1
|
Franchi F, Olthoff M, Krier J, Noble C, Al-Hijji M, Ramaswamy V, Witt T, Burke M, Benscoter M, Lerman A, Sandhu GS, Rodriguez-Porcel M. A Metabolic Intravascular Platform to Study FDG Uptake in Vascular Injury. Cardiovasc Eng Technol 2020; 11:328-336. [PMID: 32002814 DOI: 10.1007/s13239-020-00457-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/24/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Metabolic alterations underlie many pathophysiological conditions, and their understanding is critical for the development of novel therapies. Although the assessment of metabolic changes in vivo has been historically challenging, recent developments in molecular imaging have allowed us to study novel metabolic research concepts directly in the living subject, bringing us closer to patients. However, in many instances, there is need for sensors that are in close proximity to the organ under investigation, for example to study vascular metabolism. METHODS In this study, we developed and validated a metabolic detection platform directly in the living subject under an inflammatory condition. The signal collected by a scintillating fiber is amplified using a photomultiplier tube and decodified by an in-house tunable analysis platform. For in vivo testing, we based our experiments on the metabolic characteristics of macrophages, cells closely linked to inflammation and avid for glucose and its analog 18F-fluorodeoxyglucose (18F-FDG). The sensor was validated in New Zealand rabbits, in which inflammation was induced by either a) high cholesterol (HC) diet for 16 weeks or b) vascular balloon endothelial denudation followed by HC diet. RESULTS There was no difference in weight, hemodynamics, blood pressure, or heart rate between the groups. Vascular inflammation was detected by the metabolic sensor (Inflammation: 0.60 ± 0.03 AU vs. control: 0.48 ± 0.03 AU, p = 0.01), even though no significant inflammation/atherosclerosis was detected by intravascular ultrasound, underscoring the high sensitivity of the system. These findings were confirmed by the presence of macrophages on ex vivo aortic tissue staining. CONCLUSION In this study, we validated a tunable very sensitive metabolic sensor platform that can be used for the detection of vascular metabolism, such as inflammation. This sensor can be used not only for the detection of macrophage activity but, with alternative probes, it could allow the detection of other pathophysiological processes.
Collapse
Affiliation(s)
- F Franchi
- Department of Cardiovascular Medicine, Mayo Clinic School of Medicine Rochester, Mayo Clinic, 200 First St SW, Rochester, MN, 55902, USA.
| | - M Olthoff
- Department of Cardiovascular Medicine, Mayo Clinic School of Medicine Rochester, Mayo Clinic, 200 First St SW, Rochester, MN, 55902, USA
| | - J Krier
- Department of Physiology and Biomedical Engineering, Mayo Clinic School of Medicine Rochester, Rochester, MN, 55902, USA
| | - C Noble
- Department of Cardiovascular Medicine, Mayo Clinic School of Medicine Rochester, Mayo Clinic, 200 First St SW, Rochester, MN, 55902, USA
| | - M Al-Hijji
- Department of Cardiovascular Medicine, Mayo Clinic School of Medicine Rochester, Mayo Clinic, 200 First St SW, Rochester, MN, 55902, USA
| | - V Ramaswamy
- Department of Cardiovascular Medicine, Mayo Clinic School of Medicine Rochester, Mayo Clinic, 200 First St SW, Rochester, MN, 55902, USA
| | - T Witt
- Department of Cardiovascular Medicine, Mayo Clinic School of Medicine Rochester, Mayo Clinic, 200 First St SW, Rochester, MN, 55902, USA
| | - M Burke
- Division of Engineering, Mayo Clinic School of Medicine Rochester, Rochester, MN, 55902, USA
| | - M Benscoter
- Division of Engineering, Mayo Clinic School of Medicine Rochester, Rochester, MN, 55902, USA
| | - A Lerman
- Department of Cardiovascular Medicine, Mayo Clinic School of Medicine Rochester, Mayo Clinic, 200 First St SW, Rochester, MN, 55902, USA
| | - G S Sandhu
- Department of Cardiovascular Medicine, Mayo Clinic School of Medicine Rochester, Mayo Clinic, 200 First St SW, Rochester, MN, 55902, USA
| | - M Rodriguez-Porcel
- Department of Cardiovascular Medicine, Mayo Clinic School of Medicine Rochester, Mayo Clinic, 200 First St SW, Rochester, MN, 55902, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic School of Medicine Rochester, Rochester, MN, 55902, USA
| |
Collapse
|
2
|
Van Oosterom MN, Rietbergen DDD, Welling MM, Van Der Poel HG, Maurer T, Van Leeuwen FWB. Recent advances in nuclear and hybrid detection modalities for image-guided surgery. Expert Rev Med Devices 2019; 16:711-734. [PMID: 31287715 DOI: 10.1080/17434440.2019.1642104] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction: Radioguided surgery is an ever-evolving part of nuclear medicine. In fact, this nuclear medicine sub-discipline actively bridges non-invasive molecular imaging with surgical care. Next to relying on the availability of radio- and bimodal-tracers, the success of radioguided surgery is for a large part dependent on the imaging modalities and imaging concepts available for the surgical setting. With this review, we have aimed to provide a comprehensive update of the most recent advances in the field. Areas covered: We have made an attempt to cover all aspects of radioguided surgery: 1) the use of radioisotopes that emit γ, β+, and/or β- radiation, 2) hardware developments ranging from probes to 2D cameras and even the use of advanced 3D interventional imaging solutions, and 3) multiplexing solutions such as dual-isotope detection or combined radionuclear and optical detection. Expert opinion: Technical refinements in the field of radioguided surgery should continue to focus on supporting its implementation in the increasingly complex minimally invasive surgical setting, e.g. by accommodating robot-assisted laparoscopic surgery. In addition, hybrid concepts that integrate the use of radioisotopes with other image-guided surgery modalities such as fluorescence or ultrasound are likely to expand in the future.
Collapse
Affiliation(s)
- Matthias N Van Oosterom
- a Interventional Molecular Imaging laboratory, Department of Radiology, Leiden University Medical Center , Leiden , the Netherlands.,b Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital , Amsterdam , the Netherlands
| | - Daphne D D Rietbergen
- a Interventional Molecular Imaging laboratory, Department of Radiology, Leiden University Medical Center , Leiden , the Netherlands.,c Department of Radiology, Section Nuclear Medicine, Leiden University Medical Center , Leiden , the Netherlands
| | - Mick M Welling
- a Interventional Molecular Imaging laboratory, Department of Radiology, Leiden University Medical Center , Leiden , the Netherlands
| | - Henk G Van Der Poel
- b Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital , Amsterdam , the Netherlands
| | - Tobias Maurer
- d Martini-Clinic, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Fijs W B Van Leeuwen
- a Interventional Molecular Imaging laboratory, Department of Radiology, Leiden University Medical Center , Leiden , the Netherlands.,b Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital , Amsterdam , the Netherlands.,e Orsi Academy , Melle , Belgium
| |
Collapse
|
3
|
Zaman RT, Yousefi S, Long SR, Saito T, Mandella M, Qiu Z, Chen R, Contag CH, Gambhir SS, Chin FT, Khuri-Yakub BT, McConnell MV, Shung KK, Xing L. A Dual-Modality Hybrid Imaging System Harnesses Radioluminescence and Sound to Reveal Molecular Pathology of Atherosclerotic Plaques. Sci Rep 2018; 8:8992. [PMID: 29895966 PMCID: PMC5997702 DOI: 10.1038/s41598-018-26696-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 05/14/2018] [Indexed: 12/21/2022] Open
Abstract
Atherosclerosis is a progressive inflammatory condition caused by an unstable lesion, called thin-cap fibro atheromata (TCFA) that underlies coronary artery disease (CAD)-one of the leading causes of death worldwide. Therefore, early clinical diagnosis and effective risk stratification is important for CAD management as well as preventing progression to catastrophic events. However, early detection could be difficult due to their small size, motion, obscuring 18F-FDG uptake by adjacent myocardium, and complex morphological/biological features. To overcome these limitations, we developed a catheter-based Circumferential-Intravascular-Radioluminescence-Photoacoustic-Imaging (CIRPI) system that can detect vulnerable plaques in coronary arteries and characterizes them with respect to pathology and biology. Our CIRPI system combined two imaging modalities: Circumferential Radioluminescence Imaging (CRI) and PhotoAcoustic Tomography (PAT) within a novel optical probe. The probe's CaF2:Eu based scintillating imaging window provides a 360° view of human (n = 7) and murine carotid (n = 10) arterial plaques by converting β-particles into visible photons during 18F-FDG decay. A 60× and 63× higher radioluminescent signals were detected from the human and murine plaque inflammations, respectively, compared to the control. The system's photoacoustic imaging provided a comprehensive analysis of the plaque compositions and its morphologic information. These results were further verified with IVIS-200, immunohistochemical analysis, and autoradiography.
Collapse
Affiliation(s)
- Raiyan T Zaman
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, USA.
- Molecular Imaging Program at Stanford University (MIPS), Stanford University School of Medicine, Stanford, USA.
- Department of Radiology, Harvard medical School, Boston, MA, 02115, USA.
- Massachusetts General Hospital 149 13th Street, Room 5406 Charlestown, Massachusetts, 02129, USA.
| | - Siavash Yousefi
- Division of Medical Physics, Department of Radiation Oncology, Stanford University School of Medicine, Stanford, USA
| | - Steven R Long
- Department of Pathology, Stanford University School of Medicine, Stanford, USA
| | - Toshinobu Saito
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, USA
| | - Michael Mandella
- Department of Pediatrics (Neonatology), Stanford University School of Medicine, Stanford, USA
| | - Zhen Qiu
- Department of Radiology, Stanford University School of Medicine, Stanford, USA
- Michigan State University, Michigan, USA
| | - Ruimin Chen
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Stanford, USA
| | - Christopher H Contag
- Department of Pediatrics (Neonatology), Stanford University School of Medicine, Stanford, USA
- Department of Radiology, Stanford University School of Medicine, Stanford, USA
- Molecular Imaging Program at Stanford University (MIPS), Stanford University School of Medicine, Stanford, USA
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, USA
- Department of Bioengineering, Stanford University Schools of Medicine and of Engineering, Stanford, USA
| | - Sanjiv S Gambhir
- Department of Radiology, Stanford University School of Medicine, Stanford, USA
- Molecular Imaging Program at Stanford University (MIPS), Stanford University School of Medicine, Stanford, USA
- Department of Bioengineering, Stanford University Schools of Medicine and of Engineering, Stanford, USA
| | - Frederick T Chin
- Department of Radiology, Stanford University School of Medicine, Stanford, USA
- Molecular Imaging Program at Stanford University (MIPS), Stanford University School of Medicine, Stanford, USA
| | | | - Michael V McConnell
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, USA
- Molecular Imaging Program at Stanford University (MIPS), Stanford University School of Medicine, Stanford, USA
| | - K Kirk Shung
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Stanford, USA
| | - Lei Xing
- Division of Medical Physics, Department of Radiation Oncology, Stanford University School of Medicine, Stanford, USA
- Molecular Imaging Program at Stanford University (MIPS), Stanford University School of Medicine, Stanford, USA
| |
Collapse
|
4
|
Zaman RT, Kosuge H, Carpenter C, Sun C, McConnell MV, Xing L. Scintillating balloon-enabled fiber-optic system for radionuclide imaging of atherosclerotic plaques. J Nucl Med 2015; 56:771-7. [PMID: 25858046 DOI: 10.2967/jnumed.114.153239] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 03/18/2015] [Indexed: 01/28/2023] Open
Abstract
UNLABELLED Atherosclerosis underlies coronary artery disease, the leading cause of death in the United States and worldwide. Detection of coronary plaque inflammation remains challenging. In this study, we developed a scintillating balloon-enabled fiber-optic radionuclide imaging (SBRI) system to improve the sensitivity and resolution of plaque imaging using (18)F-FDG, a marker of vascular inflammation, and tested it in a murine model. METHODS The fiber-optic system uses a Complementary Metal-Oxide Silicon (CMOS) camera with a distal ferrule terminated with a wide-angle lens. The novelty of this system is a scintillating balloon in the front of the wide-angle lens to image light from the decay of (18)F-FDG emission signal. To identify the optimal scintillating materials with respect to resolution, we calculated the modulation transfer function of yttrium-aluminum-garnet doped with cerium, anthracene, and calcium fluoride doped with europium (CaF2:Eu) phosphors using an edge pattern and a thin-line optical phantom. The scintillating balloon was then fabricated from 10 mL of silicone RTV catalyst mixed with 1 mL of base and 50 mg of CaF2:Eu per mL. The addition of a lutetium oxyorthosilicate scintillating crystal (500 μm thick) to the balloon was also investigated. The SBRI system was tested in a murine atherosclerosis model: carotid-ligated mice (n = 5) were injected with (18)F-FDG, followed by ex vivo imaging of the macrophage-rich carotid plaques and nonligated controls. Confirmatory imaging of carotid plaques and controls was also performed by an external optical imaging system and autoradiography. RESULTS Analyses of the different phosphors showed that CaF2:Eu enabled the best resolution of 1.2 μm. The SBRI system detected almost a 4-fold-higher radioluminescence signal from the ligated left carotid artery than the nonligated right carotid: 1.63 × 10(2) ± 4.01 × 10(1) vs. 4.21 × 10(1) ± 2.09 × 10(0) (photon counts), P = 0.006. We found no significant benefit to adding a scintillating crystal to the balloon: 1.65 × 10(2) ± 4.07 × 10(1) vs. 4.44 × 10(1) ± 2.17 × 10(0) (photon counts), P = 0.005. Both external optical imaging and autoradiography confirmed the high signal from the (18)F-FDG in carotid plaques versus controls. CONCLUSION This SBRI system provides high-resolution and sensitive detection of (18)F-FDG uptake by murine atherosclerotic plaques.
Collapse
Affiliation(s)
- Raiyan T Zaman
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California Division of Radiation Physics, Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California; and
| | - Hisanori Kosuge
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | | | - Conroy Sun
- Division of Radiation Physics, Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California; and
| | - Michael V McConnell
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Lei Xing
- Division of Radiation Physics, Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California; and
| |
Collapse
|
5
|
Wildgruber M, Swirski FK, Zernecke A. Molecular imaging of inflammation in atherosclerosis. Am J Cancer Res 2013; 3:865-84. [PMID: 24312156 PMCID: PMC3841337 DOI: 10.7150/thno.5771] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 04/29/2013] [Indexed: 01/13/2023] Open
Abstract
Acute rupture of vulnerable plaques frequently leads to myocardial infarction and stroke. Within the last decades, several cellular and molecular players have been identified that promote atherosclerotic lesion formation, maturation and plaque rupture. It is now widely recognized that inflammation of the vessel wall and distinct leukocyte subsets are involved throughout all phases of atherosclerotic lesion development. The mechanisms that render a stable plaque unstable and prone to rupture, however, remain unknown and the identification of the vulnerable plaque remains a major challenge in cardiovascular medicine. Imaging technologies used in the clinic offer minimal information about the underlying biology and potential risk for rupture. New imaging technologies are therefore being developed, and in the preclinical setting have enabled new and dynamic insights into the vessel wall for a better understanding of this complex disease. Molecular imaging has the potential to track biological processes, such as the activity of cellular and molecular biomarkers in vivo and over time. Similarly, novel imaging technologies specifically detect effects of therapies that aim to stabilize vulnerable plaques and silence vascular inflammation. Here we will review the potential of established and new molecular imaging technologies in the setting of atherosclerosis, and discuss the cumbersome steps required for translating molecular imaging approaches into the clinic.
Collapse
|
6
|
Yang Y, Biswal NC, Wang T, Kumavor PD, Karimeddini M, Vento J, Sanders M, Brewer M, Zhu Q. Potential role of a hybrid intraoperative probe based on OCT and positron detection for ovarian cancer detection and characterization. BIOMEDICAL OPTICS EXPRESS 2011; 2:1918-30. [PMID: 21750769 PMCID: PMC3130578 DOI: 10.1364/boe.2.001918] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Revised: 06/04/2011] [Accepted: 06/09/2011] [Indexed: 05/04/2023]
Abstract
Ovarian cancer has the lowest survival rate of the gynecologic cancers because it is predominantly diagnosed in the late stages due to the lack of reliable symptoms and efficacious screening techniques. A novel hybrid intraoperative probe has been developed and evaluated for its potential role in detecting and characterizing ovarian tissue. The hybrid intraoperative dual-modality device consists of multiple scintillating fibers and an optical coherence tomography imaging probe for simultaneously mapping the local activities of (18)F-FDG uptake and imaging of local morphological changes of the ovary. Ten patients were recruited to the study and a total of 18 normal, abnormal and malignant ovaries were evaluated ex vivo using this device. Positron count rates of 7.5/8.8-fold higher were found between malignant and abnormal/normal ovaries. OCT imaging of malignant and abnormal ovaries revealed many detailed morphologic features that could be potentially valuable for evaluating local regions with high metabolic activities and detecting early malignant changes in the ovary. These initial results have demonstrated that our novel hybrid imager has great potential for ovarian cancer detection and characterization during minimally invasive endoscopic procedures.
Collapse
Affiliation(s)
- Yi Yang
- University of Connecticut, Dept. of Electrical and Computer Engineering, Storrs, CT 06269, USA
| | - Nrusingh C. Biswal
- University of Connecticut, Dept. of Electrical and Computer Engineering, Storrs, CT 06269, USA
| | - Tianheng Wang
- University of Connecticut, Dept. of Electrical and Computer Engineering, Storrs, CT 06269, USA
| | - Patrick D. Kumavor
- University of Connecticut, Dept. of Electrical and Computer Engineering, Storrs, CT 06269, USA
| | | | - John Vento
- University of Connecticut Health Center, Division of Radiology, Farmington, CT 06030, USA
| | - Melinda Sanders
- University of Connecticut Health Center, Division of Pathology, Farmington, CT 06030, USA
| | - Molly Brewer
- University of Connecticut, Dept. of Electrical and Computer Engineering, Storrs, CT 06269, USA
- University of Connecticut Health Center, Division of Gynecologic Oncology, Farmington, CT 06030, USA
| | - Quing Zhu
- University of Connecticut, Dept. of Electrical and Computer Engineering, Storrs, CT 06269, USA
| |
Collapse
|
7
|
Uchida Y, Uchida Y, Sugiyama Y, Tomaru T, Kawai S, Kanamaru R, Shimoyama E. Two-dimensional visualization of cholesterol and cholesteryl esters within human coronary plaques by near-infrared fluorescence angioscopy. Clin Cardiol 2011; 33:775-82. [PMID: 21184563 DOI: 10.1002/clc.20780] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Cholesterol (C) and cholesteryl esters (CE) within coronary plaques are minimally visualized directly by any of the available imaging modalities in vivo. If they are rendered visible in vivo, the progression of coronary plaques and the effects of respective therapies on these plaques can be objectively evaluated. HYPOTHESIS The C and CE within human coronary plaques can be visualized by near-infrared fluorescence angioscopy (NIRFA). METHODS By exciting at 710 ± 25 nm and emitting at 780 nm, near-infrared fluorescence (NIRF) of lipid components was examined by microscopy in vitro. Lipid components in 49 plaques of 32 excised human coronary arteries were examined by NIRFA in vitro. Coronary plaques were examined by NIRFA in 25 patients with coronary artery disease. RESULTS C, CE, and calcium (Ca) individually did not exhibit NIRF but did in the presence of β-carotene, which is known to coexist with lipids in the vascular wall. Other substances that are contained in atherosclerotic plaques did not.² The excised human coronary plaques were classified as those with NIRF and those without. The former plaques were classified into homogenous, doughnut-shaped, and spotty types. Histological examinations revealed that these image patterns were determined by the differences in the locations of C, CE, and Ca, and that those deposited within 700 μm in depth from the plaque surface were imaged by NIRFA. Homogenous, doughnut-shaped, or spotty NIRFA images were also observed in patients. CONCLUSIONS NIRFA is feasible for 2-dimensional imaging of C and CE deposited in human coronary plaques.
Collapse
Affiliation(s)
- Yasumi Uchida
- Department of Cardiology, Chiba-kensei Hospital, Japan.
| | | | | | | | | | | | | |
Collapse
|
8
|
Emerging Molecular Targets for Intravascular Imaging of High-Risk Plaques. CURRENT CARDIOVASCULAR IMAGING REPORTS 2010. [DOI: 10.1007/s12410-010-9028-6] [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]
|
9
|
O'Donnell M, McVeigh ER, Strauss HW, Tanaka A, Bouma BE, Tearney GJ, Guttman MA, Garcia EV. Multimodality cardiovascular molecular imaging technology. J Nucl Med 2010; 51 Suppl 1:38S-50S. [PMID: 20457794 DOI: 10.2967/jnumed.109.068155] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Cardiovascular molecular imaging is a new discipline that integrates scientific advances in both functional imaging and molecular probes to improve our understanding of the molecular basis of the cardiovascular system. These advances are driven by in vivo imaging of molecular processes in animals, usually small animals, and are rapidly moving toward clinical applications. Molecular imaging has the potential to revolutionize the diagnosis and treatment of cardiovascular disease. The 2 key components of all molecular imaging systems are the molecular contrast agents and the imaging system providing spatial and temporal localization of these agents within the body. They must deliver images with the appropriate sensitivity and specificity to drive clinical applications. As work in molecular contrast agents matures and highly sensitive and specific probes are developed, these systems will provide the imaging technologies required for translation into clinical tools. This is the promise of molecular medicine.
Collapse
|
10
|
Shikhaliev PM, Petrek P, Matthews KL, Fritz SG, Bujenovic LS, Xu T. Intravascular imaging with a storage phosphor detector. Phys Med Biol 2010; 55:2841-61. [DOI: 10.1088/0031-9155/55/10/004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
11
|
Riou LM, Broisat A, Dimastromatteo J, Pons G, Fagret D, Ghezzi C. Pre-clinical and clinical evaluation of nuclear tracers for the molecular imaging of vulnerable atherosclerosis: an overview. Curr Med Chem 2009; 16:1499-511. [PMID: 19355903 DOI: 10.2174/092986709787909596] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Cardiovascular diseases (CVD) are the leading cause of mortality worldwide. Despite major advances in the treatment of CVD, a high proportion of CVD victims die suddenly while being apparently healthy, the great majority of these accidents being due to the rupture or erosion of a vulnerable coronary atherosclerotic plaque. A non-invasive imaging methodology allowing the early detection of vulnerable atherosclerotic plaques in selected individuals prior to the occurrence of any symptom would therefore be of great public health benefit. Nuclear imaging could allow the identification of vulnerable patients by non-invasive in vivo scintigraphic imaging following administration of a radiolabeled tracer. The purpose of this review is to provide an overview of radiotracers that have been recently evaluated for the detection of vulnerable plaques together with the biological rationale that initiated their development. Radiotracers targeted at the inflammatory process seem particularly relevant and promising. Recently, macrophage targeting allowed the experimental in vivo detection of atherosclerosis using either SPECT or PET. A few tracers have also been evaluated clinically. Targeting of apoptosis and macrophage metabolism both allowed the imaging of vulnerable plaques in carotid vessels of patients. However, nuclear imaging of vulnerable plaques at the level of coronary arteries remains challenging, mostly because of their small size and their vicinity with unbound circulating tracer. The experimental and pilot clinical studies reviewed in the present paper represent a fundamental step prior to the evaluation of the efficacy of any selected tracer for the early, non-invasive detection of vulnerable patients.
Collapse
Affiliation(s)
- L M Riou
- INSERM, U877, Radiopharmaceutiques Biocliniques, Faculté de Médecine de Grenoble, F-38700, La tronche, France.
| | | | | | | | | | | |
Collapse
|
12
|
|
13
|
|
14
|
Vesely MR, Dilsizian V. Nuclear Cardiac Stress Testing in the Era of Molecular Medicine. J Nucl Med 2008; 49:399-413. [DOI: 10.2967/jnumed.107.033530] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
15
|
Young JJ, Phillips HR, Marso SP, Granada JF, McPherson JA, Waksman R, Steinhubl SR, Schwartz RS, Stone GW. Vulnerable plaque intervention: State of the art. Catheter Cardiovasc Interv 2008; 71:367-74. [DOI: 10.1002/ccd.21354] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
16
|
Affiliation(s)
- Farouc A Jaffer
- Center for Molecular Imaging Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA.
| | | | | |
Collapse
|
17
|
Zhao Y, Kuge Y, Zhao S, Morita K, Inubushi M, Strauss HW, Blankenberg FG, Tamaki N. Comparison of 99mTc-annexin A5 with 18F-FDG for the detection of atherosclerosis in ApoE-/- mice. Eur J Nucl Med Mol Imaging 2007; 34:1747-55. [PMID: 17437104 DOI: 10.1007/s00259-007-0433-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Accepted: 03/07/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE (99m)Tc-annexin A5, a marker of ongoing apoptosis, and (18)F-FDG, a marker of the increased metabolism of inflammatory cells, are supposed to be useful in the detection of metabolically active atheroma. This study reports a comparison of the intralesional distribution of these tracers in relation to lesion development in ApoE-/- mice. METHODS Male ApoE-/- mice (n = 12-14/group) were maintained on a Western-type diet after the age of 5 weeks. At 25 weeks, (99m)Tc-annexin A5 or (18)F-FDG was injected and the aortas were harvested for autoradiography (ARG) and Oil Red O staining. Regional radioactivity accumulation was compared in relation to the Oil Red O staining score (ranging from 0 to 3, a semiquantitative parameter for evaluating lesion development). RESULTS Both (99m)Tc-annexin A5 and (18)F-FDG showed preferential uptake into atherosclerotic lesions, with higher uptake levels for (18)F-FDG (mean, 56.07 %IDxkg/m(2)) than for (99m)Tc-annexin A5 (mean, 10.38 %IDxkg/m(2)). The regional uptake levels of each tracer correlated with the Oil Red O staining score (r = 0.65, p < 0.05 for (99m)Tc-annexin A5; r = 0.56, p < 0.05 for (18)F-FDG). The uptake ratios of advanced lesions (score >0.5) to early lesions (score <0.5) were significantly higher for (99m)Tc-annexin A5 than for (18)F-FDG (f = 4.73, p = 0.03). CONCLUSION Both (99m)Tc-annexin A5 and (18)F-FDG accumulate in atherosclerotic lesions and correlate with the severity of each lesion. The higher absolute uptake levels of (18)F-FDG may be advantageous for lesion detection, whereas the preferential uptake of (99m)Tc-annexin A5 in advanced lesions may be a useful indicator of late-stage lesions or vulnerable plaque transformation.
Collapse
Affiliation(s)
- Yan Zhao
- Department of Nuclear Medicine, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
| | | | | | | | | | | | | | | |
Collapse
|