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F-18 meta-fluorobenzylguanidine PET imaging of myocardial sympathetic innervation

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Background

I-123 meta-iodobenzylguanidine (MIBG) imaging has long been employed to noninvasively assess the integrity of human norepinephrine transporter-1 and, hence, myocardial sympathetic innervation. Positron-emitting F-18 meta-fluorobenzylguanidine (MFBG) has recently been developed for potentially superior quantitative characterization. We assessed the feasibility of MFBG imaging of myocardial sympathetic innervation.

Methods

16 patients were imaged with MFBG PET (30-minute dynamic imaging of chest, followed by 3 whole-body acquisitions between 30 minutes and 4-hour post-injection). Blood kinetics were assessed from multiple samples. Pharmacokinetic modeling with reversible 1- and 2-compartment models was performed. Kinetic rate constants were re-calculated from truncated datasets. All patients underwent concurrent MIBG SPECT.

Results

MFBG myocardial uptake was rapid and sustained; the mean standardized uptake value (SUV (mean ± standard deviation)) was 5.1 ± 2.2 and 3.4 ± 1.9 at 1 hour and 3-4-hour post-injection, respectively. The mean K1 and distribution volume (VT) were 1.1 ± 0.6 mL/min/g and 34 ± 22 mL/cm3, respectively. Both were reproducible when re-calculated from truncated 1-hour datasets (Intraclass Correlation Coefficient of 0.99 and 0.91, respectively). Spearman’s ϱ = 0.86 between MFBG SUV and VT and 0.80 between MFBG PET-derived VT and MIBG SPECT-derived heart-to-mediastinum activity concentration ratio.

Conclusion

MFBG is a promising PET radiotracer for the assessment of myocardial sympathetic innervation.

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Abbreviations

AIC:

Akaike Information Criterion

MIBG:

Meta-iodobenzylguanidine

MFBG:

Meta-fluorobenzylguanidine

SUV:

Standardized uptake value

V T :

Distribution volume

HMR:

Heart-to-mediastinum activity concentration ratio

1T2K:

Reversible 1-tissue compartment model with 2 kinetic rate constants

2T4K:

Reversible 2-tissue compartment model with 4 kinetic rate constants

FD:

Full dataset comprising of 30-minute dynamic F-18 MFBG PET and all three delayed static scans acquired at ~1 h, 2 h and 3-4 h after injection.

TD1:

Truncated dataset #1 comprising of 30-minute dynamic F-18 MFBG PET and the first delayed static scan acquired at ~1 hour after injection

TD2:

Truncated dataset #2 comprising of 30-minute dynamic F-18 MFBG PET only

hNET:

Human Norepinephrine transporter

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Acknowledgements

The authors thank Dr. Kevin D. Staton for help with the analysis of blood samples.

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Authors and Affiliations

  1. Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Milan Grkovski PhD, Pat B. Zanzonico PhD & John L. Humm PhD

  2. Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Shakeel Modak MD

  3. Mount Sinai Heart, The Mount Sinai Hospital, New York, NY, USA

    Jagat Narula MD, PhD

  4. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Jagat Narula MD, PhD

  5. Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Neeta Pandit-Taskar MD

  6. Department of Radiology, Weill Cornell Medical College, New York, NY, USA

    Neeta Pandit-Taskar MD

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  1. Milan Grkovski PhD
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  2. Pat B. Zanzonico PhD
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  3. Shakeel Modak MD
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  4. John L. Humm PhD
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  5. Jagat Narula MD, PhD
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  6. Neeta Pandit-Taskar MD
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Corresponding author

Correspondence to Neeta Pandit-Taskar MD.

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Disclosures

This study was funded by the Department of Radiology Seed Grant of Memorial Sloan Kettering Cancer Center; NIH grant R01 CA204093 (Principal Investigator: Neeta Pandit-Taskar) and the MSK Radiochemistry & Molecular Imaging Probes Core supported in part through the NIH/NCI Cancer Center Support Grant P30 CA008748.

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Grkovski, M., Zanzonico, P.B., Modak, S. et al. F-18 meta-fluorobenzylguanidine PET imaging of myocardial sympathetic innervation. J. Nucl. Cardiol. 29, 3179–3188 (2022). https://doi.org/10.1007/s12350-021-02813-5

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  • DOI: https://doi.org/10.1007/s12350-021-02813-5

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