Abstract
The CXC-motif chemokine receptor 4 (CXCR4) represents a promising target for molecular imaging of different CXCR4+ cell types in cardiovascular diseases including atherosclerosis and arterial wall injury. The aim of this study was to assess the prevalence, pattern, and clinical correlates of arterial wall accumulation of 68Ga-Pentixafor, a specific CXCR4 ligand for positron emission tomography (PET). Methods: Data of fifty-one patients who underwent 68Ga-Pentixafor PET/computed tomography (PET/CT) for non-cardiovascular indications were retrospectively analyzed. Tracer accumulation in the vessel wall of major arteries was analyzed qualitatively and semiquantitatively by blood-pool-corrected target-to-background ratios (TBRs). Tracer uptake was compared with calcified plaque burden and cardiovascular risk factors. Results: Focal arterial uptake of 68Ga-Pentixafor was seen at 1411 sites in 51 (100%) of patients. 68Ga-Pentixafor uptake was significantly associated with calcified plaque burden (P<0.0001) and cardiovascular risk factors including age (P<0.0001), arterial hypertension (P<0.0001), hypercholesterolemia (P = 0.0005), history of smoking (P = 0.01), and prior cardiovascular events (P = 0.0004). Both the prevalence (P<0.0001) and signal intensity (P = 0.009) of 68Ga-Pentixafor uptake increased as the number of risk factors increased. Conclusion: 68Ga-Pentixafor PET/CT is suitable for non-invasive, highly specific PET imaging of CXCR4 expression in the atherosclerotic arterial wall. Arterial wall 68Ga-Pentixafor uptake is significantly associated with surrogate markers of atherosclerosis, and is linked to the presence of cardiovascular risk factors. 68Ga-Pentixafor signal is higher in patients with a high-risk profile, and may hold promise for identification of vulnerable plaque.
- Copyright © 2017 by the Society of Nuclear Medicine and Molecular Imaging, Inc.