@article {Takagi192, author = {Gen Takagi and Masaaki Miyamoto and Yoshimitsu Fukushima and Masahiro Yasutake and Shuhei Tara and Ikuyo Takagi and Naoki Seki and Shinichiro Kumita and Wataru Shimizu}, title = {Imaging Angiogenesis Using 99mTc-Macroaggregated Albumin Scintigraphy in Patients with Peripheral Artery Disease}, volume = {57}, number = {2}, pages = {192--197}, year = {2016}, doi = {10.2967/jnumed.115.160937}, publisher = {Society of Nuclear Medicine}, abstract = {One problem of vascular angiogenesis therapy is the lack of reliable methods for evaluating blood flow in the microcirculation. We aimed to assess whether 99mTc-macroaggregated albumin perfusion scintigraphy (99mTc-MAA) predicts quantitated blood flow after therapeutic angiogenesis in patients with peripheral artery disease. Methods: Forty-six patients with peripheral artery disease were treated with bone marrow mononuclear cell implantation (BMCI). Before and 4 wk after BMCI, blood flow was evaluated via transcutaneous oxygen tension (TcPO2), ankle-brachial index, intravenous 99mTc-tetrofosmin perfusion scintigraphy (99mTc-TF), and intraaortic 99mTc-MAA. Results: Four weeks after BMCI, TcPO2 improved significantly (20.4 {\textpm} 14.4 to 36.0 {\textpm} 20.0 mm Hg, P \< 0.01), but ankle-brachial index did not (0.65 {\textpm} 0.30 to 0.76 {\textpm} 0.24, P = 0.07). Improvement in 99mTc-TF count (0.60 {\textpm} 0.23 to 0.77 {\textpm} 0.29 count ratio/pixel, P \< 0.01) and 99mTc-MAA count (5.21 {\textpm} 3.56 to 10.33 {\textpm} 7.18 count ratio/pixel, P = 0.02) was observed in the foot region but not the lower limb region, using both methods. When these data were normalized by subtracting the pixel count of the untreated side, the improvements in 99mTc-TF count (-0.04 {\textpm} 0.26 to 0.08 {\textpm} 0.32 count ratio/pixel, P = 0.04) and 99mTc-MAA count (1.49 {\textpm} 3.64 to 5.59 {\textpm} 4.84 count ratio/pixel, P = 0.03) in the foot remained significant. 99mTc-MAA indicated that the newly developed arteries were approximately 25 μm in diameter. Conclusion: BMCI induced angiogenesis in the foot, which was detected using 99mTc-TF and 99mTc-MAA. 99mTc-MAA is a useful method to quantitate blood flow, estimate vascular size, and evaluate flow distribution after therapeutic angiogenesis.}, issn = {0161-5505}, URL = {https://jnm.snmjournals.org/content/57/2/192}, eprint = {https://jnm.snmjournals.org/content/57/2/192.full.pdf}, journal = {Journal of Nuclear Medicine} }