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Vyakaranam AR, Mahamed MM, Hellman P, Eriksson O, Espes D, Christoffersson G, Sundin A. Non-invasive imaging of sympathetic innervation of the pancreas in individuals with type 2 diabetes. Diabetologia 2024; 67:199-208. [PMID: 37935826 PMCID: PMC10709256 DOI: 10.1007/s00125-023-06039-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/31/2023] [Indexed: 11/09/2023]
Abstract
AIMS/HYPOTHESIS Compromised pancreatic sympathetic innervation has been suggested as a factor involved in both immune-mediated beta cell destruction and endocrine dysregulation of pancreatic islets. To further explore these intriguing findings, new techniques for in vivo assessment of pancreatic innervation are required. This is a retrospective study that aimed to investigate whether the noradrenaline (norepinephrine) analogue 11C-hydroxy ephedrine (11C-HED) could be used for quantitative positron emission tomography (PET) imaging of the sympathetic innervation of the human pancreas. METHODS In 25 individuals with type 2 diabetes and 64 individuals without diabetes, all of whom had previously undergone 11C-HED-PET/CT because of pheochromocytoma or paraganglioma (or suspicion thereof), the 11C-HED standardised uptake value (SUVmean), 11C-HED specific binding index (SBI), pancreatic functional volume (FV, in ml), functional neuronal volume (FNV, calculated as SUVmean × FV), specific binding index with functional volume (SBI FV, calculated as SBI × FV) and attenuation on CT (HU) were investigated in the entire pancreas, and additionally in six separate anatomical pancreatic regions. RESULTS Generally, 11C-HED uptake in the pancreas was high, with marked individual variation, suggesting variability in sympathetic innervation. Moreover, pancreatic CT attenuation (HU) (p<0.001), 11C-HED SBI (p=0.0049) and SBI FV (p=0.0142) were lower in individuals with type 2 diabetes than in individuals without diabetes, whereas 11C-HED SUVmean (p=0.15), FV (p=0.73) and FNV (p=0.30) were similar. CONCLUSIONS/INTERPRETATION We demonstrate the feasibility of using 11C-HED-PET for non-invasive assessment of pancreatic sympathetic innervation in humans. These findings warrant further prospective evaluation, especially in individuals with theoretical defects in pancreatic sympathetic innervation, such as those with type 1 diabetes.
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Affiliation(s)
- Achyut Ram Vyakaranam
- Department of Surgical Sciences, Section of Radiology & Molecular Imaging, Uppsala University, Uppsala, Sweden.
| | - Maryama M Mahamed
- Department of Surgical Sciences, Section of Radiology & Molecular Imaging, Uppsala University, Uppsala, Sweden
| | - Per Hellman
- Department of Surgical Sciences, Section of Radiology & Molecular Imaging, Uppsala University, Uppsala, Sweden
| | - Olof Eriksson
- Science for Life Laboratory, Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Daniel Espes
- Science for Life Laboratory, Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Gustaf Christoffersson
- Science for Life Laboratory, Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Anders Sundin
- Department of Surgical Sciences, Section of Radiology & Molecular Imaging, Uppsala University, Uppsala, Sweden
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Klenner MA, Pascali G, Fraser BH, Darwish TA. Kinetic isotope effects and synthetic strategies for deuterated carbon-11 and fluorine-18 labelled PET radiopharmaceuticals. Nucl Med Biol 2021; 96-97:112-147. [PMID: 33892374 DOI: 10.1016/j.nucmedbio.2021.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/19/2021] [Accepted: 03/30/2021] [Indexed: 11/22/2022]
Abstract
The deuterium labelling of pharmaceuticals is a useful strategy for altering pharmacokinetic properties, particularly for improving metabolic resistance. The pharmacological effects of such metabolites are often assumed to be negligible during standard drug discovery and are factored in later at the clinical phases of development, where the risks and benefits of the treatment and side-effects can be wholly assessed. This paradigm does not translate to the discovery of radiopharmaceuticals, however, as the confounding effects of radiometabolites can inevitably show in preliminary positron emission tomography (PET) scans and thus complicate interpretation. Consequently, the formation of radiometabolites is crucial to take into consideration, compared to non-radioactive metabolites, and the application of deuterium labelling is a particularly attractive approach to minimise radiometabolite formation. Herein, we provide a comprehensive overview of the deuterated carbon-11 and fluorine-18 radiopharmaceuticals employed in PET imaging experiments. Specifically, we explore six categories of deuterated radiopharmaceuticals used to investigate the activities of monoamine oxygenase (MAO), choline, translocator protein (TSPO), vesicular monoamine transporter 2 (VMAT2), neurotransmission and the diagnosis of Alzheimer's disease; from which we derive four prominent deuteration strategies giving rise to a kinetic isotope effect (KIE) for reducing the rate of metabolism. Synthetic approaches for over thirty of these deuterated radiopharmaceuticals are discussed from the perspective of deuterium and radioisotope incorporation, alongside an evaluation of the deuterium labelling and radiolabelling efficacies across these independent studies. Clinical and manufacturing implications are also discussed to provide a more comprehensive overview of how deuterated radiopharmaceuticals may be introduced to routine practice.
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Affiliation(s)
- Mitchell A Klenner
- National Deuteration Facility (NDF) & Human Health, Australian Nuclear Science and Technology Organisation (ANSTO), Lucas Heights, NSW 2234, Australia; Department of Nuclear Medicine and PET, Liverpool Hospital, Liverpool, NSW 2170, Australia.
| | - Giancarlo Pascali
- National Deuteration Facility (NDF) & Human Health, Australian Nuclear Science and Technology Organisation (ANSTO), Lucas Heights, NSW 2234, Australia; Department of Nuclear Medicine and PET, Prince of Wales Hospital, Randwick, NSW 2031, Australia; School of Chemistry, University of New South Wales (UNSW), Kensington, NSW 2052, Australia
| | - Benjamin H Fraser
- National Deuteration Facility (NDF) & Human Health, Australian Nuclear Science and Technology Organisation (ANSTO), Lucas Heights, NSW 2234, Australia
| | - Tamim A Darwish
- National Deuteration Facility (NDF) & Human Health, Australian Nuclear Science and Technology Organisation (ANSTO), Lucas Heights, NSW 2234, Australia
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Pei C, Baotong F, Zhiming Z, Haohui T, Shuangquan L, Xiaoli S, Peilin W, Xiaoming W, Xudong Z, Long W. NEMA NU-4 performance evaluation of a non-human primate animal PET. Phys Med Biol 2019; 64:105018. [PMID: 30947155 DOI: 10.1088/1361-6560/ab1614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The Eplus-260 primate PET is an animal PET imaging system developed by the Institute of High Energy Physics, Chinese Academy of Sciences, which is designed to image non-human primates, especially the brain of large non-human primates. The system consists of 48 block detectors arranged in two 24-sided rings with a ring diameter of 263 mm and an axial extent of 64 mm. Each block detector is composed of a 16 × 16 cerium-doped lutetium-yttrium orthosilicate crystal array with a pixel size of 1.9 × 1.9 × 10 mm3. This article presents a performance evaluation of the PET scanner according to the National Electrical Manufacturers Association NU-4 2008 standards. All measurements were made for an energy window of 360-660 keV and a coincidence timing window of 2 ns. In terms of the FWHM, the FBP reconstructed spatial resolution results in all three directions at the radial position of 5 mm were better than or approached to 2 mm, and remained below 3.0 mm within the central 5 cm diameter of the FOV. The peak absolute sensitivity of the scanner was measured 1.80%. For a monkey-sized phantom, the scatter fraction was 34.2% and the peak noise equivalent count rate (NECR) was 26.5 kcps at 64.3 kBq/cc. The overall imaging capabilities of the scanner were also assessed using in vivo imaging study of a rhesus macaque. The performance measurements demonstrate that the Eplus-260 primate PET scanner has the potential ability to obtain good quality and high-contrast images for non-human primates, especially the brain of large non-human primates and could be considered as one technologically advanced dedicated non-human primate PET scanner available today.
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Affiliation(s)
- Chai Pei
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, People's Republic of China
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Naganawa M, Lim K, Nabulsi NB, Lin SF, Labaree D, Ropchan J, Herold KC, Huang Y, Harris P, Ichise M, Cline GW, Carson RE. Evaluation of Pancreatic VMAT2 Binding with Active and Inactive Enantiomers of [ 18F]FP-DTBZ in Healthy Subjects and Patients with Type 1 Diabetes. Mol Imaging Biol 2019; 20:835-845. [PMID: 29468404 DOI: 10.1007/s11307-018-1170-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Previous studies demonstrated the utility of [18F]fluoropropyl-(+)-dihydrotetrabenazine ([18F]FP-(+)-DTBZ) as a positron emission tomography (PET) radiotracer for the vesicular monoamine transporter type 2 (VMAT2) to quantify beta cell mass in healthy control (HC) and type 1 diabetes mellitus (T1DM) groups. Quantification of specific binding requires measurement of non-displaceable uptake. Our goal was to identify a reference tissue (renal cortex or spleen) to quantify pancreatic non-specific binding of [18F]FP-(+)-DTBZ with the inactive enantiomer, [18F]FP-(-)-DTBZ. This was the first human study of [18F]FP-(-)-DTBZ. PROCEDURES Six HCs and four T1DM patients were scanned on separate days after injection of [18F]FP-(+)-DTBZ or [18F]FP-(-)-DTBZ. Distribution volumes (VT) and standardized uptake values (SUVs) were compared between groups. Three methods for calculation of non-displaceable uptake (VND) or reference SUV were applied: (1) use of [18F]FP-(+)-DTBZ reference VT as VND, assuming VND is uniform across organs; (2) use of [18F]FP-(-)-DTBZ pancreatic VT as VND, assuming that VND is uniform between enantiomers in the pancreas; and (3) use of a scaled [18F]FP-(+)-DTBZ reference VT as VND, assuming that a ratio of non-displaceable uptake between organs is uniform between enantiomers. Group differences in VT (or SUV), binding potential (BPND), or SUV ratio (SUVR) were estimated using these three methods. RESULTS [18F]FP-(-)-DTBZ VT values were different among organs, and VT(+) and VT(-) were also different in the renal cortex and spleen. Method 3 with the spleen to estimate VND (or reference SUV) gave the highest non-displaceable uptake and the largest HC vs. T1DM group differences. Significant group differences were also observed in VT (or SUV) with method 1 using spleen. SUV was affected by differences in the input function between groups and between enantiomers. CONCLUSIONS Non-displaceable uptake was different among organs and between enantiomers. Use of scaled spleen VT values for VND is a suitable method for quantification of VMAT2 in the pancreas.
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Affiliation(s)
- Mika Naganawa
- Yale University, P.O. Box 208048, New Haven, CT, 06520-8048, USA.
| | - Keunpoong Lim
- Yale University, P.O. Box 208048, New Haven, CT, 06520-8048, USA
| | - Nabeel B Nabulsi
- Yale University, P.O. Box 208048, New Haven, CT, 06520-8048, USA
| | - Shu-Fei Lin
- Yale University, P.O. Box 208048, New Haven, CT, 06520-8048, USA
| | - David Labaree
- Yale University, P.O. Box 208048, New Haven, CT, 06520-8048, USA
| | - Jim Ropchan
- Yale University, P.O. Box 208048, New Haven, CT, 06520-8048, USA
| | - Kevan C Herold
- Yale University, P.O. Box 208048, New Haven, CT, 06520-8048, USA
| | - Yiyun Huang
- Yale University, P.O. Box 208048, New Haven, CT, 06520-8048, USA
| | | | | | - Gary W Cline
- Yale University, P.O. Box 208048, New Haven, CT, 06520-8048, USA
| | - Richard E Carson
- Yale University, P.O. Box 208048, New Haven, CT, 06520-8048, USA
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Wei W, Ehlerding EB, Lan X, Luo QY, Cai W. Molecular imaging of β-cells: diabetes and beyond. Adv Drug Deliv Rev 2019; 139:16-31. [PMID: 31378283 DOI: 10.1016/j.addr.2018.06.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/27/2018] [Accepted: 06/26/2018] [Indexed: 02/09/2023]
Abstract
Since diabetes is becoming a global epidemic, there is a great need to develop early β-cell specific diagnostic techniques for this disorder. There are two types of diabetes (i.e., type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM)). In T1DM, the destruction of pancreatic β-cells leads to reduced insulin production or even absolute insulin deficiency, which consequently results in hyperglycemia. Actually, a central issue in the pathophysiology of all types of diabetes is the relative reduction of β-cell mass (BCM) and/or impairment of the function of individual β-cells. In the past two decades, scientists have been trying to develop imaging techniques for noninvasive measurement of the viability and mass of pancreatic β-cells. Despite intense scientific efforts, only two tracers for positron emission tomography (PET) and one contrast agent for magnetic resonance (MR) imaging are currently under clinical evaluation. β-cell specific imaging probes may also allow us to precisely and specifically visualize transplanted β-cells and to improve transplantation outcomes, as transplantation of pancreatic islets has shown promise in treating T1DM. In addition, some of these probes can be applied to the preoperative detection of hidden insulinomas as well. In the present review, we primarily summarize potential tracers under development for imaging β-cells with a focus on tracers for PET, SPECT, MRI, and optical imaging. We will discuss the advantages and limitations of the various imaging probes and extend an outlook on future developments in the field.
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Alavi A, Werner TJ. Futility of attempts to detect and quantify beta cells by PET imaging in the pancreas: why it is time to abandon the approach. Diabetologia 2018; 61:2512-2515. [PMID: 29955934 DOI: 10.1007/s00125-018-4676-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/08/2018] [Indexed: 12/15/2022]
Abstract
In this commentary, we describe the limitations of positron emission tomography (PET) in visualising and characterising beta cell mass in the native pancreas in healthy individuals and those diagnosed with diabetes. Imaging with PET requires a large mass of targeted cells or other structures in the range of approximately 8-10 cm3. Since islets occupy only 1% of the pancreatic volume and are dispersed throughout the organ, it is our view that uptake of PET tracers, including [18F]fluoropropyl-(+)-dihydrotetrabenazine, in islets cannot be successfully detected by current imaging modalities. Therefore, we dispute the feasibility of PET imaging for the detection of loss of beta cells in the native pancreas in individuals with diabetes. However, we believe this novel approach can be successfully employed to visualise beta cell mass in individuals with hyperinsulinism and transplanted islets.
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Affiliation(s)
- Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
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Cline GW, Naganawa M, Chen L, Chidsey K, Carvajal-Gonzalez S, Pawlak S, Rossulek M, Zhang Y, Bini J, McCarthy TJ, Carson RE, Calle RA. Decreased VMAT2 in the pancreas of humans with type 2 diabetes mellitus measured in vivo by PET imaging. Diabetologia 2018; 61:2598-2607. [PMID: 29721633 DOI: 10.1007/s00125-018-4624-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/29/2018] [Indexed: 12/14/2022]
Abstract
AIMS/HYPOTHESIS The progressive loss of beta cell function is part of the natural history of type 2 diabetes. Autopsy studies suggest that this is, in part, due to loss of beta cell mass (BCM), but this has not been confirmed in vivo. Non-invasive methods to quantify BCM may contribute to a better understanding of type 2 diabetes pathophysiology and the development of therapeutic strategies. In humans, the localisation of vesicular monoamine transporter type 2 (VMAT2) in beta cells and pancreatic polypeptide cells, with minimal expression in other exocrine or endocrine pancreatic cells, has led to its development as a measure of BCM. We used the VMAT2 tracer [18F]fluoropropyl-(+)-dihydrotetrabenazine to quantify BCM in humans with impaired glucose tolerance (prediabetes) or type 2 diabetes, and in healthy obese volunteers (HOV). METHODS Dynamic positron emission tomography (PET) data were obtained for 4 h with metabolite-corrected arterial blood measurement in 16 HOV, five prediabetic and 17 type 2 diabetic participants. Eleven participants (six HOV and five with type 2 diabetes) underwent two abdominal PET/computed tomography (CT) scans for the assessment of test-retest variability. Standardised uptake value ratio (SUVR) was calculated in pancreatic subregions (head, body and tail), with the spleen as a reference region to determine non-specific tracer uptake at 3-4 h. The outcome measure SUVR minus 1 (SUVR-1) accounts for non-specific tracer uptake. Functional beta cell capacity was assessed by C-peptide release following standard (arginine stimulus test [AST]) and acute insulin response to the glucose-enhanced AST (AIRargMAX). Pearson correlation analysis was performed between the binding variables and the C-peptide AUC post-AST and post-AIRargMAX. RESULTS Absolute test-retest variability (aTRV) was ≤15% for all regions. Variability and overlap of SUVR-1 was measured in all groups; HOV and participants with prediabetes and with type 2 diabetes. SUVR-1 showed significant positive correlations with AIRargMAX (all groups) in all pancreas subregions (whole pancreas p = 0.009 and pancreas head p = 0.009; body p = 0.019 and tail p = 0.023). SUVR-1 inversely correlated with HbA1c (all groups) in the whole pancreas (p = 0.033) and pancreas head (p = 0.008). SUVR-1 also inversely correlated with years since diagnosis of type 2 diabetes in the pancreas head (p = 0.049) and pancreas tail (p = 0.035). CONCLUSIONS/INTERPRETATION The observed correlations of VMAT2 density in the pancreas and pancreas regions with years since diagnosis of type 2 diabetes, glycaemic control and beta cell function suggest that loss of BCM contributes to deficient insulin secretion in humans with type 2 diabetes.
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Affiliation(s)
- Gary W Cline
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, 06520, USA.
| | - Mika Naganawa
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, 06520, USA
| | | | | | | | | | | | | | - Jason Bini
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, 06520, USA
| | | | - Richard E Carson
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, 06520, USA
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Cline GW, McCarthy TJ, Carson RE, Calle RA. Clinical and scientific value in the pursuit of quantification of beta cells in the pancreas by PET imaging. Diabetologia 2018; 61:2671-2673. [PMID: 30136144 PMCID: PMC6219921 DOI: 10.1007/s00125-018-4718-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 08/01/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Gary W Cline
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, 06520, USA.
| | | | - Richard E Carson
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, 06520, USA
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Liu F, Choi SR, Zha Z, Ploessl K, Zhu L, Kung HF. Deuterated 18F-9-O-hexadeutero-3-fluoropropoxyl-(+)-dihydrotetrabenazine (D6-FP-(+)-DTBZ): A vesicular monoamine transporter 2 (VMAT2) imaging agent. Nucl Med Biol 2017; 57:42-49. [PMID: 29306111 DOI: 10.1016/j.nucmedbio.2017.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/21/2017] [Accepted: 11/28/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Vesicular monoamine transporters 2 (VMAT2) in the brain serve as transporter for packaging monoamine in vesicles for normal CNS neurotransmission. Several VMAT2 imaging agents, [11C]-(+)-DTBZ, dihydrotetrabenazine and [18F]FP-(+)-DTBZ (9-O-fluoropropyl-(+)-dihydro tetrabenazine, a.k.a. [18F]AV-133), are useful for studying the changes in brain function related to monoamine transmission by in vivo imaging. Deuterated analogs have been reported targeting VMAT2 binding sites. METHODS A novel deuterated [18F]9-O-hexaduterofluoropropyl-(+)-dihydrotetrabenazine, [18F]D6-FP-(+)-DTBZ, [18F]1, was prepared as a VMAT2 imaging agent. This 18F agent which targeted VMAT2 was evaluated by in vitro binding, in vivo biodistribution and microPET imaging studies in rodents. RESULTS The one step radiolabeling reaction led to the desired [18F]D6-FP-(+)-DTBZ, [18F]1, which showed excellent binding affinity to VMAT2 (Ki=0.32±0.07nM) comparable to that of FP-(+)-DTBZ (Ki=0.33±0.02nM) using [18F]FP-(+)-DTBZ and rat striatum membrane homogenates. In vivo biodistribution in normal rats showed that 1, exhibited excellent brain uptake and comparable high ratio of striatum to cerebellum (target/background) ratio at 1h after injection (ratio of 6.05±0.43 vs 5.66±0.72 for [18F]FP-(+)-DTBZ vs [18F]1, respectively). MicroPET imaging studies in rats further confirm that the striatum with high VMAT2 concentration was clearly delineated in normal rat brain after iv injection of [18F]1. We observed minor changes of metabolism in rat plasma between these two agents; however, the changes showed little effect on regional brain uptake and retention. CONCLUSIONS The results reported here lend support for using [18F]D6-FP-(+)-DTBZ, [18F]1, as in vivo PET imaging agent for VMAT2 binding in the brain.
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Affiliation(s)
- Futao Liu
- Key Laboratory of Radiopharmaceuticals, Beijing Normal University, Ministry of Education, Beijing 100875, PR China; Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Seok Rye Choi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA; Five Eleven Pharma Inc., Philadelphia, PA 19104, USA
| | - Zhihao Zha
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Karl Ploessl
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA; Five Eleven Pharma Inc., Philadelphia, PA 19104, USA
| | - Lin Zhu
- Key Laboratory of Radiopharmaceuticals, Beijing Normal University, Ministry of Education, Beijing 100875, PR China; Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hank F Kung
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA; Five Eleven Pharma Inc., Philadelphia, PA 19104, USA.
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Yang CT, Ghosh KK, Padmanabhan P, Langer O, Liu J, Halldin C, Gulyás BZ. PET probes for imaging pancreatic islet cells. Clin Transl Imaging 2017. [DOI: 10.1007/s40336-017-0251-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Jodal A, Schibli R, Béhé M. Targets and probes for non-invasive imaging of β-cells. Eur J Nucl Med Mol Imaging 2016; 44:712-727. [PMID: 28025655 PMCID: PMC5323463 DOI: 10.1007/s00259-016-3592-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 12/01/2016] [Indexed: 12/16/2022]
Abstract
β-cells, located in the islets of the pancreas, are responsible for production and secretion of insulin and play a crucial role in blood sugar regulation. Pathologic β-cells often cause serious medical conditions affecting blood glucose level, which severely impact life quality and are life-threatening if untreated. With 347 million patients, diabetes is one of the most prevalent diseases, and will continue to be one of the largest socioeconomic challenges in the future. The diagnosis still relies mainly on indirect methods like blood sugar measurements. A non-invasive diagnostic imaging modality would allow direct evaluation of β-cell mass and would be a huge step towards personalized medicine. Hyperinsulinism is another serious condition caused by β-cells that excessively secrete insulin, like for instance β-cell hyperplasia and insulinomas. Treatment options with drugs are normally not curative, whereas curative procedures usually consist of the resection of affected regions for which, however, an exact localization of the foci is necessary. In this review, we describe potential tracers under development for targeting β-cells with focus on radiotracers for PET and SPECT imaging, which allow the non-invasive visualization of β-cells. We discuss either the advantages or limitations for the various tracers and modalities. This article concludes with an outlook on future developments and discuss the potential of new imaging probes including dual probes that utilize functionalities for both a radioactive and optical moiety as well as for theranostic applications.
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Affiliation(s)
- Andreas Jodal
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institut, 5232, Villigen, Switzerland
| | - Roger Schibli
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institut, 5232, Villigen, Switzerland.,Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
| | - Martin Béhé
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institut, 5232, Villigen, Switzerland.
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Cheng G, Werner TJ, Newberg A, Alavi A. Failed PET Application Attempts in the Past, Can We Avoid Them in the Future? Mol Imaging Biol 2016; 18:797-802. [DOI: 10.1007/s11307-016-1017-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Li J, Karunananthan J, Pelham B, Kandeel F. Imaging pancreatic islet cells by positron emission tomography. World J Radiol 2016; 8:764-774. [PMID: 27721939 PMCID: PMC5039672 DOI: 10.4329/wjr.v8.i9.764] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 04/15/2016] [Accepted: 08/08/2016] [Indexed: 02/06/2023] Open
Abstract
It was estimated that every year more than 30000 persons in the United States - approximately 80 people per day - are diagnosed with type 1 diabetes (T1D). T1D is caused by autoimmune destruction of the pancreatic islet (β cells) cells. Islet transplantation has become a promising therapy option for T1D patients, while the lack of suitable tools is difficult to directly evaluate of the viability of the grafted islet over time. Positron emission tomography (PET) as an important non-invasive methodology providing high sensitivity and good resolution, is able to accurate detection of the disturbed biochemical processes and physiological abnormality in living organism. The successful PET imaging of islets would be able to localize the specific site where transplanted islets engraft in the liver, and to quantify the level of islets remain alive and functional over time. This information would be vital to establishing and evaluating the efficiency of pancreatic islet transplantation. Many novel imaging agents have been developed to improve the sensitivity and specificity of PET islet imaging. In this article, we summarize the latest developments in carbon-11, fluorine-18, copper-64, and gallium-68 labeled radioligands for the PET imaging of pancreatic islet cells.
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Naganawa M, Lin SF, Lim K, Labaree D, Ropchan J, Harris P, Huang Y, Ichise M, Carson RE, Cline GW. Evaluation of pancreatic VMAT2 binding with active and inactive enantiomers of 18F-FP-DTBZ in baboons. Nucl Med Biol 2016; 43:743-751. [PMID: 27673755 DOI: 10.1016/j.nucmedbio.2016.08.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/04/2016] [Accepted: 08/28/2016] [Indexed: 01/09/2023]
Abstract
INTRODUCTION 18F-Fluoropropyl-(+)-dihydrotetrabenazine (18F-FP-(+)-DTBZ) is a vesicular monoamine transporter type 2 (VMAT2) radiotracer for positron emission tomography (PET) imaging to quantify human β-cell mass. Renal cortex and spleen have been suggested as reference regions, however, little is known about 18F-FP-(+)-DTBZ binding in these regions including the fraction of radiometabolite. We compared the kinetics of 18F-FP-(+)-DTBZ and its inactive enantiomer 18F-FP-(-)-DTBZ in baboons, estimated the non-displaceable binding (VND) of the tracers, and used ex vivo studies to measure radiometabolite fractions. METHODS PET scans were conducted for up to 4h with (+) and (-) enantiomers. Displacement experiments using unlabeled (+) and (-) enantiomers of FP-DTBZ and fluvoxamine (to evaluate sigma-1 receptor binding) were performed. SUV curves were used to calculate displacement values in the pancreas, renal cortex, and spleen. Distribution volumes (VT) were computed, and three approaches for calculation of VND were compared: (1) 18F-FP-(+)-DTBZ reference VT, (2) 18F-FP-(-)-DTBZ pancreatic VT, and (3) a scaled 18F-FP-(+)-DTBZ reference VT values. Ex vivo study was conducted to measure radiometabolite fraction in homogenized tissue samples from baboons at 90min post-injection. RESULTS Spleen uptake was lowest for both tracers. Highest uptake was in the pancreas with 18F-FP-(+)-DTBZ and renal cortex with 18F-FP-(-)-DTBZ. Substantial displacement effect was observed only with unlabeled FP-(+)-DTBZ in the 18F-FP-(+)-DTBZ studies. Radiometabolite fraction was higher in the renal cortex than the spleen. Approaches (1) and (3) with spleen to estimate VND provided lowest inter-subject variability of BPND. CONCLUSIONS VT differences among organs and between enantiomers indicated that scaling of reference region values is needed for quantification of VMAT2 binding in the pancreas with 18F-FP-(+)-DTBZ. Since the kidney PET signal has greater partial volume averaging and more radiometabolites, the spleen was considered a more practical candidate for use as a scaled-reference region in the quantification of 18F-FP-(+)-DTBZ in the pancreas.
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Affiliation(s)
- Mika Naganawa
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, United States, 06520
| | - Shu-Fei Lin
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, United States, 06520
| | - Keunpoong Lim
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, United States, 06520
| | - David Labaree
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, United States, 06520
| | - Jim Ropchan
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, United States, 06520
| | - Paul Harris
- Columbia University, New York, NY, United States
| | - Yiyun Huang
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, United States, 06520
| | | | - Richard E Carson
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, United States, 06520
| | - Gary W Cline
- Yale University, 801 Howard Avenue, PO Box 208048, New Haven, CT, United States, 06520
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15
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Eriksson O, Laughlin M, Brom M, Nuutila P, Roden M, Hwa A, Bonadonna R, Gotthardt M. In vivo imaging of beta cells with radiotracers: state of the art, prospects and recommendations for development and use. Diabetologia 2016; 59:1340-1349. [PMID: 27094935 DOI: 10.1007/s00125-016-3959-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 03/23/2016] [Indexed: 12/15/2022]
Abstract
Radiotracer imaging is characterised by high in vivo sensitivity, with a detection limit in the lower picomolar range. Therefore, radiotracers represent a valuable tool for imaging pancreatic beta cells. High demands are made of radiotracers for in vivo imaging of beta cells. Beta cells represent only a small fraction of the volume of the pancreas (usually 1-3%) and are scattered in the tiny islets of Langerhans throughout the organ. In order to be able to measure a beta cell-specific signal, one has to rely on highly specific tracer molecules because current in vivo imaging technologies do not allow the resolution of single islets in humans non-invasively. Currently, a considerable amount of preclinical data are available for several radiotracers and three are under clinical evaluation. We summarise the current status of the evaluation of these tracer molecules and put forward recommendations for their further evaluation.
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Affiliation(s)
- Olof Eriksson
- Preclinical PET Platform, Department of Medical Chemistry, Uppsala University, Dag Hammarskjölds väg 14C, 3tr, SE-751 83, Uppsala, Sweden.
- Turku PET Centre, University of Turku, Turku, Finland.
- Department of Biosciences, Åbo Akademi University, Turku, Finland.
| | - Maren Laughlin
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Maarten Brom
- Department of Radiology and Nuclear Medicine, Radboud university medical center, PO Box 9101, 6500HB, Nijmegen, the Netherlands
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, Turku, Finland
| | - Michael Roden
- Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Düsseldorf, Germany
| | - Albert Hwa
- JDRF, Discovery Research, New York, NY, USA
| | - Riccardo Bonadonna
- Division of Endocrinology, Department of Clinical and Experimental Medicine, University of Parma and AOU of Parma, Parma, Italy
| | - Martin Gotthardt
- Department of Radiology and Nuclear Medicine, Radboud university medical center, PO Box 9101, 6500HB, Nijmegen, the Netherlands.
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16
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Hellström-Lindahl E, Danielsson A, Ponten F, Czernichow P, Korsgren O, Johansson L, Eriksson O. GPR44 is a pancreatic protein restricted to the human beta cell. Acta Diabetol 2016; 53:413-21. [PMID: 26467464 DOI: 10.1007/s00592-015-0811-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 09/21/2015] [Indexed: 10/22/2022]
Abstract
AIMS To address questions regarding onset and progression of types 1 and 2 diabetes (T1D/T2D), surrogate imaging biomarkers for beta cell function and mass are needed. Here, we assess the potential of GPR44 as a surrogate marker for beta cells, in a direct comparison with clinically used biomarker VMAT2. METHODS GPR44 surface availability was assessed by flow cytometry of human beta cells. RNA transcription levels in different pancreas compartments were evaluated. The density of GPR44 receptor in endocrine and exocrine tissues was assessed by the radiolabeled GPR44 ligand [(3)H]AZD 3825. A direct comparison with the established beta cell marker VMAT2 was performed by radiolabeled [(3)H]DTBZ. RESULTS GPR44 was available on the cell surface, and pancreatic RNA levels were restricted to the islets of Langerhans. [(3)H]AZD 3825 had nanomolar affinity for GPR44 in human islets and EndoC-βH1 beta cells, and the specific binding to human beta cells was close to 50 times higher than in exocrine preparations. The endocrine-to-exocrine binding ratio was approximately 10 times higher for [(3)H]AZD 3825 than for [(3)H]DTBZ. CONCLUSION GPR44 is a highly beta cell-specific target, which potentially offers improved imaging contrast between the human beta cell and the exocrine pancreas.
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Affiliation(s)
- Ewa Hellström-Lindahl
- Department of Medicinal Chemistry, Preclinical PET Platform, Uppsala University, 751 83, Uppsala, Sweden
| | - Angelika Danielsson
- Department of Immunology, Genetics and Pathology, Uppsala University, 751 83, Uppsala, Sweden
- Science for Life Laboratory, Rudbeck Laboratory, Uppsala University, 751 85, Uppsala, Sweden
| | - Fredrik Ponten
- Department of Immunology, Genetics and Pathology, Uppsala University, 751 83, Uppsala, Sweden
| | | | - Olle Korsgren
- Department of Immunology, Genetics and Pathology, Uppsala University, 751 83, Uppsala, Sweden
| | - Lars Johansson
- Department of Radiology, Oncology and Radiation Sciences, Uppsala University, 751 83, Uppsala, Sweden
| | - Olof Eriksson
- Department of Medicinal Chemistry, Preclinical PET Platform, Uppsala University, 751 83, Uppsala, Sweden.
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17
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Freeby MJ, Kringas P, Goland RS, Leibel RL, Maffei A, Divgi C, Ichise M, Harris PE. Cross-sectional and Test-Retest Characterization of PET with [(18)F]FP-(+)-DTBZ for β Cell Mass Estimates in Diabetes. Mol Imaging Biol 2015; 18:292-301. [PMID: 26370678 PMCID: PMC4783444 DOI: 10.1007/s11307-015-0888-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 07/07/2015] [Accepted: 08/06/2015] [Indexed: 12/15/2022]
Abstract
Purpose The vesicular monoamine transporter, type 2 (VMAT2) is expressed by insulin producing β cells and was evaluated as a biomarker of β cell mass (BCM) by positron emission tomography (PET) with [18F]fluoropropyl-dihydrotetrabenazine ([18F]FP-(+)-DTBZ). Procedures We evaluated the feasibility of longitudinal pancreatic PET VMAT2 quantification in the pancreas in two studies of healthy controls and patients with type 1 or 2 diabetes. VMAT2 binding potential (BPND) was estimated voxelwise using a reference tissue method in a cross-sectional study, followed by assessment of reproducibility using a test-retest paradigm. Metabolic function was evaluated by stimulated c-peptide measurements. Results Pancreatic BPND was significantly decreased in patients with type 1 diabetes relative to controls and the test-retest variability was 9.4 %. Conclusions Pancreatic VMAT2 content is significantly reduced in long-term diabetes patients relative to controls and repeat scans are sufficiently reproducible to suggest the feasibility clinically VMAT2 measurements in longitudinal studies of new onset diabetes. Electronic supplementary material The online version of this article (doi:10.1007/s11307-015-0888-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Matthew J Freeby
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, 90404, USA.,Naomi Berrie Diabetes Center, Columbia University Medical Center, New York, NY, 10032, USA
| | - Patricia Kringas
- Naomi Berrie Diabetes Center, Columbia University Medical Center, New York, NY, 10032, USA
| | - Robin S Goland
- Naomi Berrie Diabetes Center, Columbia University Medical Center, New York, NY, 10032, USA
| | - Rudolph L Leibel
- Naomi Berrie Diabetes Center, Columbia University Medical Center, New York, NY, 10032, USA
| | - Antonella Maffei
- Institute of Genetics and Biophysics Adriano Buzzati-Traverso, Consiglio Nazionale delle Ricerche, 80131, Naples, Italy.,Division of Endocrinology, Department of Medicine, Columbia University Medical Center, New York, NY, 10032, USA
| | - Chaitan Divgi
- Division of Nuclear Medicine and Kreitchman PET Center, Department of Radiology, Columbia University Medical Center, New York, NY, 10032, USA
| | - Masanori Ichise
- Division of Nuclear Medicine and Kreitchman PET Center, Department of Radiology, Columbia University Medical Center, New York, NY, 10032, USA
| | - Paul E Harris
- Naomi Berrie Diabetes Center, Columbia University Medical Center, New York, NY, 10032, USA. .,Division of Endocrinology, Department of Medicine, Columbia University Medical Center, New York, NY, 10032, USA.
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