Imaging intraplaque inflammation in carotid atherosclerosis with 11C-PK11195 positron emission tomography/computed tomography
Imaging intraplaque inflammation in carotid atherosclerosis with 11C-PK11195 positron emission tomography/computed tomography
复制标题
DOI：
10.1093/eurheartj/ehr367
复制
发表时间：
2012-08-01
影响因子：
39.3
通讯作者：
Camici, Paolo G.
中科院分区：
文献类型：
--
作者：
Gaemperli, Oliver;Shalhoub, Joseph;Camici, Paolo G.
我们试图确定是否可以使用C-11-PK 11195（一种由活化的巨噬细胞高度表达的转运蛋白（18 kDa）（TSPO）的选择性配体）通过正电子发射断层扫描/计算机断层扫描血管造影术（PET/CTA）测量斑块内炎症。（n 32;平均年龄70 - 9岁）颈动脉狭窄（n 36; 9例有症状，27例无症状）患者接受C-11-PK 11195 PET/CTA成像。使用目标与背景比（TBR）测量颈动脉斑块中的C-11-PK 11195摄取。在CTA图像上，通过测量颈动脉斑块的CT衰减来评估斑块组成。8例患者接受颈动脉内膜切除术，并对连续切片进行TSPO和CD 68处理（使用免疫组织化学染色，H-3-PK 11195放射自显影和共聚焦荧光显微镜）。与无同侧症状（卒中或短暂性脑缺血发作）相关的颈动脉斑块相比，TBR更高（1.06 0.20 vs. 0.86 0.11，P 0.001），CT衰减更低[（中位数，四分位数间距）37，2440 vs. 71，56125 HU，P 0.01]。在免疫组织化学和共聚焦荧光显微镜，CD 68和PBR共定位与H-3-PK 11195摄取在放射自显影。C-11-PK 11195 TBR与放射自显影标记物特异性结合之间存在显著相关性（r 0.77，P 0.025）。TBR和CT斑块衰减检测有症状的患者有很高的阴性预测值（分别为91和92）。然而，最好的阳性预测值（100）时，TBR和CT衰减相结合。成像斑块内炎症在体内与C-11-PK 11195 PET/CTA是可行的，可以区分最近症状和无症状斑块。近期发生缺血事件的患者有同侧斑块，CT衰减较低，C-11-PK 11195摄取增加。
We sought to determine whether intraplaque inflammation could be measured with positron emission tomography/computed tomography angiography (PET/CTA) using C-11-PK11195, a selective ligand of the translocator protein (18 kDa) (TSPO) which is highly expressed by activated macrophages.Patients (n 32; mean age 70 9 years) with carotid stenoses (n 36; 9 symptomatic and 27 asymptomatic) underwent C-11-PK11195 PET/CTA imaging. C-11-PK11195 uptake into carotid plaques was measured using target-to-background ratios (TBR). On CTA images, plaque composition was assessed by measuring CT attenuation of the carotid plaque. Eight patients underwent carotid endarterectomy and ultrathin contiguous sections were processed for TSPO and CD68 (using immunohistochemical staining, H-3-PK11195 autoradiography, and confocal fluorescence microscopy). Carotid plaques associated with ipsilateral symptoms (stroke or transient ischaemic attack) had higher TBR (1.06 0.20 vs. 0.86 0.11, P 0.001) and lower CT attenuation [(median, inter-quartile range) 37, 2440 vs. 71, 56125 HU, P 0.01] than those without. On immunohistochemistry and confocal fluorescence microscopy, CD68 and PBR co-localized with H-3-PK11195 uptake at autoradiography. There was a significant correlation between C-11-PK11195 TBR and autoradiographic percentage-specific binding (r 0.77, P 0.025). Both TBR and CT plaque attenuation had high negative predictive values (91 and 92, respectively) for detecting symptomatic patients. However, the best positive predictive value (100) was achieved when TBR and CT attenuation were combined.Imaging intraplaque inflammation in vivo with C-11-PK11195 PET/CTA is feasible and can distinguish between recently symptomatic and asymptomatic plaques. Patients with a recent ischaemic event had ipsilateral plaques with lower CT attenuation and increased C-11-PK11195 uptake.