Abstract
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Objectives Positron emission tomography/computed tomography (PET/CT) using sodium[18F]Fluoride (Na[18F]F) has been proven to be a promising hot-spot imaging modality for myocardial infarction (MI). Here, we investigated the Na[18F]F uptake in ischemia-reperfusion injury (IRI) of rat and human.
Methods Rat (Sprague-Dawley) myocardial IRI model was generated by coronary artery ligation for 35 minutes and removal of the ligature for 24 hrs. Two MI patients who had underwent primary percutaneous coronary intervention (PCI) within 3-4 hrs of MI onset, were examined at 11-47 hrs after the PCI. Standardized uptake value (SUV) was calculated in the infarct area. In rat, cyclosporine A (CysA) at a dose of 10 mg/kg was injected 5 min before the removal of the coronary ligation to see the Na[18F]F uptake change by the alleviation of apoptosis. Infarction size (%infarct) was measured on the TTC stained slices.
Results In rat, Na[18F]F PET/CT readily demonstrated the prominent Na[18F]F uptake in the infarct area post IRI. The SUV of the infarct area was elevated to 2.16±0.11 (n=4), which was significantly reduced to 1.20±0.35 (n=4, p=0.0286) by CysA injection. The infarct size also reduced from 33.51±9.30% (n=4) to 14.88±11.48% (n=4) by CysA injection (p=0.3143). In human, Na[18F]F PET/CT also showed increased Na[18F]F uptake post PCI. A 52-year old male patient with left anterior descending artery territory MI had a feature of ST-elevated MI and Na[18F]F uptake was observed in the anterior and anteroseptal myocardial wall with SUVmax of 1.6. The other 57-year old male patient with right coronary artery MI had a feature of non-ST-elevated MI and Na[18F]F uptake was positive in the basal inferior wall with SUVmax of 1.1.
Conclusions Na[18F]F PET/CT is a promising hot-spot imaging modality for visualization of myocardial ischemia-reperfusion injury.