Assessment of severity of coronary artery stenosis in a canine model using the PET agent 18F-fluorobenzyl triphenyl phosphonium:: Comparison with 99mTc-tetrofosmin
Assessment of severity of coronary artery stenosis in a canine model using the PET agent 18F-fluorobenzyl triphenyl phosphonium:: Comparison with 99mTc-tetrofosmin
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DOI：
10.2967/jnumed.106.038778
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发表时间：
2007-06-01
影响因子：
9.3
通讯作者：
Becker, Lewis
中科院分区：
文献类型：
--
作者：
Madar, Igal;Ravert, Hayden;Becker, Lewis
心肌灌注成像在冠状动脉疾病的临床治疗中发挥着重要作用，但最常用的放射性核素明显低估了冠状动脉狭窄的严重程度。本研究的目的是评估 PET 化合物 F-18-氟苄基三苯基鏻 (F-18-FBnTP) 的潜在临床实用性，并表征其在体内和离体犬模型中评估冠状动脉狭窄严重程度的能力。方法：使用动态 PET 和伽马井计数，测量 17 只左前降支 (LAD) 或回旋支 (LCx) 冠状动脉不同程度狭窄的犬在腺苷血管舒张期间的 F-18-FBnTP 心肌摄取情况。用放射性微球测定左心室缺血（IS）和非缺血（NIS）床中的真实心肌血流量。对 8 只狗的离体 F-18-FBnTP 和 Tc-99m-替曲膦活性进行了比较。结果：对于轻度狭窄（IS/NIS；分别为 0.72 +/- 0.08、0.93 +/- 0.07，平均 !- SE）和重度狭窄（0.42 +/- 0.05、0.64 +/-），F-18-FBnTP 的灌注缺陷定量评估明显（P < 0.03）更准确。分别为 0.08），与 微球流动（轻度，0.43 +/- 0.06；重度，0.22 +/- 0.04）。两种放射性核素的 IS/NIS 比值与微球流量差异呈线性相关，且斜率相似。根据回归线截距推断，F-18-FBnTP 的流动缺陷对比度比 99mTc-替曲膦高 2.7 倍（分别为 0.14 和 0.38）。 F-18-FBnTP PET IS/NIS 比率（轻度，0.70 +/- 0.04；重度，0.46 +/- 0.02）与离体测量值没有统计学差异（P >= 0.330）。通过早期、短时间（5-15 分钟）和延迟、长时间（30-60 分钟）F-18-FBnTP PET 扫描获得了几乎相同的狭窄严重程度的定性和定量估计。 PET 测量的狭窄区域比组织染色确定的狭窄区域小 16%。结论：F-18-FBnTP PET 是一种有前途的新技术，可用于快速无创检测和评估心肌灌注缺损的严重程度。
Myocardial perfusion imaging plays an important role in clinical management of coronary artery disease, but the most commonly used radionuclides significantly underestimate the severity of coronary artery stenosis. The objective of this study was to evaluate the potential clinical utility of the PET compound F-18-fluorobenzyl triphenyl phosphonium (F-18-FBnTP) and characterize its capacity to assess the severity of coronary artery stenosis in a canine model in vivo and ex vivo. Methods: F-18-FBnTP myocardial uptake was measured in 17 dogs with various degrees of stenosis of the left anterior descending (LAD) or circumflex (LCx) coronary arteries during adenosine vasodilation, using dynamic PET and gamma-well counting. True myocardial blood flow in ischemic (IS) and nonischemic (NIS) beds of the left ventricle was determined with radioactive microspheres. F-18-FBnTP and Tc-99m-tetrofosmin activities were compared in 8 dogs ex vivo. Results: The quantitative assessment of the perfusion defect was significantly (P < 0.03) more accurate with F-18-FBnTP than with Tc-99m-tetrofosmin, in mild (IS/NIS; 0.72 +/- 0.08, 0.93 +/- 0.07, respectively, mean !- SE) and severe stenosis (0.42 +/- 0.05, 0.64 +/- 0.08, respectively), compared with microsphere flow (mild, 0.43 +/- 0.06; severe, 0.22 +/- 0.04). The IS/NIS ratio of both radionuclides correlated linearly with microsphere flow disparity with a similar slope. Flow defect contrast was 2.7 times greater for F-18-FBnTP than for 99mTc-tetrofosmin, as inferred from the regression line intercept (0.14 vs. 0.38, respectively). The F-18-FBnTP PET IS/NIS ratio (mild, 0.70 +/- 0.04; severe, 0.46 +/- 0.02), did not differ statistically (P >= 0.330) from that measured ex vivo. A nearly identical qualitative and quantitative estimate of stenosis severity was obtained by early, short (5-15-min) and delayed, prolonged (30-60-min) F-18-FBnTP PET scans. The stenotic area measured by PET was 16% smaller than that defined by tissue staining. Conclusion: F-18-FBnTP PET is a promising new technology for rapid noninvasive detection and assessment of perfusion defect severity in the myocardium.