Use of [18F]FDG Positron Emission Tomography to Monitor the Development of Cardiac Allograft Rejection. Issue 9 (September 2015)

• Record Type: Journal Article
• Authors: Daly, Kevin P.; Dearling, Jason L. J.; Seto, Tatsuichiro; Dunning, Patricia; Fahey, Frederic; Packard, Alan B.; Briscoe, David M.
• Is Part Of: Transplantation. Volume 99:Issue 9(2015)
• Publication Date: 2015-09
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000000618
• Languages: English
• ISSNs: 0041-1337

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background</title> <p>Positron emission tomography (PET) has the potential to be a specific, sensitive and quantitative diagnostic test for transplant rejection. To test this hypothesis, we evaluated <sup>18</sup>F-labeled fluorodeoxyglucose ([<sup>18</sup>F]FDG) and <sup>13</sup>N-labeled ammonia ([<sup>13</sup>N]NH<sub>3</sub>) small animal PET imaging in a well-established murine cardiac rejection model.</p> </sec> <sec> <title>Methods</title> <p>Heterotopic transplants were performed using minor major histocompatibility complex-mismatched B6.C-H2<sup>bm12</sup> donor hearts in C57BL/6(H-2<sup>b</sup>) recipients. C57BL/6 donor hearts into C57BL/6 recipients served as isograft controls. [<sup>18</sup>F]FDG PET imaging was performed weekly between posttransplant days 7 and 42, and the percent injected dose was computed for each graft. [<sup>13</sup>N]NH<sub>3</sub> imaging was performed to evaluate myocardial perfusion.</p> </sec> <sec> <title>Results</title> <p>There was a significant increase in [<sup>18</sup>F]FDG uptake in allografts from day 14 to day 21 (1.6% to 5.2%; <italic>P</italic> < 0.001) and uptake in allografts was significantly increased on posttransplant days 21 (5.2% vs 0.9%; <italic>P</italic> = 0.005) and 28 (4.8% vs 0.9%; <italic>P</italic> = 0.006) compared to isograft controls. Furthermore, [<sup>18</sup>F]FDG uptake correlated with an increase in rejection grade within allografts between days 14 and 28 after transplantation. Finally, the uptake of [<sup>13</sup>N]NH<sub>3</sub> was significantly lower relative to the native heart in allografts with chronic vasculopathy compared to isograft controls on day 28 (<italic>P</italic> = 0.01).</p> </sec> <sec> <title>Conclusions</title> <p>PET imaging with [<sup>18</sup>F]FDG can be used after transplantation to monitor the evolution of rejection. Decreased uptake of [<sup>13</sup>N]NH<sub>3</sub> in rejecting allografts may be reflective of decreased myocardial blood flow. These data suggest that combined [<sup>18</sup>F]FDG and [<sup>13</sup>N]NH<sub>3</sub> PET imaging could be used as a noninvasive, quantitative technique for serial monitoring of allograft rejection and has potential application in human transplant recipients.</p> </sec> </abstract>