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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-07-2019 | Magnetic Resonance Imaging | Original Article

[⁶⁸Ga]Pentixafor PET/MR imaging of chemokine receptor 4 expression in the human carotid artery

Authors: Xiang Li, Wei Yu, Tim Wollenweber, Xia Lu, Yongxiang Wei, Dietrich Beitzke, Wolfgang Wadsak, Saskia Kropf, Hans J. Wester, Alexander R. Haug, Xiaoli Zhang, Marcus Hacker

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2019

Abstract

Purpose

Type 4 chemokine receptor (CXCR4) plays an important role in immune cell migration during the atherosclerosis progression. We aimed to evaluate [⁶⁸Ga]Pentixafor positron emission tomography (PET) in combination magnetic resonance imaging (MRI) for in vivo quantification of CXCR4 expression in carotid plaques.

Methods

Seventy-two patients with lymphoma were prospectively scheduled for whole body [⁶⁸Ga]Pentixafor PET/MRI with an additional T2-weighted carotid sequence. Volumes of interest (VOIs) were drawn along the carotid bifurcation regions, and the maximum tissue-to-blood ratios (TBR) of [⁶⁸Ga]Pentixafor uptake were calculated. Lesions were categorized into non-eccentric (n = 27), mild eccentric (n = 67), moderately (n = 41) and severely (n = 19) eccentric carotid atherosclerosis. A different cohort of symptomatic patients (n = 10) with carotid stenosis scheduled for thrombendarterectomy (TEA) was separately imaged with 3T MRI with dedicated plaque sequences (time of flight, T1-, and T2-weighted). MRI findings were correlated with histochemical assessment of intact carotid plaques.

Results

At hybrid PET/MRI, we observed significantly increased [⁶⁸Ga]Pentixafor uptake in mildly (mean TBR_max = 1.57 ± 0.27, mean SUV_max = 2.51 ± 0.39), moderately (mean TBR_max = 1.64 ± 0.37, mean SUV_max = 2.61 ± 0.55) and severely eccentric carotids (mean TBR_max = 1.55 ± 0.26, mean SUV_max = 2.40 ± 0.44) as compared to non-eccentric carotids (mean TBR_max = 1.29 ± 0.21, mean SUV_max = 1.77 ± 0.42) (p ≤ 0.05). Histological findings from TEA confirmed that prominent CXCR4 expression was localized within inflamed atheromas and preatheromas. Co-localization of cellular CXCR4 and CD68 expression in the plaque was observed by immunofluorescence staining.

Conclusions

In vivo evaluation of CXCR4 expression in carotid atherosclerotic lesions is feasible using [⁶⁸Ga]Pentixafor PET/MRI. In atherosclerotic plaque tissue, CXCR4 expression might be used as a surrogate marker for inflammatory atherosclerosis.

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Title: [68Ga]Pentixafor PET/MR imaging of chemokine receptor 4 expression in the human carotid artery
Authors: Xiang Li
Wei Yu
Tim Wollenweber
Xia Lu
Yongxiang Wei
Dietrich Beitzke
Wolfgang Wadsak
Saskia Kropf
Hans J. Wester
Alexander R. Haug
Xiaoli Zhang
Marcus Hacker
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Arterial Occlusive Disease
Positron Emission Tomography
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2019
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04322-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

[⁶⁸Ga]Pentixafor PET/MR imaging of chemokine receptor 4 expression in the human carotid artery

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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