardiac adipose tissue depots. Coronary computed tomography angiography (CTA) provides a means of mapping inflammatory changes to both epicardial adipose tissue (EAT) and pericoronary adipose tissue (PCAT) as independent markers of coronary risk. Radiodensity or attenuation of PCAT on coronary CTA, notably, provides indirect quantification of coronary inflammation and is emerging as a promising non-invasive imaging implement. An increasing number of observational studies have shown robust associations between PCAT attenuation and major coronary events, including acute coronary syndrome, and 'vulnerable' atherosclerotic plaque phenotypes that are associated with an increased risk of the said events. This review outlines the biological characteristics of both EAT and PCAT and provides an overview of the current literature on PCAT attenuation as a surrogate marker of coronary inflammation.
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Affiliation(s)
- Jeremy Yuvaraj
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University and Monash Heart, Monash Health, Clayton, VIC 3168, Australia; (J.Y.); (K.C.); (S.J.N.)
| | - Kevin Cheng
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University and Monash Heart, Monash Health, Clayton, VIC 3168, Australia; (J.Y.); (K.C.); (S.J.N.)
| | - Andrew Lin
- Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA 90048, USA;
| | - Peter J. Psaltis
- Department of Medicine, University of Adelaide, Adelaide, SA 5005, Australia;
- South Australian Health Medical Research Institute, Adelaide, SA 5000, Australia
| | - Stephen J. Nicholls
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University and Monash Heart, Monash Health, Clayton, VIC 3168, Australia; (J.Y.); (K.C.); (S.J.N.)
| | - Dennis T. L. Wong
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University and Monash Heart, Monash Health, Clayton, VIC 3168, Australia; (J.Y.); (K.C.); (S.J.N.)
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145
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Chowdhary A, Garg P, Das A, Nazir MS, Plein S. Cardiovascular magnetic resonance imaging: emerging techniques and applications. Heart 2021; 107:697-704. [PMID: 33402364 PMCID: PMC7611390 DOI: 10.1136/heartjnl-2019-315669] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/02/2020] [Accepted: 11/23/2020] [Indexed: 01/15/2023] Open
Abstract
This review gives examples of emerging cardiovascular magnetic resonance (CMR) techniques and applications that have the potential to transition from research to clinical application in the near future. Four-dimensional flow CMR (4D-flow CMR) allows time-resolved three-directional, three-dimensional (3D) velocity-encoded phase-contrast imaging for 3D visualisation and quantification of valvular or intracavity flow. Acquisition times of under 10 min are achievable for a whole heart multidirectional data set and commercial software packages are now available for data analysis, making 4D-flow CMR feasible for inclusion in clinical imaging protocols. Diffusion tensor imaging (DTI) is based on the measurement of molecular water diffusion and uses contrasting behaviour in the presence and absence of boundaries to infer tissue structure. Cardiac DTI is capable of non-invasively phenotyping the 3D micro-architecture within a few minutes, facilitating transition of the method to clinical protocols. Hybrid positron emission tomography-magnetic resonance (PET-MR) provides quantitative PET measures of biological and pathological processes of the heart combined with anatomical, morphological and functional CMR imaging. Cardiac PET-MR offers opportunities in ischaemic, inflammatory and infiltrative heart disease.
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Affiliation(s)
- Amrit Chowdhary
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, West Yorkshire, UK
| | - Pankaj Garg
- Cardiovascular and Metabolic Medicine Group, University of East Anglia, Norwich, UK
| | - Arka Das
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, West Yorkshire, UK
| | - Muhummad Sohaib Nazir
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Sven Plein
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, West Yorkshire, UK
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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146
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Sergienko VB, Ansheles AA. Nuclear medicine and molecular imaging in clinical practice: yesterday, today and tomorrow. TERAPEVT ARKH 2021; 93:357-362. [DOI: 10.26442/00403660.2021.04.200673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 05/31/2021] [Indexed: 11/22/2022]
Abstract
Over the past 40 years, nuclear medicine has grown to be the largest non-invasive diagnostic and therapeutic industry in the world, playing a pivotal role in various fields and disciplines of clinical practice and contributing to improved quality of life and patient prognosis. Over the first 20 years of the XXI century, the number of radionuclide procedures in the world has increased significantly, primarily due to innovations in radiopharmaceuticals, continuous improvement of the technical properties of equipment and the expansion of the boundaries of multimodal imaging. The review examines the historical and current trends in the development of nuclear medicine in the world and in Russia, including those related to radionuclide diagnostics, therapy and theranostics.
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147
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Bell M, Gandhi R, Shawer H, Tsoumpas C, Bailey MA. Imaging Biological Pathways in Abdominal Aortic Aneurysms Using Positron Emission Tomography. Arterioscler Thromb Vasc Biol 2021; 41:1596-1606. [PMID: 33761759 DOI: 10.1161/atvbaha.120.315812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Michael Bell
- Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, United Kingdom
| | - Richa Gandhi
- Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, United Kingdom
| | - Heba Shawer
- Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, United Kingdom
| | - Charalampos Tsoumpas
- Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, United Kingdom
| | - Marc A Bailey
- Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, United Kingdom
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148
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Meester EJ, de Blois E, Krenning BJ, van der Steen AFW, Norenberg JP, van Gaalen K, Bernsen MR, de Jong M, van der Heiden K. Autoradiographical assessment of inflammation-targeting radioligands for atherosclerosis imaging: potential for plaque phenotype identification. EJNMMI Res 2021; 11:27. [PMID: 33730311 PMCID: PMC7969682 DOI: 10.1186/s13550-021-00772-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 03/05/2021] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Many radioligands have been developed for the visualization of atherosclerosis by targeting inflammation. However, interpretation of in vivo signals is often limited to plaque identification. We evaluated binding of some promising radioligands in an in vitro approach in atherosclerotic plaques with different phenotypes. METHODS Tissue sections of carotid endarterectomy tissue were characterized as early plaque, fibro-calcific plaque, or phenotypically vulnerable plaque. In vitro binding assays for the radioligands [111In]In-DOTATATE; [111In]In-DOTA-JR11; [67Ga]Ga-Pentixafor; [111In]In-DANBIRT; and [111In]In-EC0800 were conducted, the expression of the radioligand targets was assessed via immunohistochemistry. Radioligand binding and expression of radioligand targets was investigated and compared. RESULTS In sections characterized as vulnerable plaque, binding was highest for [111In]In-EC0800; followed by [111In]In-DANBIRT; [67Ga]Ga-Pentixafor; [111In]In-DOTA-JR11; and [111In]In-DOTATATE (0.064 ± 0.036; 0.052 ± 0.029; 0.011 ± 0.003; 0.0066 ± 0.0021; 0.00064 ± 0.00014 %Added activity/mm2, respectively). Binding of [111In]In-DANBIRT and [111In]In-EC0800 was highest across plaque phenotypes, binding of [111In]In-DOTA-JR11 and [67Ga]Ga-Pentixafor differed most between plaque phenotypes. Binding of [111In]In-DOTATATE was the lowest across plaque phenotypes. The areas positive for cells expressing the radioligand's target differed between plaque phenotypes for all targets, with lowest percentage area of expression in early plaque sections and highest in phenotypically vulnerable plaque sections. CONCLUSIONS Radioligands targeting inflammatory cell markers showed different levels of binding in atherosclerotic plaques and among plaque phenotypes. Different radioligands might be used for plaque detection and discerning early from vulnerable plaque. [111In]In-EC0800 and [111In]In-DANBIRT appear most suitable for plaque detection, while [67Ga]Ga-Pentixafor and [111In]In-DOTA-JR11 might be best suited for differentiation between plaque phenotypes.
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Affiliation(s)
- Eric J Meester
- Department of Biomedical Engineering, Thorax Center, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Erik de Blois
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | | | - Antonius F W van der Steen
- Department of Biomedical Engineering, Thorax Center, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jeff P Norenberg
- Radiopharmaceutical Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Kim van Gaalen
- Department of Biomedical Engineering, Thorax Center, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Monique R Bernsen
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Marion de Jong
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Kim van der Heiden
- Department of Biomedical Engineering, Thorax Center, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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149
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Anderson S, Grist JT, Lewis A, Tyler DJ. Hyperpolarized 13 C magnetic resonance imaging for noninvasive assessment of tissue inflammation. NMR IN BIOMEDICINE 2021; 34:e4460. [PMID: 33291188 PMCID: PMC7900961 DOI: 10.1002/nbm.4460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/22/2020] [Accepted: 11/23/2020] [Indexed: 05/03/2023]
Abstract
Inflammation is a central mechanism underlying numerous diseases and incorporates multiple known and potential future therapeutic targets. However, progress in developing novel immunomodulatory therapies has been slowed by a need for improvement in noninvasive biomarkers to accurately monitor the initiation, development and resolution of immune responses as well as their response to therapies. Hyperpolarized magnetic resonance imaging (MRI) is an emerging molecular imaging technique with the potential to assess immune cell responses by exploiting characteristic metabolic reprogramming in activated immune cells to support their function. Using specific metabolic tracers, hyperpolarized MRI can be used to produce detailed images of tissues producing lactate, a key metabolic signature in activated immune cells. This method has the potential to further our understanding of inflammatory processes across different diseases in human subjects as well as in preclinical models. This review discusses the application of hyperpolarized MRI to the imaging of inflammation, as well as the progress made towards the clinical translation of this emerging technique.
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Affiliation(s)
- Stephanie Anderson
- Department of Physiology, Anatomy and GeneticsUniversity of OxfordOxfordUK
| | - James T. Grist
- Department of Physiology, Anatomy and GeneticsUniversity of OxfordOxfordUK
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
- Department of Radiology, The Churchill HospitalOxford University Hospitals TrustHeadingtonUK
| | - Andrew Lewis
- Department of Physiology, Anatomy and GeneticsUniversity of OxfordOxfordUK
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | - Damian J. Tyler
- Department of Physiology, Anatomy and GeneticsUniversity of OxfordOxfordUK
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
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150
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Imaging Inflammation with Positron Emission Tomography. Biomedicines 2021; 9:biomedicines9020212. [PMID: 33669804 PMCID: PMC7922638 DOI: 10.3390/biomedicines9020212] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/28/2021] [Accepted: 02/12/2021] [Indexed: 12/19/2022] Open
Abstract
The impact of inflammation on the outcome of many medical conditions such as cardiovascular diseases, neurological disorders, infections, cancer, and autoimmune diseases has been widely acknowledged. However, in contrast to neurological, oncologic, and cardiovascular disorders, imaging plays a minor role in research and management of inflammation. Imaging can provide insights into individual and temporospatial biology and grade of inflammation which can be of diagnostic, therapeutic, and prognostic value. There is therefore an urgent need to evaluate and understand current approaches and potential applications for imaging of inflammation. This review discusses radiotracers for positron emission tomography (PET) that have been used to image inflammation in cardiovascular diseases and other inflammatory conditions with a special emphasis on radiotracers that have already been successfully applied in clinical settings.
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