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 : Background: 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 18 F-labeled fluorodeoxyglucose ([ 18 F]FDG) and 13 N-labeled ammonia ([ 13 N]NH3 ) small animal PET imaging in a well-established murine cardiac rejection model. Methods: Heterotopic transplants were performed using minor major histocompatibility complex-mismatched B6.C-H2 bm12 donor hearts in C57BL/6(H-2 b ) recipients. C57BL/6 donor hearts into C57BL/6 recipients served as isograft controls. [ 18 F]FDG PET imaging was performed weekly between posttransplant days 7 and 42, and the percent injected dose was computed for each graft. [ 13 N]NH3 imaging was performed to evaluate myocardial perfusion. Results: There was a significant increase in [ 18 F]FDG uptake in allografts from day 14 to day 21 (1.6% to 5.2%; P < 0.001) and uptake in allografts was significantly increased on posttransplant days 21 (5.2% vs 0.9%; P = 0.005) and 28 (4.8% vs 0.9%; P = 0.006) compared to isograft controls. Furthermore, [ 18 F]FDG uptake correlated with an increase in rejection grade within allografts between days 14 and 28 after transplantation. Finally, the uptake of [ 13 N]NH3 was significantly lower relative to the native heart in allografts with chronic vasculopathy compared to isograft controls on day 28 ( P = 0.01). Conclusions: PET imaging with [ 18 F]FDG can be used after transplantation to monitor the evolution of rejection. Decreased uptake of [ 13 N]NH3 in rejecting allografts may be reflective of decreased myocardial blood flow. These data suggest that combined [ 18 F]FDG and [ 13 N]NH3 PET imaging could be used as a noninvasive, quantitative technique for serial monitoring of allograft rejection and has potential application in human transplant recipients. Abstract : In a murine model of cardiac allograft rejection, positon emission tomograph monitoring reveals that increased 18 F-FDG uptake correlates with cellular rejection while decreased 13N-NH3 correlates with chronic vasculopathy.