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Du N, Jia G, Zhang W, Tong Q, Qu X, Liu R, Li D, Yan Z, Zuo C, Li X, Li R, Zhang W. One-day examination of triple nuclear medicine imaging and application in evaluating transarterial embolization. Heliyon 2024; 10:e29597. [PMID: 38707399 PMCID: PMC11068529 DOI: 10.1016/j.heliyon.2024.e29597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 05/07/2024] Open
Abstract
A diagnosis based on multiple nuclear medicine imaging (NMI) was more comprehensive in approaching the nature of pathological changes. In this research, a method to realize triple NMIs within one day was developed based on the reasonable arrangements of 68Ga-RGD PET/CT specialized on neovascularization, 99mTc-HL-91 SPECT/CT specialized on hypoxia and 18F-FDG PET/CT specialized on tumor metabolism. Feasibility was verified in evaluating the therapeutic effects of transarterial embolization (TAE) performed on rabbit models with VX2 tumor. Radiation dosimetry was carried out to record the radiation exposure from multiple injections of radiopharmaceuticals. In results, the one-day examination of triple NMIs manifested the diversity of the postoperative histological changes, including the local neovascularization induced by embolization, hypoxic state of embolized tissues, and suppression of tumor metabolism. More importantly, radiation dosage from radiopharmaceuticals was limited below 5.70 ± 0.90 mSv. In conclusion, the strong timeliness and complementarity of one-day examination of triple nuclear medicine imaging made it clinically operative and worthy of popularizing. There was flexibility in combining distinct NMIs according to the clinical demands, so as to provide comprehensive information for diagnosis.
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Affiliation(s)
- Nan Du
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institution of Medical Imaging, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Guorong Jia
- Department of Nuclear Medicine, Changhai Hospital, Naval Medical University, Shanghai, 200433, China
| | - Wen Zhang
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institution of Medical Imaging, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Qianqian Tong
- Department of Nuclear Medicine, Changhai Hospital, Naval Medical University, Shanghai, 200433, China
| | - Xudong Qu
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institution of Medical Imaging, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Rong Liu
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institution of Medical Imaging, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Danni Li
- Department of Nuclear Medicine, Changhai Hospital, Naval Medical University, Shanghai, 200433, China
| | - Zhiping Yan
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institution of Medical Imaging, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Changjing Zuo
- Department of Nuclear Medicine, Changhai Hospital, Naval Medical University, Shanghai, 200433, China
| | - Xiao Li
- Department of Nuclear Medicine, Changhai Hospital, Naval Medical University, Shanghai, 200433, China
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai, 201800, China
| | - Rou Li
- Department of Nuclear Medicine, Changhai Hospital, Naval Medical University, Shanghai, 200433, China
| | - Wei Zhang
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institution of Medical Imaging, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
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Ayalew BD, Rodoshi ZN, Patel VK, Alresheq A, Babu HM, Aurangzeb RF, Aurangzeb RI, Mdivnishvili M, Rehman A, Shehryar A, Hassan A. Nuclear Cardiology in the Era of Precision Medicine: Tailoring Treatment to the Individual Patient. Cureus 2024; 16:e58960. [PMID: 38800181 PMCID: PMC11127713 DOI: 10.7759/cureus.58960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Nuclear cardiology, employing advanced imaging technologies like positron emission tomography (PET) and single photon emission computed tomography (SPECT), is instrumental in diagnosing, risk stratifying, and managing heart diseases. Concurrently, precision medicine advocates for treatments tailored to each patient's genetic, environmental, and lifestyle specificities, promising a revolution in personalized cardiovascular care. This review explores the synergy between nuclear cardiology and precision medicine, highlighting advancements, potential enhancements in patient outcomes, and the challenges and opportunities of this integration. We examined the evolution of nuclear cardiology technologies, including PET and SPECT, and their role in cardiovascular diagnostics. We also delved into the principles of precision medicine, focusing on genetic and molecular profiling, data analytics, and individualized treatment strategies. The integration of these domains aims to optimize diagnostic accuracy, therapeutic interventions, and prognostic evaluations in cardiovascular care. Advancements in molecular imaging and the application of artificial intelligence in nuclear cardiology have significantly improved the precision of diagnostics and treatment plans. The adoption of precision medicine principles in nuclear cardiology enables the customization of patient care, leveraging genetic information and biomarkers for enhanced therapeutic outcomes. However, challenges such as data integration, accessibility, cost, and the need for specialized expertise persist. The confluence of nuclear cardiology and precision medicine offers a promising pathway toward revolutionizing cardiovascular healthcare, providing more accurate, effective, and personalized patient care. Addressing existing challenges and fostering interdisciplinary collaboration is crucial for realizing the full potential of this integration in improving patient outcomes.
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Affiliation(s)
- Biruk D Ayalew
- Internal Medicine, Saint Paul's Hospital Millennium Medical College, Addis Ababa, ETH
| | | | | | - Alaa Alresheq
- Primary Care, United Nations for Relief and Works Agency, Ramallah, PSE
| | - Hisham M Babu
- Internal Medicine, Jagadguru Sri Shivarathreeshwara (JSS) Medical College and Hospital, JSS Academy of Higher Education and Research (JSSAHER), Mysore, IND
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Tingen HSA, van Praagh GD, Nienhuis PH, Tubben A, van Rijsewijk ND, ten Hove D, Mushari NA, Martinez-Lucio TS, Mendoza-Ibañez OI, van Sluis J, Tsoumpas C, Glaudemans AW, Slart RH. The clinical value of quantitative cardiovascular molecular imaging: a step towards precision medicine. Br J Radiol 2023; 96:20230704. [PMID: 37786997 PMCID: PMC10646628 DOI: 10.1259/bjr.20230704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 10/04/2023] Open
Abstract
Cardiovascular diseases (CVD) are the leading cause of death worldwide and have an increasing impact on society. Precision medicine, in which optimal care is identified for an individual or a group of individuals rather than for the average population, might provide significant health benefits for this patient group and decrease CVD morbidity and mortality. Molecular imaging provides the opportunity to assess biological processes in individuals in addition to anatomical context provided by other imaging modalities and could prove to be essential in the implementation of precision medicine in CVD. New developments in single-photon emission computed tomography (SPECT) and positron emission tomography (PET) systems, combined with rapid innovations in promising and specific radiopharmaceuticals, provide an impressive improvement of diagnostic accuracy and therapy evaluation. This may result in improved health outcomes in CVD patients, thereby reducing societal impact. Furthermore, recent technical advances have led to new possibilities for accurate image quantification, dynamic imaging, and quantification of radiotracer kinetics. This potentially allows for better evaluation of disease activity over time and treatment response monitoring. However, the clinical implementation of these new methods has been slow. This review describes the recent advances in molecular imaging and the clinical value of quantitative PET and SPECT in various fields in cardiovascular molecular imaging, such as atherosclerosis, myocardial perfusion and ischemia, infiltrative cardiomyopathies, systemic vascular diseases, and infectious cardiovascular diseases. Moreover, the challenges that need to be overcome to achieve clinical translation are addressed, and future directions are provided.
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Affiliation(s)
- Hendrea Sanne Aletta Tingen
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Gijs D. van Praagh
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Pieter H. Nienhuis
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Alwin Tubben
- Department of Cardiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Nick D. van Rijsewijk
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Derk ten Hove
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Nouf A. Mushari
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - T. Samara Martinez-Lucio
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Oscar I. Mendoza-Ibañez
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Joyce van Sluis
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - Andor W.J.M. Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
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Singh SB, Ng SJ, Lau HC, Khanal K, Bhattarai S, Paudyal P, Shrestha BB, Naseer R, Sandhu S, Gokhale S, Raynor WY. Emerging PET Tracers in Cardiac Molecular Imaging. Cardiol Ther 2023; 12:85-99. [PMID: 36593382 PMCID: PMC9986170 DOI: 10.1007/s40119-022-00295-1] [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: 10/12/2022] [Accepted: 11/26/2022] [Indexed: 01/04/2023] Open
Abstract
18F-fluorodeoxyglucose (FDG) and 18F-sodium fluoride (NaF) represent emerging PET tracers used to assess atherosclerosis-related inflammation and molecular calcification, respectively. By localizing to sites with high glucose utilization, FDG has been used to assess myocardial viability for decades, and its role in evaluating cardiac sarcoidosis has come to represent a major application. In addition to determining late-stage changes such as loss of perfusion or viability, by targeting mechanisms present in atherosclerosis, PET-based techniques have the ability to characterize atherogenesis in the early stages to guide intervention. Although it was once thought that FDG would be a reliable indicator of ongoing plaque formation, micro-calcification as portrayed by NaF-PET/CT appears to be a superior method of monitoring disease progression. PET imaging with NaF has the additional advantage of being able to determine abnormal uptake due to coronary artery disease, which is obscured by physiologic myocardial activity on FDG-PET/CT. In this review, we discuss the evolving roles of FDG, NaF, and other PET tracers in cardiac molecular imaging.
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Affiliation(s)
- Shashi Bhushan Singh
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Sze Jia Ng
- Department of Medicine, Crozer-Chester Medical Center, 1 Medical Center Boulevard, Upland, PA, 19013, USA
| | - Hui Chong Lau
- Department of Medicine, Crozer-Chester Medical Center, 1 Medical Center Boulevard, Upland, PA, 19013, USA
| | - Kishor Khanal
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
- Division of Cardiology, Memorial Healthcare System, 3501 Johnson Street, Hollywood, FL, 33021, USA
| | - Sanket Bhattarai
- Department of Medicine, KIST Medical College, Mahalaxmi 01, Lalitpur, Bagmati, Nepal
| | - Pranita Paudyal
- West China Hospital, Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, 610041, Sichuan, China
| | - Bimash Babu Shrestha
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Rizwan Naseer
- Department of Medicine, Crozer-Chester Medical Center, 1 Medical Center Boulevard, Upland, PA, 19013, USA
| | - Simran Sandhu
- College of Health and Human Development, Pennsylvania State University, 10 East College Avenue, University Park, PA, 16802, USA
| | - Saket Gokhale
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - William Y Raynor
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
- Department of Radiology, Rutgers Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, MEB #404, New Brunswick, NJ, 08901, USA.
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Recent Advances in Cardiovascular Diseases Research Using Animal Models and PET Radioisotope Tracers. Int J Mol Sci 2022; 24:ijms24010353. [PMID: 36613797 PMCID: PMC9820417 DOI: 10.3390/ijms24010353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Cardiovascular diseases (CVD) is a collective term describing a range of conditions that affect the heart and blood vessels. Due to the varied nature of the disorders, distinguishing between their causes and monitoring their progress is crucial for finding an effective treatment. Molecular imaging enables non-invasive visualisation and quantification of biological pathways, even at the molecular and subcellular levels, what is essential for understanding the causes and development of CVD. Positron emission tomography imaging is so far recognized as the best method for in vivo studies of the CVD related phenomena. The imaging is based on the use of radioisotope-labelled markers, which have been successfully used in both pre-clinical research and clinical studies. Current research on CVD with the use of such radioconjugates constantly increases our knowledge and understanding of the causes, and brings us closer to effective monitoring and treatment. This review outlines recent advances in the use of the so-far available radioisotope markers in the research on cardiovascular diseases in rodent models, points out the problems and provides a perspective for future applications of PET imaging in CVD studies.
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Crișan G, Moldovean-Cioroianu NS, Timaru DG, Andrieș G, Căinap C, Chiș V. Radiopharmaceuticals for PET and SPECT Imaging: A Literature Review over the Last Decade. Int J Mol Sci 2022; 23:ijms23095023. [PMID: 35563414 PMCID: PMC9103893 DOI: 10.3390/ijms23095023] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/23/2022] [Accepted: 04/28/2022] [Indexed: 02/04/2023] Open
Abstract
Positron emission tomography (PET) uses radioactive tracers and enables the functional imaging of several metabolic processes, blood flow measurements, regional chemical composition, and/or chemical absorption. Depending on the targeted processes within the living organism, different tracers are used for various medical conditions, such as cancer, particular brain pathologies, cardiac events, and bone lesions, where the most commonly used tracers are radiolabeled with 18F (e.g., [18F]-FDG and NA [18F]). Oxygen-15 isotope is mostly involved in blood flow measurements, whereas a wide array of 11C-based compounds have also been developed for neuronal disorders according to the affected neuroreceptors, prostate cancer, and lung carcinomas. In contrast, the single-photon emission computed tomography (SPECT) technique uses gamma-emitting radioisotopes and can be used to diagnose strokes, seizures, bone illnesses, and infections by gauging the blood flow and radio distribution within tissues and organs. The radioisotopes typically used in SPECT imaging are iodine-123, technetium-99m, xenon-133, thallium-201, and indium-111. This systematic review article aims to clarify and disseminate the available scientific literature focused on PET/SPECT radiotracers and to provide an overview of the conducted research within the past decade, with an additional focus on the novel radiopharmaceuticals developed for medical imaging.
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Affiliation(s)
- George Crișan
- Faculty of Physics, Babeş-Bolyai University, Str. M. Kogălniceanu 1, 400084 Cluj-Napoca, Romania; (G.C.); (N.S.M.-C.); (D.-G.T.)
- Department of Nuclear Medicine, County Clinical Hospital, Clinicilor 3-5, 400006 Cluj-Napoca, Romania;
| | | | - Diana-Gabriela Timaru
- Faculty of Physics, Babeş-Bolyai University, Str. M. Kogălniceanu 1, 400084 Cluj-Napoca, Romania; (G.C.); (N.S.M.-C.); (D.-G.T.)
| | - Gabriel Andrieș
- Department of Nuclear Medicine, County Clinical Hospital, Clinicilor 3-5, 400006 Cluj-Napoca, Romania;
| | - Călin Căinap
- The Oncology Institute “Prof. Dr. Ion Chiricuţă”, Republicii 34-36, 400015 Cluj-Napoca, Romania;
| | - Vasile Chiș
- Faculty of Physics, Babeş-Bolyai University, Str. M. Kogălniceanu 1, 400084 Cluj-Napoca, Romania; (G.C.); (N.S.M.-C.); (D.-G.T.)
- Institute for Research, Development and Innovation in Applied Natural Sciences, Babeș-Bolyai University, Str. Fântânele 30, 400327 Cluj-Napoca, Romania
- Correspondence:
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Qi Y, Li L, Feng G, Shao C, Cai Y, Wang Z. Research Progress of Imaging Methods for Detection of Microvascular Angina Pectoris in Diabetic Patients. Front Cardiovasc Med 2021; 8:713971. [PMID: 34621798 PMCID: PMC8490615 DOI: 10.3389/fcvm.2021.713971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/27/2021] [Indexed: 12/28/2022] Open
Abstract
Diabetes is a complex metabolic disease characterized by hyperglycemia. Its complications are various, often involving the heart, brain, kidney, and other essential organs. At present, the number of diabetic patients in the world is growing day by day. The cardiovascular disease caused by diabetes has dramatically affected the quality of life of diabetic patients. It is the leading cause of death of diabetic patients. Diabetic patients often suffer from microvascular angina pectoris without obstructive coronary artery disease. Still, there are typical ECG ischemia and angina pectoris, that is, chest pain and dyspnea under exercise. Unlike obstructive coronary diseases, nitrate does not affect chest pain caused by coronary microvascular angina in most cases. With the increasing emphasis on diabetic microvascular angina, the need for accurate diagnosis of the disease is also increasing. We can use SPECT, PET, CMR, MCE, and other methods to evaluate coronary microvascular function. SPECT is commonly used in clinical practice, and PET is considered the gold standard for non-invasive detection of myocardial blood flow. This article mainly introduces the research progress of these imaging methods in detecting microvascular angina in diabetic patients.
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Affiliation(s)
- Yiming Qi
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Lihua Li
- Department of Pathology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Guoquan Feng
- Department of Radiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Chen Shao
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Yue Cai
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Zhongqun Wang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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Leung D, Bonacorsi S, Smith RA, Weber W, Hayes W. Molecular Imaging and the PD-L1 Pathway: From Bench to Clinic. Front Oncol 2021; 11:698425. [PMID: 34497758 PMCID: PMC8420047 DOI: 10.3389/fonc.2021.698425] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/22/2021] [Indexed: 01/24/2023] Open
Abstract
Programmed death-1 (PD-1) and programmed death ligand 1 (PD-L1) inhibitors target the important molecular interplay between PD-1 and PD-L1, a key pathway contributing to immune evasion in the tumor microenvironment (TME). Long-term clinical benefit has been observed in patients receiving PD-(L)1 inhibitors, alone and in combination with other treatments, across multiple tumor types. PD-L1 expression has been associated with response to immune checkpoint inhibitors, and treatment strategies are often guided by immunohistochemistry-based diagnostic tests assessing expression of PD-L1. However, challenges related to the implementation, interpretation, and clinical utility of PD-L1 diagnostic tests have led to an increasing number of preclinical and clinical studies exploring interrogation of the TME by real-time imaging of PD-(L)1 expression by positron emission tomography (PET). PET imaging utilizes radiolabeled molecules to non-invasively assess PD-(L)1 expression spatially and temporally. Several PD-(L)1 PET tracers have been tested in preclinical and clinical studies, with clinical trials in progress to assess their use in a number of cancer types. This review will showcase the development of PD-(L)1 PET tracers from preclinical studies through to clinical use, and will explore the opportunities in drug development and possible future clinical implementation.
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Affiliation(s)
- David Leung
- Translational Medicine, Bristol Myers Squibb, Princeton, NJ, United States
| | - Samuel Bonacorsi
- Translational Medicine, Bristol Myers Squibb, Princeton, NJ, United States
| | - Ralph Adam Smith
- Translational Medicine, Bristol Myers Squibb, Princeton, NJ, United States
| | - Wolfgang Weber
- Technische Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Wendy Hayes
- Translational Medicine, Bristol Myers Squibb, Princeton, NJ, United States
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Hiroshima Y, Manabe O, Naya M, Tomiyama Y, Magota K, Obara M, Aikawa T, Oyama-Manabe N, Yoshinaga K, Hirata K, Kroenke M, Tamaki N, Katoh C. Quantification of myocardial blood flow with 11C-hydroxyephedrine dynamic PET: comparison with 15O-H 2O PET. J Nucl Cardiol 2020; 27:1118-1125. [PMID: 29270771 DOI: 10.1007/s12350-017-1140-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 11/14/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND 11C-hydroxyephedrine (HED) PET has been used to evaluate the myocardial sympathetic nervous system (SNS). Here we sought to establish a simultaneous approach for quantifying both myocardial blood flow (MBF) and the SNS from a single HED PET scan. METHODS Ten controls and 13 patients with suspected cardiac disease were enrolled. The inflow rate of 11C-HED (K1) was obtained using a one-tissue-compartment model. We compared this rate with the MBF derived from 15O-H2O PET. In the controls, the relationship between K1 from 11C-HED PET and the MBF from 15O-H2O PET was linked by the Renkin-Crone model. RESULTS The relationship between K1 from 11C-HED PET and the MBF from 15O-H2O PET from the controls' data was approximated as follows: K1 = (1 - 0.891 * exp(- 0.146/MBF)) * MBF. In the validation set, the correlation coefficient demonstrated a significantly high relationship for both the whole left ventricle (r = 0.95, P < 0.001) and three coronary territories (left anterior descending artery: r = 0.96, left circumflex artery: r = 0.81, right coronary artery: r = 0.86; P < 0.001, respectively). CONCLUSION 11C-HED can simultaneously estimate MBF and sympathetic nervous function without requiring an additional MBF scan for assessing mismatch areas between MBF and SNS.
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Affiliation(s)
- Yuji Hiroshima
- Faculty of Health Sciences, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Osamu Manabe
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo, 060-8638, Hokkaido, Japan.
| | - Masanao Naya
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yuuki Tomiyama
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo, 060-8638, Hokkaido, Japan
| | - Keiichi Magota
- Division of Medical Imaging and Technology, Hokkaido University Hospital, Sapporo, Japan
| | - Masahiko Obara
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tadao Aikawa
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Noriko Oyama-Manabe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Keiichiro Yoshinaga
- Diagnostic and Therapeutic Nuclear Medicine, National Institute of Radiological Science, Chiba, Japan
| | - Kenji Hirata
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo, 060-8638, Hokkaido, Japan
| | - Markus Kroenke
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo, 060-8638, Hokkaido, Japan
- Department of Nuclear Medicine, Klinikumrechts der Isar, Technical University of Munich, Munich, Germany
| | - Nagara Tamaki
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo, 060-8638, Hokkaido, Japan
| | - Chietsugu Katoh
- Faculty of Health Sciences, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Padakanti PK, Li S, Schmitz A, Mankoff D, Mach RH, Lee HS. Automated synthesis of [ 11C]L-glutamine on Synthra HCN plus synthesis module. EJNMMI Radiopharm Chem 2019; 4:5. [PMID: 31659517 PMCID: PMC6426911 DOI: 10.1186/s41181-019-0057-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/07/2019] [Indexed: 12/12/2022] Open
Abstract
Background L-Glutamine (L-Gln) is the most abundant amino acid present in the human body and is involved in numerous metabolic pathways. Glutaminolysis is the metabolic process deployed by many aggressive cancers such as triple negative breast cancer (TNBC). Imaging the metabolic pathways of L-glutamine could provide more insights into tumor biology. Reliable and reproducible automated synthesis of [11C]L-glutamine PET (Positron Emission Tomography) radiotracer is critical for these studies. Results [11C]L-Glutamine ([11C]L-Gln) was reliably and reproducibly synthesized. The automated process involves cleaning and drying of the synthesis module, azeotropic drying of crown ether and cesium bicarbonate, conversion of [11C]CO2 to [11C] CsCN, incorporation of [11C] CN into the starting material, and hydrolysis and deprotection of the corresponding [11C] nitrile to yield [11C]L-glutamine. Starting with approximately 1 Ci of [11C] cesium cyanide ([11C]CsCN), 47–77 mCi (n = 4) of the final product, [11C]L-Gln, was obtained after sterile filtration. The radiochemical purity of the final product was > 90% with almost exclusively L-glutamine isomer. The yield of [11C]L-Gln was 43–52% (n = 4), decay corrected to end of [11C] CsCN trapping in the reaction vessel. Conclusions All the steps including drying of the mixture of base and crown ether, preparation of [11C] cyanide, radiochemical synthesis and formulation were accomplished on a single synthesis unit. [11C]L-Gln has been successfully adapted and optimized on an automated synthesis module, Synthra HCN Plus. This process can be readily adapted for clinical research use.
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Affiliation(s)
| | - Shihong Li
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Alexander Schmitz
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - David Mankoff
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Robert H Mach
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Hsiaoju S Lee
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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Werner RA, Chen X, Rowe SP, Lapa C, Javadi MS, Higuchi T. Moving into the next era of PET myocardial perfusion imaging: introduction of novel 18F-labeled tracers. Int J Cardiovasc Imaging 2018; 35:569-577. [PMID: 30334228 PMCID: PMC6454078 DOI: 10.1007/s10554-018-1469-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 10/12/2018] [Indexed: 01/15/2023]
Abstract
The heart failure epidemic continues to rise with coronary artery disease as one of its main causes. Novel concepts for risk stratification to guide the referring cardiologist towards revascularization procedures are of significant value. Myocardial perfusion imaging using single-photon emission computed tomography (SPECT) agents has demonstrated high accuracy for the detection of clinically relevant stenoses. With positron emission tomography (PET) becoming more widely available, mainly due to its diagnostic performance in oncology, perfusion imaging with that modality is more practical than in the past and overcomes existing limitations of SPECT MPI. Advantages of PET include more reliable quantification of absolute myocardial blood flow, the routine use of computed tomography for attenuation correction, a higher spatiotemporal resolution and a higher count sensitivity. Current PET radiotracers such as rubidium-82 (half-life, 76 s), oxygen-15 water (2 min) or nitrogen-13 ammonia (10 min) are labeled with radionuclides with very short half-lives, necessitating that stress imaging is performed under pharmacological vasodilator stress instead of exercise testing. However, with the introduction of novel 18F-labeled MPI PET radiotracers (half-life, 110 min), the intrinsic advantages of PET can be combined with exercise testing. Additional advantages of those radiotracers include, but are not limited to: potentially improved cost-effectiveness due to the use of pre-existing delivery systems and superior imaging qualities, mainly due to the shortest positron range among available PET MPI probes. In the present review, widely used PET MPI radiotracers will be reviewed and potential novel 18F-labeled perfusion radiotracers will be discussed.
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Affiliation(s)
- Rudolf A Werner
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Nuclear Medicine, University of Wuerzburg, Wuerzburg, Germany.,Comprehensive Heart Failure Center, University of Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany
| | - Xinyu Chen
- Department of Nuclear Medicine, University of Wuerzburg, Wuerzburg, Germany.,Comprehensive Heart Failure Center, University of Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany
| | - Steven P Rowe
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Constantin Lapa
- Department of Nuclear Medicine, University of Wuerzburg, Wuerzburg, Germany
| | - Mehrbod S Javadi
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Takahiro Higuchi
- Department of Nuclear Medicine, University of Wuerzburg, Wuerzburg, Germany. .,Comprehensive Heart Failure Center, University of Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany. .,Department of Biomedical Imaging, National Cardiovascular and Cerebral Center, Suita, Japan.
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Li Z, Gupte AA, Zhang A, Hamilton DJ. Pet Imaging and its Application in Cardiovascular Diseases. Methodist Debakey Cardiovasc J 2017; 13:29-33. [PMID: 28413580 DOI: 10.14797/mdcj-13-1-29] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death worldwide and represent a great challenge for modern research and medicine. Despite advances in preventing and treating CVD over the decades, there remains an urgent need to develop sensitive and safe methods for early detection and personalized treatment. With refinements of molecular imaging technologies such as positron emission tomography (PET), noninvasive imaging of CVDs is experiencing impressive progress in both preclinical and clinical settings. In this review, we summarize advances in cardiovascular PET imaging, highlight the latest development of CVD imaging probes, and illustrate the potential for individualized therapy based on metabolic phenotype.
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Affiliation(s)
- Zheng Li
- Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas
| | - Anisha A Gupte
- Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas
| | - Anjun Zhang
- Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas
| | - Dale J Hamilton
- Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas
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Olivas Arroyo C. Radiopharmaceuticals in positron emission tomography: present situation and future perspectives. RADIOLOGIA 2016; 58:468-480. [PMID: 27592111 DOI: 10.1016/j.rx.2016.07.003] [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: 12/15/2015] [Revised: 05/08/2016] [Accepted: 07/05/2016] [Indexed: 11/29/2022]
Abstract
Positron emission tomography (PET) is an imaging technique that has grown greatly in recent years. PET is considered a fundamental tool in oncology, and it also has indications in other fields such as neurology and cardiology. Although 18F-fluorodeoxyglucose (18F-FDG) is the radiopharmaceutical most widely used in PET, the availability of new radiotracers has been a key element in the expansion of the use of PET. These new radiopharmaceuticals have made it possible to study different biological targets that are essential for obtaining greater knowledge and better characterization of different diseases and have thus contributed to the research and development of different therapeutic agents. This article provides a description of different PET radiopharmaceutical, structured according to their areas of application. Some of these radiotracers are already commercially available, whereas others are still under research or pending approval by regulatory bodies.
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Affiliation(s)
- C Olivas Arroyo
- Unidad de Radiofarmacia, Servicio de Medicina Nuclear, Hospital Universitari i Politècnic La Fe, Valencia, España.
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Clinical Utility and Future Applications of PET/CT and PET/CMR in Cardiology. Diagnostics (Basel) 2016; 6:diagnostics6030032. [PMID: 27598207 PMCID: PMC5039566 DOI: 10.3390/diagnostics6030032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/17/2016] [Accepted: 08/23/2016] [Indexed: 12/15/2022] Open
Abstract
Over the past several years, there have been major advances in cardiovascular positron emission tomography (PET) in combination with either computed tomography (CT) or, more recently, cardiovascular magnetic resonance (CMR). These multi-modality approaches have significant potential to leverage the strengths of each modality to improve the characterization of a variety of cardiovascular diseases and to predict clinical outcomes. This review will discuss current developments and potential future uses of PET/CT and PET/CMR for cardiovascular applications, which promise to add significant incremental benefits to the data provided by each modality alone.
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Abstract
Noninvasive cardiac imaging has an important role in the assessment of patients with acute-onset chest pain. In patients with suspected acute coronary syndrome (ACS), cardiac imaging offers incremental value over routine clinical assessment, the electrocardiogram, and blood biomarkers of myocardial injury, to confirm or refute the diagnosis of coronary artery disease and to assess future cardiovascular risk. This Review covers the current guidelines and clinical use of the common noninvasive imaging techniques, including echocardiography and stress echocardiography, computed tomography coronary angiography, myocardial perfusion scintigraphy, positron emission tomography, and cardiovascular magnetic resonance imaging, in patients with suspected ACS, and provides an update on the developments in noninvasive imaging techniques in the past 5 years.
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