[F]健康对照者和帕金森病患者心肌交感神经支配的MFBG PET/CT成像：剂量学与药代动力学
[F]MFBG PET/CT imaging of myocardial sympathetic innervation in healthy controls and patients with parkinson's disease: dosimetry and pharmacokinetics.
作者信息
Versweyveld Louis, Delva Aline, Cohilis Marie, Deroose Christophe M, Van Weehaeghe Donatienne, Koole Michel, Vandenberghe Wim, Van Laere Koen
机构信息
Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
Department of Neurology, University Hospitals Leuven, Leuven, Belgium.
出版信息
Eur J Nucl Med Mol Imaging. 2025 Sep 9. doi: 10.1007/s00259-025-07517-3.
PURPOSE
Cardiac noradrenergic denervation visualized by meta-[I]iodobenzylguanidine ([I]MIBG) imaging supports the diagnosis of Parkinson's disease (PD). Recently, meta-[F] fluorobenzylguanidine ([F]MFBG) PET demonstrated favorable imaging characteristics compared with [I]MIBG scintigraphy for neuroendocrine tumors. We assessed [F]MFBG dosimetry and myocardial pharmacokinetics in healthy controls and PD patients.
METHODS
For dosimetry, three controls underwent sequential whole-body [F]MFBG PET/CT up to 6 hours postinjection. Five controls and three PD patients underwent 120-min dynamic cardiac [F]MFBG PET/CT and two static [I]MIBG SPECT/CT scans with planar scintigraphy, at 15 min and 3-4 h postinjection. An aortic image-derived input function with population-based radiometabolite corrections was validated against arterial sampling to derive myocardial distribution volume (V) using a 2-tissue compartment model (2TCM). [F]MFBG Vwas assessed for time-stability and compared to heart-to-mediastinum ratio (HMR) for [F]MFBG and [I]MIBG.
RESULTS
Mean effective dose was 23.1±2.6 μSv/MBq. [F]MFBG exhibited rapid blood pool clearance and cardiac uptake, with V of 35.1±10.6 mL/cm3 in controls and 5.9±1.6 mL/cm3 in PD. 2TCM V from 30-min dynamic PET datasets starting at tracer injection showed strong agreement (mean difference -1.3 mL/cm3 and LoA=-7.1 mL/cm3 to 4.5 mL/cm3) and correlation (R2=0.97, p<0.001) to 2TCM V from full 120-min datasets. [F]MFBG HMR correlated the same to [F]MFBG V (ρ=0.88, p=0.007) for 10-30-min as for 100-120-min postinjection time intervals. [I]MIBG HMR correlated more strongly to [F]MFBG V at 3-4h (ρ=0.9, p<0.005) compared to at 15-min (ρ=0.69, p=0.069) postinjection.
CONCLUSION
[F]MFBG PET is a feasible and safe imaging modality for non-invasive and simplified quantification of myocardial sympathetic innervation.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov https://clinicaltrials.gov/study/NCT06120049.
目的
间位[I]碘苄胍（[I]MIBG）显像显示的心脏去甲肾上腺素能神经支配有助于帕金森病（PD）的诊断。最近，间位[F]氟苄胍（[F]MFBG）PET与[I]MIBG闪烁显像相比，在神经内分泌肿瘤方面显示出良好的显像特征。我们评估了健康对照者和PD患者的[F]MFBG剂量学及心肌药代动力学。
方法
对于剂量学研究，3名对照者在注射后6小时内接受了连续的全身[F]MFBG PET/CT检查。5名对照者和3名PD患者在注射后15分钟和3 - 4小时接受了120分钟的动态心脏[F]MFBG PET/CT检查以及两次静态[I]MIBG SPECT/CT平面闪烁显像扫描。通过动脉采样验证了基于人群放射性代谢物校正的主动脉图像衍生输入函数，以使用双组织隔室模型（2TCM）得出心肌分布容积（V）。评估了[F]MFBG的V随时间的稳定性，并将其与[F]MFBG和[I]MIBG的心脏与纵隔比值（HMR）进行比较。
结果
平均有效剂量为23.1±2.6 μSv/MBq。[F]MFBG显示出血池快速清除和心脏摄取，对照组的V为35.1±10.6 mL/cm³，PD患者为5.9±1.6 mL/cm³。从示踪剂注射开始的30分钟动态PET数据集中得出的2TCM V与完整120分钟数据集得出的2TCM V显示出高度一致性（平均差异 -1.3 mL/cm³，一致性界限为 -7.1 mL/cm³至4.5 mL/cm³）和相关性（R² = 0.97，p < 0.001）。注射后10 - 30分钟和100 - 120分钟时间间隔内，[F]MFBG的HMR与[F]MFBG的V相关性相同（ρ = 0.88，p = 0.007）。与注射后15分钟（ρ = 0.69，p = 0.069）相比，注射后3 - 4小时[I]MIBG的HMR与[F]MFBG的V相关性更强（ρ = 0.9，p < 0.005）。
结论
[F]MFBG PET是一种可行且安全的成像方式，可用于无创且简化的心肌交感神经支配定量分析。
临床试验注册
ClinicalTrials.gov https://clinicaltrials.gov/study/NCT06120049 。
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