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Maccioni L, Michelle CM, Brusaferri L, Silvestri E, Bertoldo A, Schubert JJ, Nettis MA, Mondelli V, Howes O, Turkheimer FE, Bottlaender M, Bodini B, Stankoff B, Loggia ML, Veronese M. A blood-free modeling approach for the quantification of the blood-to-brain tracer exchange in TSPO PET imaging. Front Neurosci 2024; 18:1395769. [PMID: 39104610 PMCID: PMC11299498 DOI: 10.3389/fnins.2024.1395769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 07/02/2024] [Indexed: 08/07/2024] Open
Abstract
Introduction Recent evidence suggests the blood-to-brain influx rate (K1 ) in TSPO PET imaging as a promising biomarker of blood-brain barrier (BBB) permeability alterations commonly associated with peripheral inflammation and heightened immune activity in the brain. However, standard compartmental modeling quantification is limited by the requirement of invasive and laborious procedures for extracting an arterial blood input function. In this study, we validate a simplified blood-free methodologic framework for K1 estimation by fitting the early phase tracer dynamics using a single irreversible compartment model and an image-derived input function (1T1K-IDIF). Methods The method is tested on a multi-site dataset containing 177 PET studies from two TSPO tracers ([11C]PBR28 and [18F]DPA714). Firstly, 1T1K-IDIF K1 estimates were compared in terms of both bias and correlation with standard kinetic methodology. Then, the method was tested on an independent sample of [11C]PBR28 scans before and after inflammatory interferon-α challenge, and on test-retest dataset of [18F]DPA714 scans. Results Comparison with standard kinetic methodology showed good-to-excellent intra-subject correlation for regional 1T1K-IDIF-K1 (ρintra = 0.93 ± 0.08), although the bias was variable depending on IDIF ability to approximate blood input functions (0.03-0.39 mL/cm3/min). 1T1K-IDIF-K1 unveiled a significant reduction of BBB permeability after inflammatory interferon-α challenge, replicating results from standard quantification. High intra-subject correlation (ρ = 0.97 ± 0.01) was reported between K1 estimates of test and retest scans. Discussion This evidence supports 1T1K-IDIF as blood-free alternative to assess TSPO tracers' unidirectional blood brain clearance. K1 investigation could complement more traditional measures in TSPO studies, and even allow further mechanistic insight in the interpretation of TSPO signal.
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Affiliation(s)
- Lucia Maccioni
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Carranza Mellana Michelle
- Department of Information Engineering, University of Padova, Padova, Italy
- Paris Brain Institute, ICM, CNRS, Inserm, Sorbonne Université, Paris, France
| | - Ludovica Brusaferri
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
- Computer Science and Informatics, School of Engineering, London South Bank University, London, United Kingdom
| | - Erica Silvestri
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Alessandra Bertoldo
- Department of Information Engineering, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Julia J. Schubert
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Maria A. Nettis
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Valeria Mondelli
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Oliver Howes
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Federico E. Turkheimer
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Michel Bottlaender
- BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS Inserm, Université Paris-Saclay, Orsay, France
| | - Benedetta Bodini
- Paris Brain Institute, ICM, CNRS, Inserm, Sorbonne Université, Paris, France
| | - Bruno Stankoff
- Paris Brain Institute, ICM, CNRS, Inserm, Sorbonne Université, Paris, France
| | - Marco L. Loggia
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Mattia Veronese
- Department of Information Engineering, University of Padova, Padova, Italy
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
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Kirienko M, Erba PA, Chiti A, Sollini M. Hybrid PET/MRI in Infection and Inflammation: An Update About the Latest Available Literature Evidence. Semin Nucl Med 2023; 53:107-124. [PMID: 36369091 DOI: 10.1053/j.semnuclmed.2022.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/13/2022] [Accepted: 10/26/2022] [Indexed: 11/10/2022]
Abstract
PET/MRI has been reported to be promising in the diagnosis and evaluation of infection and inflammation including brain disorders, bone and soft tissue infections and inflammations, cardiovascular, abdominal, and systemic diseases. However, evidence came out manly from anecdotal cases or small cohorts. The present review aimed to update the latest available evidence about the role of PET/MRI in infection and inflammation. The search (January, 1 2018-July, 8 2022) on PubMed produced 504 results. Sixty-five articles were selected and included in the qualitative synthesis. The number of publications on PET/MRI in the 3 years 2018-2020 was comparable, while it increased in 2021 and 2022 (from 11 to 17 and 15, respectively). [18F]FDG and 68Ga-DOTA-FAPI-04 were the most frequently used (42/65) and innovative radiopharmaceuticals, respectively. [18F]fluoride (9/65), translocator protein (TSPO)-targeted PET agents (6/65), CXCR4 receptor targeting tracer and β-amyloid plaques binding radiopharmaceuticals (2/65 and 2/65, respectively) were also used. Most PET/MRI studies in the period 2018-2022 focused on inflammation (55/65), and cardiovascular diseases represented the most frequent field of interest (30/65), also when considering each year singularly. An increasing trend in bone and joint publications was observed in the considered period (12/65). Other topics included neurology (11/65), inflammatory bowel disease (8/65), and other (4/65). PET/MRI technology demonstrated to be useful in infection and inflammation, being superior to each single modality and/or facilitating diagnosis in a number of conditions (eg, cardiac sarcoidosis, myocarditis, endocarditis), and/or allowing to provide insightful information about disease biology and apply innovative radiopharmaceuticals (eg, neurology, atherosclerosis). Publications focused on PET/MRI in large vessel vasculitis and aortic diseases include both diagnostic and discovery objectives. The current review corroborates the potential of PET/MRI - combining in a single examination the high soft tissue contrast, high resolution, and functional information of MRI, with molecular data provided by PET technology - to positively impact on the management of infectious diseases and inflammatory conditions.
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Affiliation(s)
| | - Paola A Erba
- Nuclear Medicine Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Arturo Chiti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; IRCCS Humanitas Research Hospital, Milan, Italy.
| | - Martina Sollini
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; IRCCS Humanitas Research Hospital, Milan, Italy
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