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Muñiz-Sáenz-Diez J, Ezponda A, Caballeros M, de la Fuente A, Gavira JJ, Bastarrika G. Safety, feasibility, and hemodynamic response of regadenoson for stress perfusion CMR. Int J Cardiovasc Imaging 2023; 39:1765-1774. [PMID: 37354385 PMCID: PMC10520095 DOI: 10.1007/s10554-023-02877-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/15/2023] [Indexed: 06/26/2023]
Abstract
Owing to its pharmacodynamics and posology, the use of regadenoson for stress cardiac magnetic resonance (CMR) has potential advantages over other vasodilators. We sought to evaluate the safety, hemodynamic response and diagnostic performance of regadenoson stress-CMR in routine clinical practice. All regadenoson stress-CMR examinations performed between May 2017 and July 2020 at our institution were retrospectively reviewed. A total of 698 studies were included for the final analysis. A conventional stress/rest protocol was performed using a 1.5T MRI scanner (Magnetom Aera, Siemens Healthineers, Erlangen, Germany). Adverse events, clinical symptoms, and hemodynamic response were assessed. Diagnostic accuracy of the test was evaluated in patients who underwent invasive coronary angiography. Nearly half of patients (48.5%) remained asymptomatic. Most common clinical symptoms included dyspnea (137, 19.6%), chest pain (116, 16.6%) and flushing (44, 6.3%). Two patients (0.28%) could not complete the examination due to severe hypotension or unbearable chest pain. Overall, an increase in heart rate (HR) response (36.2% [IQR: 22.5?50.9]) and a decrease in systolic and diastolic blood pressure (BP) (median systolic BP response of -5% [IQR: -11.5-0.6]; median diastolic BP response of -6.3 mmHg [IQR: -13.4-0]) was observed. Patients with symptoms induced by regadenoson showed higher HR response (40.3%, IQR: 26.4?56.1 vs. 32.4%, IQR: 19-45.6, p < 0.001), whereas a blunted HR response was observed in diabetic (29.6%, IQR: 18.4?42 p < 0.001), obese (31.7%, IQR: 20.7?46.2 p = 0.005) and patients aged 70 years or older (32.9%, IQR: 22.6?43.1 p < 0.001). Overall, regadenoson stress-CMR showed 95.65% (IQ 91.49?99.81) sensitivity, 54.84% (IQ 35.71?73.97) specificity, 86.99% (IQ 82.74?94.68) positive predictive value, and 77.27% (IQ 57.49?97.06) negative predictive value for detecting significant coronary stenosis as compared with invasive coronary angiography. Regadenoson is a well-tolerated vasodilator that can be safely employed for stress perfusion CMR, with high diagnostic performance.
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Affiliation(s)
- Javier Muñiz-Sáenz-Diez
- Department of Cardiology, Clínica Universidad de Navarra, Avenida Pío XII, 36, Pamplona, 31007, Spain.
| | - Ana Ezponda
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Meylin Caballeros
- Department of Radiology, Clínica Universidad de Navarra, Madrid, Spain
| | - Ana de la Fuente
- Department of Cardiology, Clínica Universidad de Navarra, Madrid, Spain
| | - Juan J Gavira
- Department of Cardiology, Clínica Universidad de Navarra, Avenida Pío XII, 36, Pamplona, 31007, Spain
| | - Gorka Bastarrika
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain
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García MT, Bautista E, de la Fuente A, Pérez L. Cholinium-Based Ionic Liquids as Promising Antimicrobial Agents in Pharmaceutical Applications: Surface Activity, Antibacterial Activity and Ecotoxicological Profile. Pharmaceutics 2023; 15:1806. [PMID: 37513993 PMCID: PMC10385515 DOI: 10.3390/pharmaceutics15071806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
Cholinium-based ionic liquids are compounds increasingly studied in pharmaceutics and biomedicine to enhance bioavailability in drug delivery systems and as bioactive ingredients in pharmaceutical formulations. However, their potential as antimicrobial agents has scarcely been investigated. Herein, we explored the antimicrobial activity of a series of surface-active cholinium-based ionic liquids (Chol-ILs). For this purpose, Chol-ILs with alkyl chains of 10-16 carbon atoms were synthesized and their self-assembly in aqueous medium was investigated. Subsequently, their antimicrobial activity against a panel of clinically relevant bacteria and their ability to eradicate MRSA and P. aeruginosa PAO1 biofilms was evaluated. Finally, we analyzed the ecotoxicological profile of Chol-ILs in terms of susceptibility to aerobic biodegradation and acute aquatic toxicity against D. magna and V. fisheri. Our results reveal that cholinium-based ILs with alkyl chain lengths ≥12 C show a broad spectrum of antibacterial activity. Their antimicrobial efficacy depends on their hydrophobicity, with the C14-C16 homologs being the most effective compounds. These ILs exhibit antimicrobial activity similar to that of imidazolium ILs and quaternary ammonium antiseptics. Moreover, the longer alkyl chain Chol-ILs are able to eradicate established biofilms at concentrations as low as 16-32 µg/mL. The biodegradation rate of cholinium-based ILs decreases with alkyl chain elongation. Our results reinforce the suitability of Chol-ILs as promising multifunctional compounds for application in pharmaceutical and biomedical formulation.
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Affiliation(s)
- María Teresa García
- Department of Surfactants and Nanobiotechnology, Institute of Advanced Chemistry of Catalonia (IQAC-CSIC), 08034 Barcelona, Spain
| | - Elena Bautista
- Department of Surfactants and Nanobiotechnology, Institute of Advanced Chemistry of Catalonia (IQAC-CSIC), 08034 Barcelona, Spain
| | - Ana de la Fuente
- Department of Surfactants and Nanobiotechnology, Institute of Advanced Chemistry of Catalonia (IQAC-CSIC), 08034 Barcelona, Spain
| | - Lourdes Pérez
- Department of Surfactants and Nanobiotechnology, Institute of Advanced Chemistry of Catalonia (IQAC-CSIC), 08034 Barcelona, Spain
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Refoyo E, Troya J, de la Fuente A, Beltrán A, Celada OL, Díaz-González L, Pedrero-Tomé R, García-Yébenes M, Villalón JM. Myocardial Work Index in Professional Football Players: A Novel Method for Assessment of Cardiac Adaptation. J Clin Med 2023; 12:jcm12093059. [PMID: 37176500 PMCID: PMC10179020 DOI: 10.3390/jcm12093059] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/10/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The global myocardial work index (GWI), a novel, valid, and non-invasive method based on speckle-tracking echocardiography, could provide value for calculating left ventricular (LV) function and energy consumption in athletes. MATERIALS AND METHODS We prospectively analyzed a single-center cohort of Spanish First-Division football players who attended a pre-participation screening program from June 2020 to June 2021, compared to a control group. All the individuals underwent an electrocardiogram and echocardiography, including two-dimensional speckle tracking and 4D-echo. The study aimed to evaluate the feasibility of myocardial work in professional football players and its correlations with other echocardiographic parameters. RESULTS The study population comprised 97 individuals (49 professional players and 48 controls). The mean age was 30.48 ± 7.20 years old. The professional football players had significantly higher values of LVEDV (p < 0.001), LVESV (p < 0.001), LV-mass index (p = 0.011), PWTd (p = 0.023), and EA (p < 0.001) compared with the control group. In addition, the professional players had lower GCW (p = 0.003) and a tendency to show lower GWI values (p < 0.001). These findings could suggest that professional football players have more remodeling and less MW, related to their adaptation to intensive training. Significant differences in GLS (p = 0.01) and GWE (p = 0.04) were observed as a function of the septal thickness of the athletes. Irrespective of the MW variable, the parameters with better correlations across all the populations were SBP, DBP, and GLS. CONCLUSIONS The GWI is a novel index to assess cardiac performance, with less load dependency than strain measurements. Future GWI analyses are warranted to understand myocardial deformation and other pathological differential diagnoses.
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Affiliation(s)
- Elena Refoyo
- Department of Cardiology, Clínica Universidad de Navarra, 28027 Madrid, Spain
- Cardiac Imaging Unit, Department of Cardiology, Hospital Universitario la PAZ, IdiPAZ, 28046 Madrid, Spain
| | - Jesús Troya
- Department of Internal Medicine, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Ana de la Fuente
- Department of Cardiology, Clínica Universidad de Navarra, 28027 Madrid, Spain
| | - Almudena Beltrán
- Department of Internal Medicine, Clínica Universidad de Navarra, 28027 Madrid, Spain
| | | | - Leonel Díaz-González
- Cardiac Imaging Unit, Department of Cardiology, Hospital Universitario la PAZ, IdiPAZ, 28046 Madrid, Spain
| | - Roberto Pedrero-Tomé
- Infanta Leonor Hospital Research and Innovation Foundation, 28031 Madrid, Spain
- EPINUT Research Group, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
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Piras AM, Fabiano A, Sartini S, Zambito Y, Braccini S, Chiellini F, Cataldi AG, Bartoli F, de la Fuente A, Erba PA. pH-Responsive Carboxymethylcellulose Nanoparticles for 68Ga-WBC Labeling in PET Imaging. Polymers (Basel) 2019; 11:polym11101615. [PMID: 31590371 PMCID: PMC6835547 DOI: 10.3390/polym11101615] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 02/07/2023] Open
Abstract
Carboxymethylcellulose (CMC) is a well-known pharmaceutical polymer, recently gaining attention in the field of nanomedicine, especially as a polyelectrolyte agent for the formation of complexes with oppositely charged macromolecules. Here, we report on the application of pH-sensitive pharmaceutical grade CMC-based nanoparticles (NP) for white blood cells (WBC) PET imaging. In this context and as an alternative to 99mTc-HMPAO SPECT labeling, the use of 68Ga3+ as PET radionuclide was investigated since, at early time points, it could provide the greater spatial resolution and patient convenience of PET tomography over SPECT clinical practices. Two operator-friendly kit-type formulations were compared, with the intention of radiolabeling within a short time (10 min), under mild conditions (physiological pH, room temperature) and in agreement with the actual clinically applied guidelines. NP were labeled by directly using 68Ga3+ eluted in HCL 0.05 N, from hospital suited 68Ge/68Ga generator and in absence of chelator. The first kit type approach involved the application of 68Ga3+ as an ionotropic gelation agent for in-situ forming NP. The second kit type approach concerned the re-hydration of a proper freeze-dried injectable NP powder. pH-sensitive NP with 250 nm average diameter and 80% labeling efficacy were obtained. The NP dispersant medium, including a cryoprotective agent, was modulated in order to optimize the Zeta potential value (−18 mV), minimize the NP interaction with serum proteins and guarantee a physiological environment for WBC during NP incubation. Time-dependent WBC radiolabeling was correlated to NP uptake by using both confocal and FT-IR microscopies. The ready to use lyophilized NP formulation approach appears promising as a straightforward 68Ga-WBC labeling tool for PET imaging applications.
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Affiliation(s)
- Anna Maria Piras
- Department of Pharmacy, University of Pisa, Via Bonanno 33, 56126, Pisa, Italy.
| | - Angela Fabiano
- Department of Pharmacy, University of Pisa, Via Bonanno 33, 56126, Pisa, Italy.
| | - Stefania Sartini
- Department of Pharmacy, University of Pisa, Via Bonanno 33, 56126, Pisa, Italy.
| | - Ylenia Zambito
- Department of Pharmacy, University of Pisa, Via Bonanno 33, 56126, Pisa, Italy.
| | - Simona Braccini
- Department of Chemistry and Industrial Chemistry, UdR INSTM - Pisa, University of Pisa, Via G. Moruzzi 13, 56124 Pisa, Italy.
| | - Federica Chiellini
- Department of Chemistry and Industrial Chemistry, UdR INSTM - Pisa, University of Pisa, Via G. Moruzzi 13, 56124 Pisa, Italy.
| | - Angela G Cataldi
- Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine and Surgery, University of Pisa and Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy.
| | - Francesco Bartoli
- Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine and Surgery, University of Pisa and Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy.
| | - Ana de la Fuente
- Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine and Surgery, University of Pisa and Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy.
| | - Paola Anna Erba
- Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine and Surgery, University of Pisa and Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy.
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de la Fuente A, Kramer S, Mohr N, Pektor S, Klasen B, Bausbacher N, Miederer M, Zentel R, Rösch F. 68Ga[Ga]-, 111In[In]-oxine: a novel strategy of in situ radiolabeling of HPMA-based micelles. Am J Nucl Med Mol Imaging 2019; 9:67-83. [PMID: 30911437 PMCID: PMC6420711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Abstract
Polymeric micelles are of increasing interest as drug delivery vehicles since they can accumulate in tumor tissue through EPR effect and deliver their hydrophobic cargo. The pharmacology can be visualized and quantified noninvasively by molecular imaging techniques. Here, a novel, fast and efficient technique for radiolabeling various HPMA-LMA based micellar aggregates with hydrophobic oxine-complexes of the trivalent radiometals 68Ga and 111In was investigated. The radiometal-oxine complexes resemble the hydrophobic drug 111In[In]-oxine considered for the diagnosis of infection and inflammation. Promising in vitro stability lead to in vivo evaluation in healthy mice in terms of quantitative ex vivo organ distribution. The results show that while the hydrophobic radiometal-oxine complexes were safely encapsulated in aqueous saline, they left the polymeric micelles slowly in contact with blood serum and more rapidly in vivo. Due to the similarity between the radiometal complexes and hydrophobic drugs transported in the polymeric micelles this has significant implications for further strategies on transport mechanisms of hydrophobically encapsulated drugs.
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Affiliation(s)
- Ana de la Fuente
- Institute of Nuclear Chemistry, Johannes Gutenberg-UniversityFritz-Straßmann-Weg 2, Mainz 55128, Germany
| | - Stefan Kramer
- Institute of Organic Chemistry, Johannes Gutenberg-UniversityDuesbergweg 10-14, Mainz 55128, Germany
| | - Nicole Mohr
- Institute of Organic Chemistry, Johannes Gutenberg-UniversityDuesbergweg 10-14, Mainz 55128, Germany
| | - Stefanie Pektor
- Department of Nuclear Medicine, University Medical Centre Johannes Gutenberg-UniversityLangenbeckstrasse 1, Mainz 55131, Germany
| | - Benedikt Klasen
- Institute of Nuclear Chemistry, Johannes Gutenberg-UniversityFritz-Straßmann-Weg 2, Mainz 55128, Germany
| | - Nicole Bausbacher
- Department of Nuclear Medicine, University Medical Centre Johannes Gutenberg-UniversityLangenbeckstrasse 1, Mainz 55131, Germany
| | - Matthias Miederer
- Department of Nuclear Medicine, University Medical Centre Johannes Gutenberg-UniversityLangenbeckstrasse 1, Mainz 55131, Germany
| | - Rudolf Zentel
- Institute of Organic Chemistry, Johannes Gutenberg-UniversityDuesbergweg 10-14, Mainz 55128, Germany
| | - Frank Rösch
- Institute of Nuclear Chemistry, Johannes Gutenberg-UniversityFritz-Straßmann-Weg 2, Mainz 55128, Germany
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García-Bolao I, Ballesteros G, Ramos Ardanaz P, Vives E, Neglia R, Menéndez D, Erkiaga Aio A, de la Fuente A. Do 'difficult to identify' pulmonary vein connections explain continuing high recurrence rates after atrial fibrillation ablation? Europace 2019; 21:i4-i11. [PMID: 30801131 DOI: 10.1093/europace/euy177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/03/2018] [Indexed: 11/13/2022] Open
Abstract
Despite the emerging technical evolution of the last two decades, the primary success rate of single-procedure pulmonary vein isolation (PVI), the cornerstone for any atrial fibrillation ablation procedure, is highly variable ranging from 53% to 92%. The recent development of ultra-high-density electroanatomic mapping systems, capable of acquiring and annotating multiple electrograms, with high spatiotemporal precision, which are processed by automated algorithms to generate activation and substrate maps to support and guide ablation procedures, has opened a new stage in cardiac electrophysiology. In this article, we review the existing evidence on the utility of high-density mapping on catheter-based PVI, the possibility to detect pulmonary vein potentials that remain undetected when using a standard approach and its potential relevance to the clinical outcome, and how this new technology is providing novel pathophysiological insights on complete PVI and atrial fibrillation ablation outcomes.
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Affiliation(s)
- Ignacio García-Bolao
- Department of Cardiology and Cardiovascular Surgery, Clínica Universidad de Navarra, Avenida Pío XII, 36 Pamplona, Spain
| | - Gabriel Ballesteros
- Department of Cardiology and Cardiovascular Surgery, Clínica Universidad de Navarra, Avenida Pío XII, 36 Pamplona, Spain
| | - Pablo Ramos Ardanaz
- Department of Cardiology and Cardiovascular Surgery, Clínica Universidad de Navarra, Avenida Pío XII, 36 Pamplona, Spain
| | - Enrique Vives
- Department of Cardiology and Cardiovascular Surgery, Clínica Universidad de Navarra, Avenida Pío XII, 36 Pamplona, Spain
| | - Renzo Neglia
- Department of Cardiology and Cardiovascular Surgery, Clínica Universidad de Navarra, Avenida Pío XII, 36 Pamplona, Spain
| | - Diego Menéndez
- Department of Cardiology and Cardiovascular Surgery, Clínica Universidad de Navarra, Avenida Pío XII, 36 Pamplona, Spain
| | - Ane Erkiaga Aio
- Rhythmia Field Clinical Specialist, Boston Scientific Corporation, Madrid, Spain
| | - Ana de la Fuente
- Department of Cardiology and Cardiovascular Surgery, Clínica Universidad de Navarra, Avenida Pío XII, 36 Pamplona, Spain
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Eppard E, de la Fuente A, Mohr N, Allmeroth M, Zentel R, Miederer M, Pektor S, Rösch F. Labeling of DOTA-conjugated HPMA-based polymers with trivalent metallic radionuclides for molecular imaging. EJNMMI Res 2018; 8:16. [PMID: 29488030 PMCID: PMC5829281 DOI: 10.1186/s13550-018-0372-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 02/19/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND In this work, the in vitro and in vivo stabilities and the pharmacology of HPMA-made homopolymers were studied by means of radiometal-labeled derivatives. Aiming to identify the fewer amount and the optimal DOTA-linker structure that provides quantitative labeling yields, diverse DOTA-linker systems were conjugated in different amounts to HPMA homopolymers to coordinate trivalent radiometals Me(III)* = gallium-68, scandium-44, and lutetium-177. RESULTS Short linkers and as low as 1.6% DOTA were enough to obtain labeling yields > 90%. Alkoxy linkers generally exhibited lower labeling yields than alkane analogues despite of similar chain length and DOTA incorporation rate. High stability of the radiolabel in all examined solutions was observed for all conjugates. Labeling with scandium-44 allowed for in vivo PET imaging and ex vivo measurements of organ distribution for up to 24 h. CONCLUSIONS This study confirms the principle applicability of DOTA-HPMA conjugates for labeling with different trivalent metallic radionuclides allowing for diagnosis and therapy.
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Affiliation(s)
- Elisabeth Eppard
- Clinic for Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
| | - Ana de la Fuente
- Institute of Nuclear Chemistry, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Nicole Mohr
- Institute of Organic Chemistry, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Mareli Allmeroth
- Institute of Organic Chemistry, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Rudolf Zentel
- Institute of Organic Chemistry, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Matthias Miederer
- Clinic for Nuclear Medicine, University Medical Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Stefanie Pektor
- Clinic for Nuclear Medicine, University Medical Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
| | - Frank Rösch
- Institute of Nuclear Chemistry, Johannes Gutenberg University Mainz, Mainz, Germany
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Eppard E, de la Fuente A, Benešová M, Khawar A, Bundschuh RA, Gärtner FC, Kreppel B, Kopka K, Essler M, Rösch F. Clinical Translation and First In-Human Use of [ 44Sc]Sc-PSMA-617 for PET Imaging of Metastasized Castrate-Resistant Prostate Cancer. Theranostics 2017; 7:4359-4369. [PMID: 29158832 PMCID: PMC5695136 DOI: 10.7150/thno.20586] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 08/15/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Various trivalent radiometals are well suited for labeling of DOTA-conjugated variants of Glu-ureido-based prostate-specific membrane antigen (PSMA) inhibitors. The DOTA-conjugate PSMA-617 has proven high potential in PSMA radioligand therapy (PSMA-RLT) of prostate cancer as well as PET imaging when labeled with lutetium-177 and gallium-68 respectively. Considering the relatively short physical half-life of gallium-68 this positron emitter precludes prolonged acquisition periods, as required for pre-therapeutic dosimetry or intraoperative applications. In this context, the positron emitter scandium-44 is an attractive alternative for PET imaging. We report the synthesis of [44Sc]Sc-PSMA-617 as radiopharmaceutical with generator produced scandium-44, its in vitro characterization and clinical translation as part of a first in-human study. Methods: Scandium-44 was obtained from a 44Ti/44Sc radionuclide generator. PSMA-617 was labeled with 142.4±12.7 MBq of scandium-44 in analogy to [68Ga]Ga-PSMA-617 and evaluated in vitro and in cell studies using PSMA+ LNCaP cells. A first-in-human investigation was subsequently carried out in a cohort of 4 patients (mean age 70±1.8 a) registered for [177Lu]Lu-PSMA-617 therapy. 50.5±9.3 MBq (40 µg, 38.4 nmol) [44Sc]Sc-PSMA-617 were applied via intravenous injection (i.v.), respectively. A Siemens Biograph 2 PET/CT system was used to acquire initial dynamic PET data (30 min) of abdomen in list mode followed by static PET/CT data (skull to mid-thigh) at 45 min, 2 and 18 h post-injection (p.i.). For quantitative analysis, dynamic images were reconstructed as 6 data sets of 300 s each. The noise ratio was measured in liver, lung and an additional region outside the body. SUV values in different organs and lesions were measured and compared to [68Ga]Ga-PSMA-11 data of the same patients. Residence times and organ absorbed doses were calculated using OLINDA/EXM software. Results: Quantitative radiochemical yields of ≥98 % were achieved using 18 nmol of PSMA-617 after 20 min at 95 °C with apparent molar activity of 6.69±0.78 MBq/nmol. Following purification, >99 % radiochemical purity was obtained. [44Sc]Sc-PSMA-617 showed high stability (>95 %) in serum for 24 h. The binding affinity and internalization fraction were determined in PSMA+ LNCaP cells (IC50 = 4.72±0.7 nM and internalization fraction: 15.78±2.14 % IA/106 LNCaP cells) and compared to [68Ga]Ga-PSMA-11 (12.0±2.8 nM and 9.47±2.56 % IA/106 LNCaP cells). Physiological tracer uptake was observed in kidneys, liver, spleen, small intestine, urinary bladder, and salivary glands and pathological uptake in both soft and skeletal metastases. SUV values were significantly lower in the kidneys (14.0) compared to [68Ga]Ga-PSMA-11 OET (30.5). All other measured SUV values did not show a statistically significant difference. Tumor to liver ratios were found to lie between 1.9 and 8.3 for [68Ga]Ga-PSMA-11 and between 2.5 and 8.8 for [44Sc]Sc-PSMA-617 after 120 min. For [44Sc]Sc-PSMA-617 the ratios were higher and no statistically significant differences were observed. Total and % activity were highest in liver followed by kidneys, spleen, small intestine and salivary glands. Rapid wash out was seen in liver and spleen and gradually over time in kidneys. Kidneys received the highest radiation absorbed dose of 0.354 (0.180-0.488) mSv/MBq. No adverse pharmacological effects were observed. Conclusion: In conclusion [44Sc]Sc-PSMA-617 PET is suitable for PET imaging of prostate cancer tissue. [44Sc]Sc-PSMA-617 shows promise to enable pre-therapeutic dosimetry in clinical settings. However, the clinical advantages for individual dosimetry or other applications like intraoperative applications have to be investigated in further studies.
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Fuente ADL, Zanca R, Boni R, Cataldi AG, Sollini M, Lazzeri E, Mariani G, Erba PA. Miniaturized Radiochemical Purity Testing for 99mTc-HMPAO, 99mTc-HMDP, and 99mTc-Tetrofosmin. J Nucl Med Technol 2017; 45:236-240. [PMID: 28705928 DOI: 10.2967/jnmt.115.154484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 06/20/2017] [Indexed: 11/16/2022] Open
Abstract
Quick methods are functional in clinical practice to ensure the fastest availability of radiopharmaceuticals. For this purpose, we investigated the radiochemical purity of the widely used 99mTc-hydroxymethylene diphosphonate, 99mTc-hexamethylpropyleneamine oxime, and 99mTc-tetrofosmin by reducing time as compared with the manufacturer's method. Methods: We applied a miniaturized chromatographic method with a reduced strip development from 18 cm to 9 cm for all 3 radiopharmaceuticals. The specific support medium and solvent system of the manufacturer's methods was kept unchanged for 99mTc-hydroxymethylene diphosphonate and 99mTc-tetrofosmin, whereas for 99mTc-hexamethylpropyleneamine oxime the instant thin-layer chromatography (ITLC) polysilicic gel (silicic acid [SA]) was replaced with a monosilicic gel (silicic gel [SG]) in the chromatographic system that uses methyl ethyl ketone as solvent. The method was applied and compared with the routine ITLC insert method in a total of 30 batches for each radiopharmaceutical. The precision of repeated tests was determined by comparison with the results of 10 replications on the same batch. Small volumes of concentrated 99mTcO4-, and 99mTc-albumin nanocolloid were used to produce potential radiochemical impurities. Correlation between the quick methods and the insert methods was analyzed using a nonparametric 2-tailed test and a 2 × 2 contingency table with the associated Fisher exact test to evaluate sensitivity and specificity. A receiver-operating-characteristic analysis was performed to evaluate the best cutoff. Results: The percentage radiochemical purity of the quick methods agreed with the standard chromatography procedures. We found that 99mTcO4 and colloidal impurities are not the only common radiochemical impurities with 99mTc-tetrofosmin, and shortening of the ITLC strip with respect to the manufacturer's method will worsen system resolution and may produce inaccuracy. Conclusion: The miniaturized methods we described represent a fast and reliable alternative for 99mTc-exametazime and 99mTc-oxidronate quality control, with the upper cutoff for acceptable radiochemical purity values being 84% and 95%, respectively. For 99mTc-tetrofosmin radiochemical purity testing, a longer strip as described in the standard method is warranted.
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Affiliation(s)
- Ana de la Fuente
- Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy; and
| | - Roberta Zanca
- Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy; and
| | - Roberto Boni
- Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy; and
| | - Angela G Cataldi
- Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy; and
| | - Martina Sollini
- Nuclear Medicine Unit, Department of Oncology and Advanced Technology, "Arcispedale Santa Maria Nuova"-IRCCS, Reggio Emilia, Italy
| | - Elena Lazzeri
- Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy; and
| | - Giuliano Mariani
- Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy; and
| | - Paola A Erba
- Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy; and
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Eppard E, Homann T, de la Fuente A, Essler M, Rösch F. Optimization of Labeling PSMAHBED with Ethanol-Postprocessed 68Ga and Its Quality Control Systems. J Nucl Med 2017; 58:432-437. [DOI: 10.2967/jnumed.116.177634] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 10/02/2016] [Indexed: 01/28/2023] Open
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Radchenko V, Bouziotis P, Tsotakos T, Paravatou-Petsotas M, la Fuente AD, Loudos G, Harris AL, Xanthopoulos S, Filosofov D, Hauser H, Eisenhut M, Ponsard B, Roesch F. Labeling and preliminary in vivo assessment of niobium-labeled radioactive species: A proof-of-concept study. Nucl Med Biol 2016; 43:280-7. [PMID: 27150030 DOI: 10.1016/j.nucmedbio.2016.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 01/15/2016] [Accepted: 02/04/2016] [Indexed: 10/22/2022]
Abstract
The application of radionuclide-labeled biomolecules such as monoclonal antibodies or antibody fragments for imaging purposes is called immunoscintigraphy. More specifically, when the nuclides used are positron emitters, such as zirconium-89, the technique is referred to as immuno-PET. Currently, there is an urgent need for radionuclides with a half-life which correlates well with the biological kinetics of the biomolecules under question and which can be attached to the proteins by robust labeling chemistry. (90)Nb is a promising candidate for in vivo immuno-PET, due its half-life of 14.6h and low β(+) energy of Emean=0.35MeV per decay. (95)Nb on the other hand, is a convenient alternative for longer-term ex vivo biodistribution studies, due to its longer half-life of (t½=35days) and its convenient, lower-cost production (reactor-based production). In this proof-of-principle work, the monoclonal antibody bevacizumab (Avastin(®)) was labeled with (95/90)Nb and in vitro and in vivo stability was evaluated in normal Swiss mice and in tumor-bearing SCID mice. Initial ex vivo experiments with (95)Nb-bevacizumab showed adequate tumor uptake, however at the same time high uptake in the liver, spleen and kidneys was observed. In order to investigate whether this behavior is due to instability of (⁎)Nb-bevacizumab or to the creation of other (⁎)Nb species in vivo, we performed biodistribution studies of (95)Nb-oxalate, (95)Nb-chloride and (95)Nb-Df. These potential metabolite species did not show any specific uptake, apart from bone accumulation for (95)Nb-oxalate and (95)Nb-chloride, which, interestingly, may serve as an "indicator" for the release of (90)Nb from labeled biomolecules. Concerning the initial uptake of (95)Nb-bevacizumab in non-tumor tissue, biodistribution of a higher specific activity radiolabeled antibody sample did show only negligible uptake in the liver, spleen, kidneys or bones. In-vivo imaging of a tumor-bearing SCID mouse after injection with (90)Nb-bevacizumab was acquired on an experimental small-animal PET camera, and indeed showed localization of the radiotracer in the tumor area. It is the first time that such results are described in the literature, and indicates promise of application of (90)Nb-labeled antibodies for the purposes of immuno-PET.
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Affiliation(s)
- Valery Radchenko
- Institute of Nuclear Chemistry, Johannes Gutenberg University, Mainz, Germany.
| | - Penelope Bouziotis
- Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, N.C.S.R. "Demokritos", Athens, Greece
| | - Theodoros Tsotakos
- Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, N.C.S.R. "Demokritos", Athens, Greece
| | - Mari Paravatou-Petsotas
- Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, N.C.S.R. "Demokritos", Athens, Greece
| | - Ana de la Fuente
- Institute of Nuclear Chemistry, Johannes Gutenberg University, Mainz, Germany
| | - George Loudos
- Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, N.C.S.R. "Demokritos", Athens, Greece; Department of Biomedical Engineering, Technological Educational Institute of Athens, Athens, Greece
| | - Adrian L Harris
- Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Stavros Xanthopoulos
- Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, N.C.S.R. "Demokritos", Athens, Greece
| | - Dmitry Filosofov
- Dzhelepov Laboratory of Nuclear Problems, Joint Institute of Nuclear Research, Dubna, Moscow region, Russian Federation
| | - Harald Hauser
- Radiopharmaceutical Chemistry, German Cancer Research Center, Heidelberg, Germany
| | - Michael Eisenhut
- Radiopharmaceutical Chemistry, German Cancer Research Center, Heidelberg, Germany
| | - Bernard Ponsard
- Institute of Nuclear Materials Science, BR2 Reactor, Radioisotopes and NTD Silicon Production, Belgian Nuclear Research Centre, SCKCEN, Mol, Belgium
| | - Frank Roesch
- Institute of Nuclear Chemistry, Johannes Gutenberg University, Mainz, Germany.
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Ortiz-Rey JA, Fernández GC, Magdalena CJ, Alvarez C, Antón I, San Miguel P, de la Fuente A. Fine needle aspiration appearance of extragastrointestinal stromal tumor. A case report. Acta Cytol 2003; 47:490-4. [PMID: 12789938 DOI: 10.1159/000326557] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Gastrointestinal stromal tumors (GISTs) rarely develop outside the digestive tract and in the soft tissues of abdomen and retroperitoneum. Such tumors are designated extra-GISTs (EGISTs). Cytologic and immunocytochemical features of a case of EGIST are reported. CASE A 54-year-old woman presented with a peritoneal mass, diameter 22 cm, adherent to the omentum and without a connection to the digestive tract. Fine needle aspiration biopsy (FNAB) of the excised tumor showed high cellularity in two patterns: monotonous spindle cells were intermingled with a mildly atypical epithelioid component. Immunocytochemistry performed on cytospins revealed reactivity for c-kit (CD117), CD34 and smooth muscle actin and negativity for S-100. The findings were concordant with a histologic diagnosis of EGIST. CONCLUSION EGISTs are infrequent neoplasms and can be diagnosed in FNAB samples. The clinical/radiologic setting must be considered together with the cytologic features. Immunocytochemistry is a clue to the diagnosis when it detects c-kit reactivity.
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Affiliation(s)
- José A Ortiz-Rey
- Department of Pathology, Policlínico de Vigo, S.A., Vigo, Pontevedra, Spain.
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Fernández GC, Tardáguila FM, López CT, Velasco M, Miguel PS, Fuente ADL. Fisiopatología de la placa de ateroma y sus implicaciones en la imagen. Radiología 2003. [DOI: 10.1016/s0033-8338(03)77872-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Fernández GC, Tardáguila FM, Rivas C, Meijide F, Miguel PS, Fuente ADL. Papel de la resonancia magnética en la patología testicular y paratesticular. Radiología 2001. [DOI: 10.1016/s0033-8338(01)76985-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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