Hailey Houson1, Andria Hedrick1, Vibhudutta Awasthi1,2. 1. Research Imaging Facility Department of Pharmaceutical Sciences College of Pharmacy University of Oklahoma Health Science Center Oklahoma City OK USA. 2. Hexakit, Inc. Edmond OK USA.
Abstract
BACKGROUND: Drug-induced cardiomyopathy is a significant medical problem. Clinical diagnosis of myocardial injury is based on initial electrocardiogram, levels of circulating biomarkers, and perfusion imaging with single photon emission computed tomography (SPECT). Positron emission tomography (PET) is an alternative imaging modality that provides better resolution and sensitivity than SPECT, improves diagnostic accuracy, and allows therapeutic monitoring. The objective of this study was to assess the detection of drug-induced cardiomyopathy by PET using 2-deoxy-2-[18F]fluoro-D-glucose (FDG) and compare it with the conventional SPECT technique with [99mTc]-Sestamibi (MIBI). METHODS: Cardiomyopathy was induced in Sprague Dawley rats using high-dose isoproterenol. Nuclear [18F]FDG/PET and [99mTc]MIBI/SPECT were performed before and after isoproterenol administration. [18F]FDG (0.1 mCi, 200-400 µL) and [99mTc]MIBI (2 mCi, 200-600 µL) were administered via the tail vein and imaging was performed 1 hour postinjection. Isoproterenol-induced injury was confirmed by the plasma level of cardiac troponin and triphenyltetrazolium chloride (TTC) staining. RESULTS: Isoproterenol administration resulted in an increase in circulating cardiac troponin I and showed histologic damage in the myocardium. Visually, preisoproterenol and postisoproterenol images showed alterations in cardiac accumulation of [18F]FDG, but not of [99mTc]MIBI. Image analysis revealed that myocardial uptake of [18F]FDG reduced by 60% after isoproterenol treatment, whereas that of [99mTc]MIBI decreased by 45%. CONCLUSION: We conclude that [18F]FDG is a more sensitive radiotracer than [99mTc]MIBI for imaging of drug-induced cardiomyopathy. We theorize that isoproterenol-induced cardiomyopathy impacts cellular metabolism more than perfusion, which results in more substantial changes in [18F]FDG uptake than in [99mTc]MIBI accumulation in cardiac tissue.
BACKGROUND: Drug-induced cardiomyopathy is a significant medical problem. Clinical diagnosis of myocardial injury is based on initial electrocardiogram, levels of circulating biomarkers, and perfusion imaging with single photon emission computed tomography (SPECT). Positron emission tomography (PET) is an alternative imaging modality that provides better resolution and sensitivity than SPECT, improves diagnostic accuracy, and allows therapeutic monitoring. The objective of this study was to assess the detection of drug-induced cardiomyopathy by PET using 2-deoxy-2-[18F]fluoro-D-glucose (FDG) and compare it with the conventional SPECT technique with [99mTc]-Sestamibi (MIBI). METHODS: Cardiomyopathy was induced in Sprague Dawley rats using high-dose isoproterenol. Nuclear [18F]FDG/PET and [99mTc]MIBI/SPECT were performed before and after isoproterenol administration. [18F]FDG (0.1 mCi, 200-400 µL) and [99mTc]MIBI (2 mCi, 200-600 µL) were administered via the tail vein and imaging was performed 1 hour postinjection. Isoproterenol-induced injury was confirmed by the plasma level of cardiac troponin and triphenyltetrazolium chloride (TTC) staining. RESULTS: Isoproterenol administration resulted in an increase in circulating cardiac troponin I and showed histologic damage in the myocardium. Visually, preisoproterenol and postisoproterenol images showed alterations in cardiac accumulation of [18F]FDG, but not of [99mTc]MIBI. Image analysis revealed that myocardial uptake of [18F]FDG reduced by 60% after isoproterenol treatment, whereas that of [99mTc]MIBI decreased by 45%. CONCLUSION: We conclude that [18F]FDG is a more sensitive radiotracer than [99mTc]MIBI for imaging of drug-induced cardiomyopathy. We theorize that isoproterenol-induced cardiomyopathy impacts cellular metabolism more than perfusion, which results in more substantial changes in [18F]FDG uptake than in [99mTc]MIBI accumulation in cardiac tissue.
Authors: Kristian Thygesen; Joseph S Alpert; Harvey D White; Allan S Jaffe; Fred S Apple; Marcello Galvani; Hugo A Katus; L Kristin Newby; Jan Ravkilde; Bernard Chaitman; Peter M Clemmensen; Mikael Dellborg; Hanoch Hod; Pekka Porela; Richard Underwood; Jeroen J Bax; George A Beller; Robert Bonow; Ernst E Van der Wall; Jean-Pierre Bassand; William Wijns; T Bruce Ferguson; Philippe G Steg; Barry F Uretsky; David O Williams; Paul W Armstrong; Elliott M Antman; Keith A Fox; Christian W Hamm; E Magnus Ohman; Maarten L Simoons; Philip A Poole-Wilson; Enrique P Gurfinkel; José-Luis Lopez-Sendon; Prem Pais; Shanti Mendis; Jun-Ren Zhu; Lars C Wallentin; Francisco Fernández-Avilés; Kim M Fox; Alexander N Parkhomenko; Silvia G Priori; Michal Tendera; Liisa-Maria Voipio-Pulkki; Alec Vahanian; A John Camm; Raffaele De Caterina; Veronica Dean; Kenneth Dickstein; Gerasimos Filippatos; Christian Funck-Brentano; Irene Hellemans; Steen Dalby Kristensen; Keith McGregor; Udo Sechtem; Sigmund Silber; Michal Tendera; Petr Widimsky; José Luis Zamorano; Joao Morais; Sorin Brener; Robert Harrington; David Morrow; Michael Lim; Marco A Martinez-Rios; Steve Steinhubl; Glen N Levine; W Brian Gibler; David Goff; Marco Tubaro; Darek Dudek; Nawwar Al-Attar Journal: Circulation Date: 2007-10-19 Impact factor: 29.690
Authors: Alan H B Wu; Erin Shea; Quynhanh Thuc Lu; Jennifer Minyard; Khanh Bui; Jenny C Y Hsu; Sara Jane Agee; John Todd Journal: Clin Chem Date: 2009-09-03 Impact factor: 8.327