[Ga]Pentixafor PET/MR imaging of chemokine receptor 4 expression in the human carotid artery.

Authors:
Xiang Li
Xiang Li
Huazhong University of Science and Technology
Wei Yu
Wei Yu
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases
China
Tim Wollenweber
Tim Wollenweber
Hannover Medical School
Germany
Xia Lu
Xia Lu
Hannover Medical School
Germany
Yongxiang Wei
Yongxiang Wei
Capital Medical University
China
Dietrich Beitzke
Dietrich Beitzke
Medical University of Vienna
Austria
Wolfgang Wadsak
Wolfgang Wadsak
Medical University of Vienna
Austria
Saskia Kropf
Saskia Kropf
Scintomics GmbH

Eur J Nucl Med Mol Imaging 2019 Jul 19;46(8):1616-1625. Epub 2019 Apr 19.

Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.

Purpose: Type 4 chemokine receptor (CXCR4) plays an important role in immune cell migration during the atherosclerosis progression. We aimed to evaluate [Ga]Pentixafor positron emission tomography (PET) in combination magnetic resonance imaging (MRI) for in vivo quantification of CXCR4 expression in carotid plaques.

Methods: Seventy-two patients with lymphoma were prospectively scheduled for whole body [Ga]Pentixafor PET/MRI with an additional T2-weighted carotid sequence. Volumes of interest (VOIs) were drawn along the carotid bifurcation regions, and the maximum tissue-to-blood ratios (TBR) of [Ga]Pentixafor uptake were calculated. Lesions were categorized into non-eccentric (n = 27), mild eccentric (n = 67), moderately (n = 41) and severely (n = 19) eccentric carotid atherosclerosis. A different cohort of symptomatic patients (n = 10) with carotid stenosis scheduled for thrombendarterectomy (TEA) was separately imaged with 3T MRI with dedicated plaque sequences (time of flight, T1-, and T2-weighted). MRI findings were correlated with histochemical assessment of intact carotid plaques.

Results: At hybrid PET/MRI, we observed significantly increased [Ga]Pentixafor uptake in mildly (mean TBR = 1.57 ± 0.27, mean SUV = 2.51 ± 0.39), moderately (mean TBR = 1.64 ± 0.37, mean SUV = 2.61 ± 0.55) and severely eccentric carotids (mean TBR = 1.55 ± 0.26, mean SUV = 2.40 ± 0.44) as compared to non-eccentric carotids (mean TBR = 1.29 ± 0.21, mean SUV = 1.77 ± 0.42) (p ≤ 0.05). Histological findings from TEA confirmed that prominent CXCR4 expression was localized within inflamed atheromas and preatheromas. Co-localization of cellular CXCR4 and CD68 expression in the plaque was observed by immunofluorescence staining.

Conclusions: In vivo evaluation of CXCR4 expression in carotid atherosclerotic lesions is feasible using [Ga]Pentixafor PET/MRI. In atherosclerotic plaque tissue, CXCR4 expression might be used as a surrogate marker for inflammatory atherosclerosis.

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Source
http://link.springer.com/10.1007/s00259-019-04322-7
Publisher Site
http://dx.doi.org/10.1007/s00259-019-04322-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6584241PMC

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July 2019
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