[^99mTc]-PentixaTec SPECT/CT for Imaging of Chemokine Receptor 4 Expression After Myocardial Infarction.

IF 6.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation: Cardiovascular Imaging Pub Date : 2024-11-01 Epub Date: 2024-11-13 DOI:10.1161/CIRCIMAGING.124.016992

Alessandro Liebich, Ralph A Bundschuh, Christian H Pfob, Malte Kircher, Georgine Wienand, Philip Raake, Stephan G Nekolla, Margret Schottelius, Takahiro Higuchi, Maximilian Rieger, Constantin Lapa

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引用次数: 0

Abstract

Background: Accumulation of CXCR4 (C-X-C motif chemokine receptor 4)-positive immune cells after acute myocardial infarction (AMI) can be visualized by positron emission tomography. For a broader clinical application, there is a need for CXCR4-directed radiotracers labeled with isotopes that can be used with single-photon emission computed tomography (SPECT). We report on the detection of CXCR4 expression after AMI in humans using the novel tracer [^99mTc]-PentixaTec.

Methods: In this retrospective analysis, 9 patients with AMI after mechanical revascularization underwent myocardial inflammation imaging with [^99mTc]-PentixaTec SPECT/computed tomography and rest perfusion SPECT imaging. Tracer uptake in the infarcted area, spleen, bone marrow, and blood pool were used for semiquantitative analysis and calculation of signal-to-background ratios. The extent and intensity of SPECT-derived inflammatory changes were compared with serological markers and perfusion defects.

Results: CXCR4-directed SPECT was positive in all patients. Increased CXCR4 expression was only detected in areas with diminished perfusion corresponding to the affected vessel in coronary angiography, with a signal-to-background ratio (infarcted area-to-blood pool) of 2.36±0.74. Uptake in bone marrow and spleen showed a significant correlation with CXCR4 expression in the infarcted areas (r=0.73 and P=0.03 for spleen and r=0.81 and P=0.008 for bone marrow, respectively). The extent and intensity of SPECT-derived inflammatory changes showed no significant association with serum troponin, CK (creatine kinase), leukocyte, or CRP (C-reactive protein) levels.

Conclusions: This is the first report of in vivo CXCR4 imaging after AMI using a ^99mTc-labeled tracer. Increased CXCR4 expression was observed locally in the infarcted region and was related to a systemic inflammatory response in the reticuloendothelial system. This proof-of-concept investigation demonstrates the general feasibility of evaluating the inflammation-related CXCR4 expression in the myocardium after AMI using conventional scintigraphy or SPECT and might, thus, broaden its worldwide application in clinical practice.

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用于心肌梗死后趋化因子受体 4 表达成像的 [99mTc]-PentixaTec SPECT/CT

背景：急性心肌梗死（AMI）后，CXCR4（C-X-C 矩阵趋化因子受体 4）阳性免疫细胞的聚集可通过正电子发射断层扫描显像。为了更广泛地应用于临床，需要用同位素标记的、可与单光子发射计算机断层扫描（SPECT）一起使用的 CXCR4 定向放射性racers。我们报告了使用新型示踪剂[99mTc]-PentixaTec检测人类AMI后CXCR4表达的情况：在这项回顾性分析中，9 名机械性血管重建后的 AMI 患者接受了[99mTc]-PentixaTec SPECT/计算机断层扫描和静息灌注 SPECT 成像的心肌炎症成像。对梗死区、脾脏、骨髓和血池的示踪剂摄取进行半定量分析，并计算信噪比。将 SPECT 衍生炎症变化的范围和强度与血清学标记物和灌注缺陷进行比较：结果：所有患者的 CXCR4 定向 SPECT 均呈阳性。仅在冠状动脉造影中与受影响血管相对应的灌注减少区域检测到 CXCR4 表达增加，信号-背景比（梗死区-血池）为 2.36±0.74。骨髓和脾脏的摄取量与梗死区域的 CXCR4 表达量有显著相关性（脾脏的相关性分别为 r=0.73 和 P=0.03，骨髓的相关性分别为 r=0.81 和 P=0.008）。SPECT衍生炎症变化的范围和强度与血清肌钙蛋白、肌酸激酶（CK）、白细胞或CRP（C反应蛋白）水平无明显关联：这是首次使用 99mTc 标记的示踪剂对急性心肌梗死后体内 CXCR4 进行成像的报告。在梗死区局部观察到 CXCR4 表达增加，这与网状内皮系统的全身炎症反应有关。这项概念验证研究证明了使用传统闪烁成像或 SPECT 评估急性心肌梗死后心肌中与炎症相关的 CXCR4 表达的普遍可行性，从而可能扩大其在全球临床实践中的应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Circulation: Cardiovascular Imaging 医学-核医学

CiteScore

6.30

自引率

2.70%

发文量

225

审稿时长

6-12 weeks

期刊介绍： Circulation: Cardiovascular Imaging, an American Heart Association journal, publishes high-quality, patient-centric articles focusing on observational studies, clinical trials, and advances in applied (translational) research. The journal features innovative, multimodality approaches to the diagnosis and risk stratification of cardiovascular disease. Modalities covered include echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging and spectroscopy, magnetic resonance angiography, cardiac positron emission tomography, noninvasive assessment of vascular and endothelial function, radionuclide imaging, molecular imaging, and others. Article types considered by Circulation: Cardiovascular Imaging include Original Research, Research Letters, Advances in Cardiovascular Imaging, Clinical Implications of Molecular Imaging Research, How to Use Imaging, Translating Novel Imaging Technologies into Clinical Applications, and Cardiovascular Images.