Rat imaging and in vivo stability studies using [11C]-dimethyl-diphenyl ammonium, a candidate agent for PET-myocardial perfusion imaging

Preclinical Imaging of Cardiovascular Disesase

Noninvasive imaging techniques, such as SPECT, PET, CT, echocardiography, or MRI, have become essential in cardiovascular research. They allow for the evaluation of biological processes in vivo without the need for invasive procedures. Nuclear imaging methods, such as SPECT and PET, offer numerous advantages, including high sensitivity, reliable quantification, and the potential for serial imaging. Modern SPECT and PET imaging systems, equipped with CT and MRI components in order to get access to morphological information with high spatial resolution, are capable of imaging a wide range of established and innovative agents in both preclinical and clinical settings. This review highlights the utility of SPECT and PET imaging as powerful tools for translational research in cardiology. By incorporating these techniques into a well-defined workflow- similar to those used in clinical imaging- the concept of "bench to bedside" can be effectively implemented.

Organic Cation Transporter-Mediated Accumulation of Quinolinium Salts in the LV Myocardium of Rodents

Purpose

Quaternary ammonium salts have demonstrated marked accumulation in the left ventricular (LV) myocardium of rodents and swine. To investigate the mechanism underlying this uptake, the present study examined the interaction of [¹⁸F]fluoroethylquinolinium ([¹⁸F]FEtQ) with the family of organic cation transporters (OCTs).

Procedures

The cellular uptake of [¹⁸F]FEtQ into HEK293 cells, expressing human OCT1, -2, or -3 (HEK293-hOCT), and its inhibition by corticosterone was evaluated in vitro. The inhibitory effect of decynium 22 (D 22) in vivo was also studied, using PET/CT of HEK293-hOCT tumor-bearing mice. Furthermore, the distribution kinetics of [¹⁸F]FEtQ were determined in rats, with and without pre-administration of corticosterone, and following administration to a non-human primate (NHP).

Results

The accumulation of [¹⁸F]FEtQ in HEK293-hOCT cells was 15–20-fold higher than in control cells and could be inhibited by corticosterone. in vivo, the uptake of [¹⁸F]FEtQ in the LV myocardium of corticosterone-treated rats was significantly reduced compared to that of untreated animals. Similarly, following administration of D 22 to HEK293-hOCT tumor-bearing mice, the peak tumor uptake of [¹⁸F]FEtQ was reduced by 40–45 % compared to baseline. Contrary to the distinct accumulation of [¹⁸F]FEtQ in the LV myocardium of rats, no cardiac uptake was observed following its administration to a NHP.

Conclusions

The quinolinium salt derivative [¹⁸F]FEtQ interacts with the family of OCTs, and this interaction could account, at least in part, for the increased uptake in the LV myocardium of rodents. Nonetheless, its low affinity for hOCT3 and the results of PET/CT imaging in a NHP indicate a limited clinical applicability as a radiopharmaceutical for cardiac and/or OCT imaging.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11307-022-01728-y.

Development and preclinical evaluation of novel fluorinated ammonium salts for PET myocardial perfusion imaging

We previously presented the radiolabeled ammonium salt [¹¹C]-dimethyl diphenylammonium trifluoromethanesulfonate ([¹¹C]DMDPA) as a potential novel PET-MPI agent. The current study aimed to increase the clinical applicability of PET-MPI by designing and synthesizing fluorinated ammonium salt derivatives. Four fluorinated DMDPA derivatives and two quinolinium salt analogs were radiolabeled. The dynamic distribution in vivo, following injection of each derivative into male SD rats, was evaluated using small-animal dedicated PET/CT. Organ uptake after injection of [¹⁸F]fluoroethylquinolinium acetate ([¹⁸F]FEtQ) was examined ex vivo. Four fluorinated DMDPA derivatives were synthesized, two were labeled with fluorine-18: [¹⁸F]fluoroethyl-methyldiphenylammonium trifluoromethanesulfonate ([¹⁸F]FEMDPA) and [¹⁸F]fluorobuthyl-methyldiphenylammonium trifluoromethanesulfonate ([¹⁸F]FBMDPA). The other two were labeled using carbon-11: [¹¹C]methyl-(3-fluorophenyl)-methylphenylammonium trifluoromethanesulfonate ([¹¹C]3-F-DMDPA) and [¹¹C]methyl-(4-fluorophenyl)-methylphenylammonium trifluoromethanesulfonate ([¹¹C]4-F-DMDPA). All four DMDPA derivatives exhibited significantly lower heart/liver radioactivity uptake ratios (0.6, 0.4, 0.7 and 0.6, respectively) compared to that of [¹¹C]DMDPA (1.2). Conversely, the two radiolabeled quinolinium salt derivatives, [¹¹C]methylquinolinium iodide ([¹¹C]MeQ) and [¹⁸F]FEtQ demonstrated improved heart/liver ratios (2.0 and 1.3, respectively) with clear visualization of the left ventricle myocardium. Renal clearance was the major route of elimination. Among the fluorinated quaternary ammonium salts tested, [¹⁸F]FEtQ yielded the best images. Further studies are in progress to elucidate the underlying mechanism of its cardiac uptake.

Emerging Tracers for Nuclear Cardiac PET Imaging

Myocardial perfusion imaging using positron emission tomography (PET) has several advantages over single photon emission computed tomography (SPECT). The recent advances in SPECT technology have shown promise, but there is still a large need for PET in the clinical management of coronary artery disease (CAD). Especially, absolute quantification of myocardial blood flow (MBF) using PET is extremely important. In spite of considerable advances in the diagnosis of CAD, novel PET radiopharmaceuticals remain necessary for the diagnosis of CAD because clinical use of current cardiac radiotracers is limited by their physical characteristics, such as decay mode, emission energy, and half-life. Thus, the use of a radioisotope that has proper characteristics and a proper half-life to develop myocardial perfusion agents could overcome these limitations. In this review, the current state of cardiac PET and a general overview of novel 18F or 68Ga-labeled radiotracers, including their radiosynthesis, in vivo characterization, and evaluation, are provided. The future perspectives are discussed in terms of their potential usefulness based on new image analysis methods and hybrid imaging.

Radiosynthesis and preclinical evaluation of [18F] 4-(2-fluoroethoxy)-2H-chromen-2-one as a novel myocardial perfusion imaging agent

Recently we developed [18F] 4-(2-fluoroethoxy)-2H-chromen-2-one as a novel 18F myocardial perfusion imaging radiotracer. It was synthesized in good radiochemical yield (>90%). The total time from radiosynthesis to its purification was less than 40 min, with excellent radiochemical purity (≥99%). It showed good stability over a period of 5 h at room temperature. The partition coefficient (log P) of radiotracer was found to be 2.70, suggesting the lipophilic nature of radiotracer. Ex vivo biodistribution study of radiotracer in normal Wistar rats for 30 min post-injection, demonstrated a good heart uptake (>1.3% ID/g) and favorable pharmacokinetics. Additionally, the radiotracer showed significant excretion (>11% ID) by liver, which is indicative of its rapid clearance. Further, in vivo biodistribution study of radiotracer in New Zealand White rabbit provided the clear PET/CT images of cardiomyocytes and myocardial perfusion. All these experimental findings suggest that [18F] 4-(2-fluoroethoxy)-2H-chromen-2-one could be used as a potential hit for myocardial perfusion imaging.

Cardiac PET for translational imaging

All along, translational cardiovascular research has been dependent on non-invasive imaging (such as single-photon emission computed tomography (SPECT), positron emission tomography (PET), computed tomography (CT), echocardiography, or magnetic resonance imaging (MRI)), as these techniques allow the assessment of surrogate markers in intact living organisms non-invasively. PET offers the advantages of high sensitivity; the capability for longitudinal, quantitative imaging; and that an armamentarium of promising radiotracers is readily available. All commercially available PET scanners are equipped with a CT component, and thus, the often cited disadvantage of a lack of morphologic correlation does not really count anymore. This review aims to give an outline on PET as a promising tool for translational research in cardiology as dedicated preclinical systems with virtually the same imaging features as those used in clinical imaging allows the straightforward concept of "bench to bedside."