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Imaging Vascular Endothelial Growth Factor (VEGF) Receptors in Turpentine-Induced Sterile Thigh Abscesses with Radiolabeled Single-Chain VEGF

¹ Department of Radiology/MIPS, School of Medicine, Stanford University, Stanford, California; and ² Sibtech, Inc., Brookfield, Connecticut

Correspondence: For correspondence or reprints contact: Francis G. Blankenberg, Lucile Salter Packard Children's Hospital at Stanford, 725 Welch Rd., Room 1673, Stanford, CA 94304-1601. E-mail: blankenb{at}stanford.edu

Angiogenesis plays a central role in the pathogenesis of chronic inflammatory disorders. Vascular endothelial growth factor (VEGF) and its receptors are the most important regulators of angiogenesis. We wished to determine whether labeled forms of single-chain VEGF (scVEGF) could be used to image VEGF receptors in a well-characterized model of sterile soft-tissue inflammation induced by intramuscular injection of turpentine. Methods: Anesthetized adult male Swiss–Webster mice received a 20-µL intramuscular injection of turpentine into the right thigh. At 4, 7, or 10 d later, groups of 3–5 mice were injected via the tail vein with 50 µg of either scVEGF that had been site specifically labeled with Cy5.5 (scVEGF/Cy) or inactivated scVEGF/Cy (inVEGF/Cy) and then examined by fluorescence imaging. At 3, 4, 6, 7, 9, 10, or 12 d, additional groups of 3–5 mice were injected via the tail vein with 74–111 MBq of ^99mTc-scVEGF (or ^99mTc-inVEGF) and then examined by SPECT imaging. Results: On days 3 through 10, both forms of scVEGF (scVEGF/Cy and ^99mTc-scVEGF) showed significantly higher uptake (P < 0.05) in the right (abscessed) thigh than in the contralateral thigh (and higher uptake than the inactivated tracer). Peak uptake occurred on day 7 (3.67 ± 1.79 [ratio of uptake in abscessed thigh to uptake in normal thigh, mean ± SD] and 0.72 ± 0.01 for scVEGF/Cy and inVEGF/Cy, respectively, and 3.49 ± 1.22 and 1.04 ± 0.41 for ^99mTc-scVEGF and ^99mTc-inVEGF, respectively) and slowly decreased thereafter. Autoradiography revealed peak tracer uptake in the thick irregular angiogenic rim of the abscess cavity on day 9 (5.83 x 10^–7 ± 9.22 x 10^–8 and 5.85 x 10^–8 ± 5.95 x 10^–8 percentage injected dose per pixel for ^99mTc-scVEGF and ^99mTc-inVEGF, respectively); in comparison, a thin circumscribed rim of uptake was seen with ^99mTc-inVEGF. Immunostaining revealed that VEGFR-2 (VEGF receptor) colocalized with CD31 (endothelial cell marker) at all time points in the abscess rim, whereas F4/80 (macrophage) immunostaining reached a maximum at day 7 and decreased by day 10. Conclusion: The uptake of scVEGF in turpentine-induced abscesses was specific and directly related to VEGFR-2 expression in the neovasculature of the angiogenic rim. Peak tracer uptake coincided with maximum macrophage infiltration, suggesting that scVEGF imaging may be useful for the detection, localization, and monitoring of chronic inflammation in bone, joints, or soft tissues.

Key Words: angiogenesis • VEGF • SPECT • inflammation • musculoskeletal system

COPYRIGHT © 2009 by the Society of Nuclear Medicine, Inc.

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