氟-18-氟丁苯那嗪和碳-11-羟基麻黄碱用于心脏交感神经 PET 成像的区域性分布。
Regional Distribution of Fluorine-18-Flubrobenguane and Carbon-11-Hydroxyephedrine for Cardiac PET Imaging of Sympathetic Innervation.
机构信息
Division of Cardiology, University of Ottawa Heart Institute and University of Ottawa, Ottawa, Canada; Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Molecular Function and Imaging Program, The National Cardiac PET Centre, University of Ottawa Heart Institute and University of Ottawa, Ottawa, Canada.
Molecular Function and Imaging Program, The National Cardiac PET Centre, University of Ottawa Heart Institute and University of Ottawa, Ottawa, Canada.
出版信息
JACC Cardiovasc Imaging. 2021 Jul;14(7):1425-1436. doi: 10.1016/j.jcmg.2020.09.026. Epub 2020 Nov 18.
OBJECTIVES
The aim of this study was to investigate the regional distribution of novel F-labeled positron emission tomographic (PET) tracer flubrobenguane (FBBG) (whose longer half-life could enable more widespread use) to assess myocardial presynaptic sympathetic nerve function in humans in comparison to [C]meta-hydroxyephedrine (HED).
BACKGROUND
The sympathetic nervous system (SNS) is vitally linked to cardiovascular regulation and disease. SNS imaging has shown prognostic value. HED is the most commonly used PET tracer for evaluation of sympathetic function in humans, but widespread clinical use is limited because of the short half-life of C.
METHODS
A total of 25 participants (n = 6 healthy; n = 14 ischemic cardiomyopathy, left ventricular [LV] ejection fraction [EF] = 34 ± 5%; and n = 5 nonischemic cardiomyopathy, EF = 33 ± 3%) underwent 2 separate PET imaging visits 8.7 ± 7.6 days apart. On 1 visit, participants underwent dynamic HED PET imaging. On a different visit, participants underwent dynamic FBBG PET imaging. The order of testing was random. HED and FBBG global innervation (retention index [RI] and distribution volume [DV]) and regional denervation (% nonuniformity) were quantified to assess regional presynaptic sympathetic innervations.
RESULTS
FBBG RI (r = 0.72; ICC = 0.79; p < 0.0001), DV (r = 0.62; ICC = 0.78; p < 0.0001), and regional denervation (r = 0.97; ICC = 0.98; p < 0.0001) correlated highly with HED. Average LV RI values were highly similar between HED (7.3 ± 2.4%/min) and FBBG (7.0 ± 1.7%/min; p = 0.33). Post-hoc analysis did not reveal any between-tracer differences on a regional level (17-segment), suggesting equivalent regional distributions in both patients with and without ischemic cardiomyopathy.
CONCLUSIONS
FBBG and HED yield equivalent global and regional distributions in both patients with and without ischemic cardiomyopathy. F-labeled PET tracers, such as FBBG, are critical for widespread distribution necessary for multicenter clinical trials and to maximize patient impact.
目的
本研究旨在探究新型 F 标记正电子发射断层扫描（PET）示踪剂氟苯胍（FBBG）（其半衰期更长，因此应用更为广泛）的区域性分布，以评估人类心肌节前交感神经功能，并与[C]间羟麻黄碱（HED）进行比较。
背景
交感神经系统（SNS）与心血管调节和疾病密切相关。SNS 成像已显示出预后价值。HED 是目前最常用于评估人类交感神经功能的 PET 示踪剂，但由于 C 的半衰期较短，其广泛的临床应用受到限制。
方法
共有 25 名参与者（n=6 名健康者；n=14 名缺血性心肌病，左心室射血分数[EF]=34±5%；n=5 名非缺血性心肌病，EF=33±3%）在相隔 8.7±7.6 天的 2 次单独的 PET 成像检查中接受了研究。在一次检查中，参与者接受了动态 HED PET 成像检查。在另一次检查中，参与者接受了动态 FBBG PET 成像检查。测试顺序是随机的。通过量化 HED 和 FBBG 的全局神经支配（保留指数[RI]和分布容积[DV]）和区域性去神经支配（%非均匀性）来评估区域性节前交感神经支配。
结果
FBBG RI（r=0.72；ICC=0.79；p<0.0001）、DV（r=0.62；ICC=0.78；p<0.0001）和区域性去神经支配（r=0.97；ICC=0.98；p<0.0001）与 HED 高度相关。HED（7.3±2.4%/min）和 FBBG（7.0±1.7%/min；p=0.33）的平均左心室 RI 值非常相似。事后分析未发现任何示踪剂之间在区域性水平（17 节段）上的差异，表明在缺血性心肌病患者和非缺血性心肌病患者中，两者的区域性分布均相当。
结论
FBBG 和 HED 在缺血性心肌病患者和非缺血性心肌病患者中均产生等效的全局和区域性分布。F 标记的 PET 示踪剂，如 FBBG，对于广泛的分布至关重要，这对于多中心临床试验和最大程度地提高患者的影响都是必要的。
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