Initial experience with [18F]DPA-714 TSPO-PET to image inflammation in primary angiitis of the central nervous system
Initial experience with [18F]DPA-714 TSPO-PET to image inflammation in primary angiitis of the central nervous system
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DOI：
10.1007/s00259-019-04662-4
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发表时间：
2020-08-01
影响因子：
9.1
通讯作者：
Minnerup, Jens
中科院分区：
文献类型：
--
作者：
Backhaus, Philipp;Roll, Wolfgang;Minnerup, Jens
目的原发性中枢神经系统血管炎(PACNS)是一种异质性、少见且知之甚少的炎症性疾病。我们的目标是通过使用[F-18]DPA-714靶向转运蛋白(TSPO)的PET-MRI对PACNS患者激活的小胶质细胞/巨噬细胞进行非侵入性成像，以潜在地辅助鉴别诊断、治疗监测和活检计划。方法对9例确诊或怀疑为PACNS的缺血性卒中患者行[F-18]DPA-714-PET-MRI检查。注射233+/-19MBq[F-18]DPA-714后60min行动态PET扫描，同时行MRI检查。结果在2例PACNS患者中，[F-18]DPA-714摄取模式超过了脑梗塞的MRI相关性，而4例PACNS患者摄取仅限于梗死灶，初步怀疑PACNS不能得到证实。大约3名PACNS或大脑主要淋巴管炎的患者没有或仅有轻微的摄取增加。一名PACNS患者的短期[F-18]DPA-714-PET随访显示，抗炎治疗后皮损[F-18]DPA-714摄取减少。同一患者的活检确定了示踪剂摄取到表达TSPO的免疫细胞的来源。结论[F-18]DPA-714-PET显像有助于PACNS的诊断和疗效监测。需要进一步的研究，以充分了解TSPO-PET在破译疾病异质性方面的潜力。
Purpose Primary angiitis of the central nervous system (PACNS) is a heterogeneous, rare, and poorly understood inflammatory disease. We aimed at non-invasive imaging of activated microglia/macrophages in patients with PACNS by PET-MRI targeting the translocator protein (TSPO) with [F-18]DPA-714 to potentially assist differential diagnosis, therapy monitoring, and biopsy planning. Methods In total, nine patients with ischemic stroke and diagnosed or suspected PACNS underwent [F-18]DPA-714-PET-MRI. Dynamic PET scanning was performed for 60 min after injection of 233 +/- 19 MBq [F-18]DPA-714, and MRI was simultaneously acquired. Results In two PACNS patients, [F-18]DPA-714 uptake patterns exceeded MRI correlates of infarction, whereas uptake was confined to the infarct in four patients where initial suspicion of PACNS could not be confirmed. About three patients with PACNS or cerebral predominant lymphocytic vasculitis showed no or only faintly increased uptake. Short-term [F-18]DPA-714-PET follow-up in a patient with PACNS showed reduced lesional [F-18]DPA-714 uptake after anti-inflammatory treatment. Biopsy in the same patient pinpointed the source of tracer uptake to TSPO-expressing immune cells. Conclusions [F-18]DPA-714-PET imaging may facilitate the diagnosis and treatment monitoring of PACNS. Further studies are needed to fully understand the potential of TSPO-PET in deciphering the heterogeneity of the disease.