Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, SE-751 85 Uppsala, Sweden.
Eur J Vasc Endovasc Surg. 2013 Apr;45(4):351-6. doi: 10.1016/j.ejvs.2013.01.011. Epub 2013 Feb 8.
The aim of this study was to investigate the relevance of inflammation in the pathogenesis of abdominal aortic aneurysm (AAA) in vivo with two novel positron emission tomography (PET) tracers: [(11)C]-PK11195 which targets the translocator protein (18 kDa) expressed on macrophages and [(11)C]-d-deprenyl with a yet unknown target receptor expressed in chronic inflammation.
Prospective clinical study.
MATERIALS/METHODS: Five patients were examined with [(11)C]-PK11195-positron emission tomography/computed tomography (PET/CT) and 10 with [(11)C]-d-deprenyl-PET/CT. Nine large AAAs (54-66 mm) scheduled for repair and six small AAA (35-44 mm). All 15 patients were male and the AAAs were all asymptomatic. Regional activity was measured as standardised uptake values (SUVs) and retention index was calculated. Biopsies were taken from the aneurysm wall for histological examinations, in the nine patients operated on.
No aortic uptake was recorded on the visual inspection, neither with [(11)C]-PK11195 nor with [(11)C]-d-deprenyl. For [(11)C]-PK11195 the median SUV of the AAA wall was 0.9 (range 0.8-1.0) and for [(11)C]-d-deprenyl, 0.7 (range 0.4-1.2). No increased uptake was seen in the aneurysmal infrarenal aorta compared with the non-aneurysmal suprarenal aorta. Histological examination of the aneurysm wall showed high inflammatory cell infiltration with lymphocytes and macrophages.
The chronic inflammation observed in the vessel wall was not detectable with [(11)C]-PK11195 and [(11)C]-d-deprenyl. In order to study the relevance of the inflammation in the pathogenesis of AAA in vivo other PET tracers need to be investigated.
本研究旨在通过两种新型正电子发射断层扫描(PET)示踪剂——靶向巨噬细胞表达的转位蛋白(18 kDa)的 [(11)C]-PK11195 和在慢性炎症中表达的未知靶受体的 [(11)C]-d-丙炔基,研究炎症在腹主动脉瘤(AAA)发病机制中的相关性。
前瞻性临床研究。
材料/方法:5 名患者接受 [(11)C]-PK11195-PET/CT 检查,10 名患者接受 [(11)C]-d-deprenyl-PET/CT 检查。9 例大 AAA(54-66mm)拟行修复术,6 例小 AAA(35-44mm)。所有 15 名患者均为男性,AAA 均无症状。采用标准化摄取值(SUV)测量局部活性,并计算保留指数。对 9 名手术患者的动脉瘤壁进行活检,进行组织学检查。
无论使用 [(11)C]-PK11195 还是 [(11)C]-d-丙炔基,视觉检查均未记录到主动脉摄取。[(11)C]-PK11195 测量 AAA 壁的中位数 SUV 为 0.9(范围 0.8-1.0),[(11)C]-d-丙炔基为 0.7(范围 0.4-1.2)。与非动脉瘤性肾上主动脉相比,动脉瘤下主动脉无摄取增加。动脉瘤壁的组织学检查显示淋巴细胞和巨噬细胞浸润的炎症细胞浸润明显。
[(11)C]-PK11195 和 [(11)C]-d-丙炔基无法检测到血管壁中的慢性炎症。为了研究炎症在 AAA 发病机制中的相关性,需要进一步研究其他 PET 示踪剂。