1
|
Ahmadpour S, Habibi MA, Hosseinimehr SJ. Various Aspects of Fasting on the Biodistribution of Radiopharmaceuticals. Curr Drug Metab 2022; 23:827-841. [PMID: 36121082 DOI: 10.2174/1389200223666220919121354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/08/2022] [Accepted: 07/30/2022] [Indexed: 01/11/2023]
Abstract
It is demonstrated that fasting can alter the biodistribution of radiopharmaceuticals in nuclear medicine. Various studies have highlighted that fasting is interpreted to be easy for physicians during PET study, fasting is one of the most important factors determining the usefulness of this protocol. It is well documented that fasting can suppress normal 18F-FDG PET uptake during nuclear cardiology. However, there is no consensus about the usefulness of fasting on radiopharmaceuticals, especially on 18F-FDG in PET imaging, but special attention should be paid to the setting of the fasting duration. Nevertheless, it does seem we still need extensive clinical studies in the future. The present study aims to review the various aspects of fasting, especially metabolic alteration on radiopharmaceutical biodistribution. In this study, we focused more on the effect of fasting on 18F-FDG biodistribution, which alters its imaging contrast in cardiology and cancer imaging. Therefore, shifting substrate metabolism from glucose to free fatty acids during fasting can be an alternative approach to suppress physiological myocardial uptake.
Collapse
Affiliation(s)
- Sajjad Ahmadpour
- Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Mohammad Amin Habibi
- Iranian Tissue Bank and Research Center, Gene, Cell and Tissue Institute, Tehran University of Medical Sciences, Tehran, Iran.,Clinical Research of Development Center, Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Seyed Jalal Hosseinimehr
- Department of Radiopharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
2
|
Goel S, Miller A, Agarwal C, Zakin E, Acholonu M, Gidwani U, Sharma A, Kulbak G, Shani J, Chen O. Imaging Modalities to Identity Inflammation in an Atherosclerotic Plaque. Radiol Res Pract 2015; 2015:410967. [PMID: 26798515 PMCID: PMC4699110 DOI: 10.1155/2015/410967] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/19/2015] [Indexed: 11/18/2022] Open
Abstract
Atherosclerosis is a chronic, progressive, multifocal arterial wall disease caused by local and systemic inflammation responsible for major cardiovascular complications such as myocardial infarction and stroke. With the recent understanding that vulnerable plaque erosion and rupture, with subsequent thrombosis, rather than luminal stenosis, is the underlying cause of acute ischemic events, there has been a shift of focus to understand the mechanisms that make an atherosclerotic plaque unstable or vulnerable to rupture. The presence of inflammation in the atherosclerotic plaque has been considered as one of the initial events which convert a stable plaque into an unstable and vulnerable plaque. This paper systemically reviews the noninvasive and invasive imaging modalities that are currently available to detect this inflammatory process, at least in the intermediate stages, and discusses the ongoing studies that will help us to better understand and identify it at the molecular level.
Collapse
Affiliation(s)
- Sunny Goel
- Department of Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA
| | - Avraham Miller
- Department of Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA
| | - Chirag Agarwal
- Department of Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA
| | - Elina Zakin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Michael Acholonu
- Department of Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA
| | - Umesh Gidwani
- Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Abhishek Sharma
- Division of Cardiovascular Medicine, State University of New York Downstate Medical Centre, Brooklyn, NY 11203, USA
| | - Guy Kulbak
- Department of Cardiology, Maimonides Medical Center, Brooklyn, NY 11219, USA
| | - Jacob Shani
- Department of Cardiology, Maimonides Medical Center, Brooklyn, NY 11219, USA
| | - On Chen
- Department of Cardiology, Maimonides Medical Center, Brooklyn, NY 11219, USA
| |
Collapse
|
3
|
Alie N, Eldib M, Fayad ZA, Mani V. Inflammation, Atherosclerosis, and Coronary Artery Disease: PET/CT for the Evaluation of Atherosclerosis and Inflammation. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2015; 8:13-21. [PMID: 25674025 PMCID: PMC4294600 DOI: 10.4137/cmc.s17063] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/16/2014] [Accepted: 11/20/2014] [Indexed: 12/16/2022]
Abstract
Atherosclerosis is a prevalent cardiovascular disease marked by inflammation and the formation of plaque within arterial walls. As the disease progresses, there is an increased risk of major cardiovascular events. Owing to the nature of atherosclerosis, it is imperative to develop methods to further understand the physiological implications and progression of the disease. The combination of positron emission tomography (PET)/computed tomography (CT) has proven to be promising for the evaluation of atherosclerotic plaques and inflammation within the vessel walls. The utilization of the radiopharmaceutical tracer, 18F-fluorodeoxyglucose (18F-FDG), with PET/CT is invaluable in understanding the pathophysiological state involved in atherosclerosis. In this review, we will discuss the use of 18F-FDG-PET/CT imaging for the evaluation of atherosclerosis and inflammation both in preclinical and clinical studies. The potential of more specific novel tracers will be discussed. Finally, we will touch on the potential benefits of using the newly introduced combined PET/magnetic resonance imaging (MRI) for non-invasive imaging of atherosclerosis.
Collapse
Affiliation(s)
- Nadia Alie
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mootaz Eldib
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zahi A Fayad
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Venkatesh Mani
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
4
|
Teresa Albelda M, Garcia-España E, Frias JC. Visualizing the atherosclerotic plaque: a chemical perspective. Chem Soc Rev 2014; 43:2858-76. [PMID: 24526041 DOI: 10.1039/c3cs60410a] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Atherosclerosis is the major underlying pathologic cause of coronary artery disease. An early detection of the disease can prevent clinical sequellae such as angina, myocardial infarction, and stroke. The different imaging techniques employed to visualize the atherosclerotic plaque provide information of diagnostic and prognostic value. Furthermore, the use of contrast agents helps to improve signal-to-noise ratio providing better images. For nuclear imaging techniques and optical imaging these agents are absolutely necessary. We report on the different contrast agents that have been used, are used or may be used in future in animals, humans, or excised tissues for the distinct imaging modalities for atherosclerotic plaque imaging.
Collapse
Affiliation(s)
- Ma Teresa Albelda
- Universidad de Valencia, Instituto de Ciencia Molecular, Edificio de Institutos de Paterna, c/ Catedrático José Beltrán 2, 46071 Valencia, Spain
| | | | | |
Collapse
|
5
|
Seo JW, Baek H, Mahakian LM, Kusunose J, Hamzah J, Ruoslahti E, Ferrara KW. (64)Cu-labeled LyP-1-dendrimer for PET-CT imaging of atherosclerotic plaque. Bioconjug Chem 2014; 25:231-9. [PMID: 24433095 PMCID: PMC4311647 DOI: 10.1021/bc400347s] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The ability to detect and quantify macrophage accumulation can provide important diagnostic and prognostic information for atherosclerotic plaque. We have previously shown that LyP-1, a cyclic 9-amino acid peptide, binds to p32 proteins on activated macrophages, facilitating the visualization of atherosclerotic plaque with PET. Yet, the in vivo plaque accumulation of monomeric [(18)F]FBA-LyP-1 was low (0.31 ± 0.05%ID/g). To increase the avidity of LyP-1 constructs to p32, we synthesized a dendritic form of LyP-1 on solid phase using lysine as the core structural element. Imaging probes (FAM or 6-BAT) were conjugated to a lysine or cysteine on the dendrimer for optical and PET studies. The N-terminus of the dendrimer was further modified with an aminooxy group in order to conjugate LyP-1 and ARAL peptides bearing a ketone. Oxime ligation of peptides to both dendrimers resulted in (LyP-1)4- and (ARAL)4-dendrimers with optical (FAM) and PET probes (6-BAT). For PET-CT studies, (LyP-1)4- and (ARAL)4-dendrimer-6-BAT were labeled with (64)Cu (t1/2 = 12.7 h) and intravenously injected into the atherosclerotic (ApoE(-/-)) mice. After two hours of circulation, PET-CT coregistered images demonstrated greater uptake of the (LyP-1)4-dendrimer-(64)Cu than the (ARAL)4-dendrimer-(64)Cu in the aortic root and descending aorta. Ex vivo images and the biodistribution acquired at three hours after injection also demonstrated a significantly higher uptake of the (LyP-1)4-dendrimer-(64)Cu (1.1 ± 0.26%ID/g) than the (ARAL)4-dendrimer-(64)Cu (0.22 ± 0.05%ID/g) in the aorta. Similarly, subcutaneous injection of the LyP-1-dendrimeric carriers resulted in preferential accumulation in plaque-containing regions over 24 h. In the same model system, ex vivo fluorescence images within aortic plaque depict an increased accumulation and penetration of the (LyP-1)4-dendrimer-FAM as compared to the (ARAL)4-dendrimer-FAM. Taken together, the results suggest that the (LyP-1)4-dendrimer can be applied for in vivo PET imaging of plaque and that LyP-1 could be further exploited for the delivery of therapeutics with multivalent carriers or nanoparticles.
Collapse
Affiliation(s)
- Jai Woong Seo
- Department of Biomedical Engineering, University of California , Davis, California 95616, United States
| | | | | | | | | | | | | |
Collapse
|
6
|
Bucerius J, Mani V, Moncrieff C, Machac J, Fuster V, Farkouh ME, Tawakol A, Rudd JHF, Fayad ZA. Optimizing 18F-FDG PET/CT imaging of vessel wall inflammation: the impact of 18F-FDG circulation time, injected dose, uptake parameters, and fasting blood glucose levels. Eur J Nucl Med Mol Imaging 2013; 41:369-83. [PMID: 24271038 DOI: 10.1007/s00259-013-2569-6] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 08/30/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE (18)F-FDG PET is increasingly used for imaging of vessel wall inflammation. However, limited data are available on the impact of methodological variables, i.e. prescan fasting glucose, FDG circulation time and injected FDG dose, and of different FDG uptake parameters, in vascular FDG PET imaging. METHODS Included in the study were 195 patients who underwent vascular FDG PET/CT of the aorta and the carotids. Arterial standardized uptake values (meanSUVmax), target-to-background ratios (meanTBRmax) and FDG blood-pool activity in the superior vena cava (SVC) and the jugular veins (JV) were quantified. Vascular FDG uptake values classified according to the tertiles of prescan fasting glucose levels, the FDG circulation time, and the injected FDG dose were compared using ANOVA. Multivariate regression analyses were performed to identify the potential impact of all variables described on the arterial and blood-pool FDG uptake. RESULTS Tertile analyses revealed FDG circulation times of about 2.5 h and prescan glucose levels of less than 7.0 mmol/l, showing a favorable relationship between arterial and blood-pool FDG uptake. FDG circulation times showed negative associations with aortic meanSUVmax values as well as SVC and JV FDG blood-pool activity, but positive correlations with aortic and carotid meanTBRmax values. Prescan glucose levels were negatively associated with aortic and carotid meanTBRmax and carotid meanSUVmax values, but were positively correlated with SVC blood-pool uptake. The injected FDG dose failed to show any significant association with vascular FDG uptake. CONCLUSION FDG circulation times and prescan blood glucose levels significantly affect FDG uptake in the aortic and carotid walls and may bias the results of image interpretation in patients undergoing vascular FDG PET/CT. The injected FDG dose was less critical. Therefore, circulation times of about 2.5 h and prescan glucose levels less than 7.0 mmol/l should be preferred in this setting.
Collapse
Affiliation(s)
- Jan Bucerius
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, P.O. Box 1234, New York, NY, 10029, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Rosa GM, Bauckneht M, Masoero G, Mach F, Quercioli A, Seitun S, Balbi M, Brunelli C, Parodi A, Nencioni A, Vuilleumier N, Montecucco F. The vulnerable coronary plaque: update on imaging technologies. Thromb Haemost 2013; 110:706-22. [PMID: 23803753 DOI: 10.1160/th13-02-0121] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 06/01/2013] [Indexed: 12/21/2022]
Abstract
Several studies have been carried out on vulnerable plaque as the main culprit for ischaemic cardiac events. Historically, the most important diagnostic technique for studying coronary atherosclerotic disease was to determine the residual luminal diameter by angiographic measurement of the stenosis. However, it has become clear that vulnerable plaque rupture as well as thrombosis, rather than stenosis, triggers most acute ischaemic events and that the quantification of risk based merely on severity of the arterial stenosis is not sufficient. In the last decades, substantial progresses have been made on optimisation of techniques detecting the arterial wall morphology, plaque composition and inflammation. To date, the use of a single technique is not recommended to precisely identify the progression of the atherosclerotic process in human beings. In contrast, the integration of data that can be derived from multiple methods might improve our knowledge about plaque destabilisation. The aim of this narrative review is to update evidence on the accuracy of the currently available non-invasive and invasive imaging techniques in identifying components and morphologic characteristics associated with coronary plaque vulnerability.
Collapse
Affiliation(s)
- Gian Marco Rosa
- Fabrizio Montecucco, MD, PhD, Division of Cardiology, Faculty of Medicine, Geneva University Hospital, Avenue de la Roseraie 64, 1211 Geneva 4, Switzerland, Tel.: +41 22 372 71 92, Fax: +41 22 382 72 45, E-mail:
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Abstract
The underlying pathologic mechanism of most acute coronary syndromes is atherosclerotic plaque rupture. One cause of rupture is plaque inflammation, leading to fibrous cap destabilization. Several imaging techniques, including x-ray coronary angiography and multislice CT, can be used for the detection of coronary atherosclerosis. However, these anatomical methods cannot measure arterial inflammation. Positron emission tomography imaging of atherosclerosis using the metabolic marker fluorodeoxyglucose allows quantification of arterial inflammation across multiple vessels. This review discusses the rationale, utility, potential future applications, and limitations of this emerging biomarker of cardiovascular risk.
Collapse
|
9
|
Abstract
Computed tomography coronary angiography (CTCA) and myocardial perfusion imaging techniques (single photon emission computed tomography, SPECT, or positron emission tomography, PET) are established non-invasive modalities for the diagnosis of coronary artery disease (CAD). Cardiac hybrid imaging consists of the combination (or 'fusion') of both modalities and allows obtaining complementary morphological (coronary anatomy, stenoses) and functional (myocardial perfusion) information in a single setting. However, hybrid cardiac imaging has also generated controversy with regard to which patients should undergo such integrated examinations for clinical effectiveness and minimization of costs and radiation dose. The feasibility and clinical value of hybrid imaging has been documented in small cohort studies and selected series of patients. Hybrid imaging appears to offer superior diagnostic and prognostic information compared with stand-alone or side-by-side interpretation of data sets. Particularly in patients with multivessel disease, the hybrid approach allows identification of flow-limiting coronary lesions and thereby provides useful information for the planning of revascularization procedures. Furthermore, integration of the detailed anatomical information from CTCA with the high molecular sensitivity of SPECT and PET may be useful to evaluate targeted molecular and cellular abnormalities in the future. While currently still restricted to specialized cardiac centres, the ongoing efforts to reduce radiation exposure and the increasing clinical interest will further pave the way for an increasing use of cardiac hybrid imaging in clinical practice.
Collapse
Affiliation(s)
- Oliver Gaemperli
- Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland.
| | | | | |
Collapse
|