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免疫正电子发射断层扫描(immunoPET)方法的进展与挑战

Advances and challenges in immunoPET methodology.

作者信息

Mohr Philipp, van Sluis Joyce, Lub-de Hooge Marjolijn N, Lammertsma Adriaan A, Brouwers Adrienne H, Tsoumpas Charalampos

机构信息

Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.

Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.

出版信息

Front Nucl Med. 2024 Feb 19;4:1360710. doi: 10.3389/fnume.2024.1360710. eCollection 2024.

Abstract

Immuno-positron emission tomography (immunoPET) enables imaging of specific targets that play a role in targeted therapy and immunotherapy, such as antigens on cell membranes, targets in the disease microenvironment, or immune cells. The most common immunoPET applications use a monoclonal antibody labeled with a relatively long-lived positron emitter such as Zr (  = 78.4 h), but smaller antibody-based constructs labeled with various other positron emitting radionuclides are also being investigated. This molecular imaging technique can thus guide the development of new drugs and may have a pivotal role in selecting patients for a particular therapy. In early phase immunoPET trials, multiple imaging time points are used to examine the time-dependent biodistribution and to determine the optimal imaging time point, which may be several days after tracer injection due to the slow kinetics of larger molecules. Once this has been established, usually only one static scan is performed and semi-quantitative values are reported. However, total PET uptake of a tracer is the sum of specific and nonspecific uptake. In addition, uptake may be affected by other factors such as perfusion, pre-/co-administration of the unlabeled molecule, and the treatment schedule. This article reviews imaging methodologies used in immunoPET studies and is divided into two parts. The first part summarizes the vast majority of clinical immunoPET studies applying semi-quantitative methodologies. The second part focuses on a handful of studies applying pharmacokinetic models and includes preclinical and simulation studies. Finally, the potential and challenges of immunoPET quantification methodologies are discussed within the context of the recent technological advancements provided by long axial field of view PET/CT scanners.

摘要

免疫正电子发射断层扫描(immunoPET)能够对在靶向治疗和免疫治疗中发挥作用的特定靶点进行成像,例如细胞膜上的抗原、疾病微环境中的靶点或免疫细胞。最常见的immunoPET应用使用标记有相对长寿命正电子发射体(如Zr,半衰期为78.4小时)的单克隆抗体,但也在研究用各种其他正电子发射放射性核素标记的基于抗体的较小构建体。因此,这种分子成像技术可以指导新药的开发,并且在为特定治疗选择患者方面可能具有关键作用。在早期的immunoPET试验中,使用多个成像时间点来检查时间依赖性生物分布并确定最佳成像时间点,由于大分子的动力学较慢,最佳成像时间点可能在示踪剂注射后几天。一旦确定了最佳成像时间点,通常只进行一次静态扫描并报告半定量值。然而,示踪剂的总PET摄取是特异性摄取和非特异性摄取的总和。此外,摄取可能受到其他因素的影响,如灌注、未标记分子的预给药/共同给药以及治疗方案。本文回顾了immunoPET研究中使用的成像方法,并分为两部分。第一部分总结了绝大多数应用半定量方法的临床immunoPET研究。第二部分重点介绍了少数应用药代动力学模型的研究,包括临床前研究和模拟研究。最后,在长轴视野PET/CT扫描仪提供的最新技术进展的背景下,讨论了immunoPET定量方法的潜力和挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e0d/11440922/c10fdbb9b8c0/fnume-04-1360710-g001.jpg

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