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Advanced tracers in PET imaging of cardiovascular disease.

Li Y, Zhang W, Wu H, Liu G - Biomed Res Int (2014)

Bottom Line: Cardiovascular disease is the leading cause of death worldwide.Molecular imaging with targeted tracers by positron emission tomography (PET) allows for the noninvasive detection and characterization of biological changes at the molecular level, leading to earlier disease detection, objective monitoring of therapies, and better prognostication of cardiovascular diseases progression.Here we review, the current role of PET in cardiovascular disease, with emphasize on tracers developed for PET imaging of cardiovascular diseases.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China ; Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China.

ABSTRACT
Cardiovascular disease is the leading cause of death worldwide. Molecular imaging with targeted tracers by positron emission tomography (PET) allows for the noninvasive detection and characterization of biological changes at the molecular level, leading to earlier disease detection, objective monitoring of therapies, and better prognostication of cardiovascular diseases progression. Here we review, the current role of PET in cardiovascular disease, with emphasize on tracers developed for PET imaging of cardiovascular diseases.

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Related in: MedlinePlus

(a) Flurpiridaz F-18 PET images of healthy rat and [13N]NH3 PET image in coronal view. (b) Images of rat with permanent left coronary artery occlusion using Flurpiridaz F-18 PET and [13N]NH3 PET. Arrows indicate localization of myocardial infarction (from [58] with permission).
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fig2: (a) Flurpiridaz F-18 PET images of healthy rat and [13N]NH3 PET image in coronal view. (b) Images of rat with permanent left coronary artery occlusion using Flurpiridaz F-18 PET and [13N]NH3 PET. Arrows indicate localization of myocardial infarction (from [58] with permission).

Mentions: Flurpiridaz F-18 (18F-BMS-747158-02) is a derivative of the pyridazinone insecticide pyridaben, which is known to bind tightly to mitochondrial complex I, with high affinity in myocardial tissue [54, 55]. The high first-pass extraction fraction (94%) of flurpiridaz F-18 [56] has several advantages, including detection of milder perfusion defects, and better accuracy in reflecting the true extent of perfusion defects compared to 201Tl, the 99mTc-labelled tracers, or 82Rb. Flurpiridaz F-18 also offers better image quality and higher diagnostic certainty, compared to Tc-99m SPECT [57]. Additionally, compared with [13N]NH3, flurpiridaz F-18 was shown to produce improved contrast and higher resolution, resulting in better delineation of induced perfusion defects with lower injected dose of tracers (Figure 2) [58]. In a phase 1 study using flurpiridaz F-18 no drug-related adverse events were identified, and it was well tolerated in all subjects [59]. A phase II study using flurpiridaz F-18 has proved that PET MPI with flurpiridaz F-18 has a higher sensitivity than SPECT, with an increase in diagnostic certainty for PET versus SPECT [60]. As such, flurpiridaz F-18 might be close to an ideal myocardial perfusion tracer and is currently being evaluated in phase III clinical studies. Exercise stress testing offers important clinical and hemodynamic information in addition to myocardial perfusion. Flurpiridaz F-18 can potentially be used in exercise stress testing by injection of tracer during peak exercise and postinjection imaging because of the longer half-life of 18F. However, the long physical half-life of flurpiridaz F-18 may limit its use in protocols involving repeated measurements on a single day; therefore, protocols involving stress and rest studies should perform on separate days or protocols involving repeated measurements on a single day should correct for the residual activity of the first acquisition and the validity of a tracer reinjection protocol.


Advanced tracers in PET imaging of cardiovascular disease.

Li Y, Zhang W, Wu H, Liu G - Biomed Res Int (2014)

(a) Flurpiridaz F-18 PET images of healthy rat and [13N]NH3 PET image in coronal view. (b) Images of rat with permanent left coronary artery occlusion using Flurpiridaz F-18 PET and [13N]NH3 PET. Arrows indicate localization of myocardial infarction (from [58] with permission).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4214169&req=5

fig2: (a) Flurpiridaz F-18 PET images of healthy rat and [13N]NH3 PET image in coronal view. (b) Images of rat with permanent left coronary artery occlusion using Flurpiridaz F-18 PET and [13N]NH3 PET. Arrows indicate localization of myocardial infarction (from [58] with permission).
Mentions: Flurpiridaz F-18 (18F-BMS-747158-02) is a derivative of the pyridazinone insecticide pyridaben, which is known to bind tightly to mitochondrial complex I, with high affinity in myocardial tissue [54, 55]. The high first-pass extraction fraction (94%) of flurpiridaz F-18 [56] has several advantages, including detection of milder perfusion defects, and better accuracy in reflecting the true extent of perfusion defects compared to 201Tl, the 99mTc-labelled tracers, or 82Rb. Flurpiridaz F-18 also offers better image quality and higher diagnostic certainty, compared to Tc-99m SPECT [57]. Additionally, compared with [13N]NH3, flurpiridaz F-18 was shown to produce improved contrast and higher resolution, resulting in better delineation of induced perfusion defects with lower injected dose of tracers (Figure 2) [58]. In a phase 1 study using flurpiridaz F-18 no drug-related adverse events were identified, and it was well tolerated in all subjects [59]. A phase II study using flurpiridaz F-18 has proved that PET MPI with flurpiridaz F-18 has a higher sensitivity than SPECT, with an increase in diagnostic certainty for PET versus SPECT [60]. As such, flurpiridaz F-18 might be close to an ideal myocardial perfusion tracer and is currently being evaluated in phase III clinical studies. Exercise stress testing offers important clinical and hemodynamic information in addition to myocardial perfusion. Flurpiridaz F-18 can potentially be used in exercise stress testing by injection of tracer during peak exercise and postinjection imaging because of the longer half-life of 18F. However, the long physical half-life of flurpiridaz F-18 may limit its use in protocols involving repeated measurements on a single day; therefore, protocols involving stress and rest studies should perform on separate days or protocols involving repeated measurements on a single day should correct for the residual activity of the first acquisition and the validity of a tracer reinjection protocol.

Bottom Line: Cardiovascular disease is the leading cause of death worldwide.Molecular imaging with targeted tracers by positron emission tomography (PET) allows for the noninvasive detection and characterization of biological changes at the molecular level, leading to earlier disease detection, objective monitoring of therapies, and better prognostication of cardiovascular diseases progression.Here we review, the current role of PET in cardiovascular disease, with emphasize on tracers developed for PET imaging of cardiovascular diseases.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China ; Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China.

ABSTRACT
Cardiovascular disease is the leading cause of death worldwide. Molecular imaging with targeted tracers by positron emission tomography (PET) allows for the noninvasive detection and characterization of biological changes at the molecular level, leading to earlier disease detection, objective monitoring of therapies, and better prognostication of cardiovascular diseases progression. Here we review, the current role of PET in cardiovascular disease, with emphasize on tracers developed for PET imaging of cardiovascular diseases.

Show MeSH
Related in: MedlinePlus