Imaging angiogenesis in atherosclerosis in large arteries with 68Ga-NODAGA-RGD PET/CT: relationship with clinical atherosclerotic cardiovascular disease

Matthieu Dietz; Christel H Kamani; Emmanuel Deshayes; Vincent Dunet; Periklis Mitsakis; George Coukos; Marie Nicod Lalonde; Niklaus Schaefer; John O Prior

doi:10.1186/s13550-021-00815-5

Imaging angiogenesis in atherosclerosis in large arteries with ⁶⁸Ga-NODAGA-RGD PET/CT: relationship with clinical atherosclerotic cardiovascular disease

EJNMMI Res. 2021 Aug 14;11(1):71. doi: 10.1186/s13550-021-00815-5.

Authors

Matthieu Dietz¹, Christel H Kamani¹, Emmanuel Deshayes², Vincent Dunet³, Periklis Mitsakis¹, George Coukos⁴, Marie Nicod Lalonde¹, Niklaus Schaefer¹, John O Prior⁵

Affiliations

¹ Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
² Nuclear Medicine Department, Montpellier Cancer Institute (ICM), University of Montpellier, 208 Avenue des Apothicaires, 34298, Montpellier Cedex 5, France.
³ Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
⁴ Ludwig Institute for Cancer Research and Department of Oncology, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
⁵ Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland. [email protected].

Abstract

Background: Integrin alpha-V-beta-3 (αvβ3) pathway is involved in intraplaque angiogenesis and inflammation and represents a promising target for molecular imaging in cardiovascular diseases such as atherosclerosis. The aim of this study was to assess the clinical correlates of arterial wall accumulation of ⁶⁸Ga-NODAGA-RGD, a specific α_vβ₃ integrin ligand for PET.

Materials and methods: The data of 44 patients who underwent ⁶⁸Ga-NODAGA-RGD PET/CT scans were retrospectively analyzed. Tracer accumulation in the vessel wall of major arteries was analyzed semi-quantitatively by blood-pool-corrected target-to-background ratios. Tracer uptake was compared with clinically documented atherosclerotic cardiovascular disease, cardiovascular risk factors and calcified plaque burden. Data were compared using the Mann-Whitney U test, Pearson correlation and Spearman correlation.

Results: ⁶⁸Ga-NODAGA-RGD arterial uptake was significantly higher in patients with previous clinically documented atherosclerotic cardiovascular disease (mean TBR 2.44 [2.03-2.55] vs. 1.81 [1.56-1.96], p = 0.001) and showed a significant correlation with prior cardiovascular or cerebrovascular event (r = 0.33, p = 0.027), BMI (ρ = 0.38, p = 0.01), plaque burden (ρ = 0.31, p = 0.04) and hypercholesterolemia (r = 0.31, p = 0.04).

Conclusions: ⁶⁸Ga-NODAGA-RGD holds promise as a non-invasive marker of disease activity in atherosclerosis, providing information about intraplaque angiogenesis.

Keywords: 68Ga-NODAGA-RGD; Angiogenesis; Atherosclerosis; PET/CT.