Imaging of Chemotherapy-Induced Acute Cardiotoxicity with 18 F-Labeled Lipophilic Cations

Many chemotherapy agents are toxic to the heart, such that increasing numbers of cancer survivors are now living with the potentially lethal cardiovascular consequences of their treatment. Earlier and more sensitive detection of chemotherapy-induced cardiotoxicity may allow improved treatment strate...

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Veröffentlicht in:Journal of Nuclear Medicine 2019-12, Vol.60 (12), p.1750-1756
Hauptverfasser: McCluskey, Stuart P, Haslop, Anna, Coello, Christopher, Gunn, Roger N, Tate, Edward W, Southworth, Richard, Plisson, Christophe, Long, Nicholas J, Wells, Lisa A
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container_end_page 1756
container_issue 12
container_start_page 1750
container_title Journal of Nuclear Medicine
container_volume 60
creator McCluskey, Stuart P
Haslop, Anna
Coello, Christopher
Gunn, Roger N
Tate, Edward W
Southworth, Richard
Plisson, Christophe
Long, Nicholas J
Wells, Lisa A
description Many chemotherapy agents are toxic to the heart, such that increasing numbers of cancer survivors are now living with the potentially lethal cardiovascular consequences of their treatment. Earlier and more sensitive detection of chemotherapy-induced cardiotoxicity may allow improved treatment strategies and increase long-term survival. Lipophilic cation PET tracers may be suitable for early detection of cardiotoxicity. This study aimed to evaluate an F-labeled lipophilic phosphonium cation, [1-(2- F-fluoroethyl),1 [1,2,3]triazole-4-ethylene]triphenylphosphonium bromide ( F-MitoPhos), as a cardiac imaging agent, comparing it with leading PET and SPECT lipophilic cationic tracers before further assessing its potential for imaging cardiotoxicity in an acute doxorubicin model. Cardiac uptake and response to decreased mitochondrial membrane potential of F-MitoPhos and Tc-sestamibi were tested in isolated perfused rat hearts. Baseline pharmacokinetic profiles of F-MitoPhos and F-fluorobenzyltriphenylphosphonium and their response to acute doxorubicin-induced cardiotoxicity were assessed in rats in vivo (10, 15, or 20 mg of doxorubicin per kilogram, intravenously, 48 h beforehand). Cardiac retention of F-MitoPhos was more than double that of Tc-sestamibi in isolated perfused rat hearts. A favorable biodistribution of F-MitoPhos in vivo was observed, with heart-to-tissue ratios of 304 ± 186, 11.2 ± 1.2, and 3.8 ± 0.6 for plasma, liver, and lung, respectively (60 min). A significant dose-dependent loss of cardiac retention of F-MitoPhos was observed on doxorubicin treatment, with average cardiac SUV from 30 to 60 min (mean ± SD) decreasing from 3.5 ± 0.5 (control) to 1.8 ± 0.1 (doxorubicin, 20 mg/kg). Other assessed biomarkers showed no alterations. F-MitoPhos showed pharmacokinetic parameters suitable for cardiac imaging. A significant dose response of cardiac uptake to doxorubicin treatment was observed before detectable biomarker alterations. F-MitoPhos is therefore a promising tracer for imaging chemotherapy-induced cardiotoxicity. To our knowledge, this is the first demonstration of radiolabeled lipophilic cations being used for the PET imaging of chemotherapy-induced cardiotoxicity and indicates the potential application of these compounds in this area.
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Earlier and more sensitive detection of chemotherapy-induced cardiotoxicity may allow improved treatment strategies and increase long-term survival. Lipophilic cation PET tracers may be suitable for early detection of cardiotoxicity. This study aimed to evaluate an F-labeled lipophilic phosphonium cation, [1-(2- F-fluoroethyl),1 [1,2,3]triazole-4-ethylene]triphenylphosphonium bromide ( F-MitoPhos), as a cardiac imaging agent, comparing it with leading PET and SPECT lipophilic cationic tracers before further assessing its potential for imaging cardiotoxicity in an acute doxorubicin model. Cardiac uptake and response to decreased mitochondrial membrane potential of F-MitoPhos and Tc-sestamibi were tested in isolated perfused rat hearts. Baseline pharmacokinetic profiles of F-MitoPhos and F-fluorobenzyltriphenylphosphonium and their response to acute doxorubicin-induced cardiotoxicity were assessed in rats in vivo (10, 15, or 20 mg of doxorubicin per kilogram, intravenously, 48 h beforehand). Cardiac retention of F-MitoPhos was more than double that of Tc-sestamibi in isolated perfused rat hearts. A favorable biodistribution of F-MitoPhos in vivo was observed, with heart-to-tissue ratios of 304 ± 186, 11.2 ± 1.2, and 3.8 ± 0.6 for plasma, liver, and lung, respectively (60 min). A significant dose-dependent loss of cardiac retention of F-MitoPhos was observed on doxorubicin treatment, with average cardiac SUV from 30 to 60 min (mean ± SD) decreasing from 3.5 ± 0.5 (control) to 1.8 ± 0.1 (doxorubicin, 20 mg/kg). Other assessed biomarkers showed no alterations. F-MitoPhos showed pharmacokinetic parameters suitable for cardiac imaging. A significant dose response of cardiac uptake to doxorubicin treatment was observed before detectable biomarker alterations. F-MitoPhos is therefore a promising tracer for imaging chemotherapy-induced cardiotoxicity. 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Baseline pharmacokinetic profiles of F-MitoPhos and F-fluorobenzyltriphenylphosphonium and their response to acute doxorubicin-induced cardiotoxicity were assessed in rats in vivo (10, 15, or 20 mg of doxorubicin per kilogram, intravenously, 48 h beforehand). Cardiac retention of F-MitoPhos was more than double that of Tc-sestamibi in isolated perfused rat hearts. A favorable biodistribution of F-MitoPhos in vivo was observed, with heart-to-tissue ratios of 304 ± 186, 11.2 ± 1.2, and 3.8 ± 0.6 for plasma, liver, and lung, respectively (60 min). A significant dose-dependent loss of cardiac retention of F-MitoPhos was observed on doxorubicin treatment, with average cardiac SUV from 30 to 60 min (mean ± SD) decreasing from 3.5 ± 0.5 (control) to 1.8 ± 0.1 (doxorubicin, 20 mg/kg). Other assessed biomarkers showed no alterations. F-MitoPhos showed pharmacokinetic parameters suitable for cardiac imaging. 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Earlier and more sensitive detection of chemotherapy-induced cardiotoxicity may allow improved treatment strategies and increase long-term survival. Lipophilic cation PET tracers may be suitable for early detection of cardiotoxicity. This study aimed to evaluate an F-labeled lipophilic phosphonium cation, [1-(2- F-fluoroethyl),1 [1,2,3]triazole-4-ethylene]triphenylphosphonium bromide ( F-MitoPhos), as a cardiac imaging agent, comparing it with leading PET and SPECT lipophilic cationic tracers before further assessing its potential for imaging cardiotoxicity in an acute doxorubicin model. Cardiac uptake and response to decreased mitochondrial membrane potential of F-MitoPhos and Tc-sestamibi were tested in isolated perfused rat hearts. Baseline pharmacokinetic profiles of F-MitoPhos and F-fluorobenzyltriphenylphosphonium and their response to acute doxorubicin-induced cardiotoxicity were assessed in rats in vivo (10, 15, or 20 mg of doxorubicin per kilogram, intravenously, 48 h beforehand). Cardiac retention of F-MitoPhos was more than double that of Tc-sestamibi in isolated perfused rat hearts. A favorable biodistribution of F-MitoPhos in vivo was observed, with heart-to-tissue ratios of 304 ± 186, 11.2 ± 1.2, and 3.8 ± 0.6 for plasma, liver, and lung, respectively (60 min). A significant dose-dependent loss of cardiac retention of F-MitoPhos was observed on doxorubicin treatment, with average cardiac SUV from 30 to 60 min (mean ± SD) decreasing from 3.5 ± 0.5 (control) to 1.8 ± 0.1 (doxorubicin, 20 mg/kg). Other assessed biomarkers showed no alterations. F-MitoPhos showed pharmacokinetic parameters suitable for cardiac imaging. A significant dose response of cardiac uptake to doxorubicin treatment was observed before detectable biomarker alterations. F-MitoPhos is therefore a promising tracer for imaging chemotherapy-induced cardiotoxicity. To our knowledge, this is the first demonstration of radiolabeled lipophilic cations being used for the PET imaging of chemotherapy-induced cardiotoxicity and indicates the potential application of these compounds in this area.</abstract><cop>United States</cop><pmid>31147403</pmid><doi>10.2967/jnumed.119.226787</doi><tpages>7</tpages></addata></record>
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source MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Animals
Antineoplastic Agents - adverse effects
Cardiotoxicity - diagnostic imaging
Cardiotoxicity - etiology
Cardiotoxicity - metabolism
Doxorubicin - adverse effects
Fluorine Radioisotopes
Hydrophobic and Hydrophilic Interactions
Isotope Labeling
Male
Organophosphorus Compounds - chemistry
Organophosphorus Compounds - pharmacokinetics
Positron-Emission Tomography
Rats
Rats, Sprague-Dawley
Tissue Distribution
title Imaging of Chemotherapy-Induced Acute Cardiotoxicity with 18 F-Labeled Lipophilic Cations
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