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Research ArticlePulmonary

Glycoprotein IIb/IIIa Receptor Imaging with 18F-GP1 PET for Acute Venous Thromboembolism: An Open-Label, Nonrandomized, Phase 1 Study

Chanwoo Kim, Jae Seung Lee, Youngjin Han, Sun Young Chae, Soyoung Jin, Changhwan Sung, Hye Joo Son, Seung Jun Oh, Sang Ju Lee, Jungsu S. Oh, Yong-Pil Cho, Tae-Won Kwon, Deok Hee Lee, Seongsoo Jang, Bohyun Kim, Norman Koglin, Mathias Berndt, Andrew W. Stephens and Dae Hyuk Moon
Journal of Nuclear Medicine February 2019, 60 (2) 244-249; DOI: https://doi.org/10.2967/jnumed.118.212084
Chanwoo Kim
1Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Jae Seung Lee
2Department of Pulmonology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Youngjin Han
3Department of Vascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Sun Young Chae
1Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Soyoung Jin
4Department of Nuclear Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
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Changhwan Sung
1Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Hye Joo Son
1Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Seung Jun Oh
1Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Sang Ju Lee
1Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Jungsu S. Oh
1Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Yong-Pil Cho
3Department of Vascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Tae-Won Kwon
3Department of Vascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Deok Hee Lee
5Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Seongsoo Jang
6Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Bohyun Kim
7Department of Laboratory Medicine, Soonchunhyang University Hospital Cheonan, Soonchunhyang University College of Medicine, Cheonan, Chungcheongnam-do, Republic of Korea; and
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Norman Koglin
8Piramal Imaging GmbH (now Life Molecular Imaging GmbH), Berlin, Germany
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Mathias Berndt
8Piramal Imaging GmbH (now Life Molecular Imaging GmbH), Berlin, Germany
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Andrew W. Stephens
8Piramal Imaging GmbH (now Life Molecular Imaging GmbH), Berlin, Germany
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Dae Hyuk Moon
1Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Abstract

18F-GP1 is a derivative of elarofiban with a high affinity to activated platelet glycoprotein IIb/IIIa and favorable in vivo characteristics for thrombus imaging in preclinical models. We aimed to explore the detection rate of thromboembolic foci with 18F-GP1 PET/CT in patients with acute venous thromboembolism and to evaluate the safety, biodistribution, pharmacokinetics, and metabolism of 18F-GP1. Methods: We studied patients who had signs or symptoms of acute deep-vein thrombosis (DVT) of the leg or acute pulmonary embolism (PE) within 14 d before 18F-GP1 PET/CT and had thromboembolic foci confirmed by conventional imaging (n = 10 for DVT and n = 10 for PE). Dynamic whole-body PET/CT images were acquired for up to 140 min after injection of 250 MBq of 18F-GP1. Results: 18F-GP1 PET/CT was well tolerated, without any drug-related adverse events, and showed high initial uptake in the spleen, kidneys, and blood pool, followed by rapid clearance. The overall image quality was excellent and allowed interpretation in all patients. 18F-GP1 PET/CT identified thromboembolic foci in all 20 patients with either DVT or PE. Vessel-level analysis revealed that 18F-GP1 PET/CT detected 89% (68/76) of vessels with DVT and 60% (146/245) with PE. Importantly, 18F-GP1 PET/CT showed increased uptake in 32 vessels that were not detected by conventional imaging, of which 25 were located in distal veins of the lower extremity in 12 patients. A positive correlation was found between 18F-GP1 uptake and P-selectin–positive circulating platelets (r = 0.656, P = 0.002). Conclusion: 18F-GP1 is a promising PET tracer for imaging acute venous thromboembolism in patients. 18F-GP1 PET/CT may identify thrombi in distal veins of the leg, where conventional imaging has limitations.

  • deep vein thrombosis
  • pulmonary embolism
  • positron emission tomography
  • 18F-GP1
  • platelet activation

Footnotes

  • ↵* Contributed equally to this work.

  • Published online Jun. 29, 2018.

  • © 2019 by the Society of Nuclear Medicine and Molecular Imaging.
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Journal of Nuclear Medicine: 60 (2)
Journal of Nuclear Medicine
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February 1, 2019
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Glycoprotein IIb/IIIa Receptor Imaging with 18F-GP1 PET for Acute Venous Thromboembolism: An Open-Label, Nonrandomized, Phase 1 Study
Chanwoo Kim, Jae Seung Lee, Youngjin Han, Sun Young Chae, Soyoung Jin, Changhwan Sung, Hye Joo Son, Seung Jun Oh, Sang Ju Lee, Jungsu S. Oh, Yong-Pil Cho, Tae-Won Kwon, Deok Hee Lee, Seongsoo Jang, Bohyun Kim, Norman Koglin, Mathias Berndt, Andrew W. Stephens, Dae Hyuk Moon
Journal of Nuclear Medicine Feb 2019, 60 (2) 244-249; DOI: 10.2967/jnumed.118.212084

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Glycoprotein IIb/IIIa Receptor Imaging with 18F-GP1 PET for Acute Venous Thromboembolism: An Open-Label, Nonrandomized, Phase 1 Study
Chanwoo Kim, Jae Seung Lee, Youngjin Han, Sun Young Chae, Soyoung Jin, Changhwan Sung, Hye Joo Son, Seung Jun Oh, Sang Ju Lee, Jungsu S. Oh, Yong-Pil Cho, Tae-Won Kwon, Deok Hee Lee, Seongsoo Jang, Bohyun Kim, Norman Koglin, Mathias Berndt, Andrew W. Stephens, Dae Hyuk Moon
Journal of Nuclear Medicine Feb 2019, 60 (2) 244-249; DOI: 10.2967/jnumed.118.212084
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Keywords

  • deep vein thrombosis
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  • Positron emission tomography
  • 18F-GP1
  • platelet activation
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