Clinical molecular imaging of chemokine receptor CXCR4 expression in atherosclerotic plaque using 68 Ga-pentixafor PET: Correlation with cardiovascular risk factors and calcified plaque burden

Desiree Weiberg, James T. Thackeray, Guenter Daum, Jan M. Sohns, Saskia Kropf, Hans Juergen Wester, Tobias L. Ross, Frank M. Bengel, Thorsten Derlin

Research output: Contribution to journalArticlepeer-review

86 Scopus citations

Abstract

The CXC-motif chemokine receptor 4 (CXCR4) represents a promising target for molecular imaging of different CXCR4-positive cell types in cardiovascular diseases such as atherosclerosis and arterial wall injury. The aim of this study was to assess the prevalence, pattern, and clinical correlates of arterial wall accumulation of 68 Ga-pentixafor, a specific CXCR4 ligand for PET. Methods: The data for 51 patients who underwent 68 Ga-pentixafor PET/ CT for noncardiovascular indications were retrospectively analyzed. Tracer accumulation in the vessel wall of major arteries was analyzed qualitatively and semiquantitatively by blood-pool–corrected target-to-background ratios. Tracer uptake was compared with calcified plaque burden and cardiovascular risk factors. Results: Focal arterial uptake of 68 Ga-pentixafor was seen at 1,411 sites in 51 (100%) of patients. 68 Ga-pentixafor uptake was significantly associated with calcified plaque burden (P, 0.0001) and cardiovascular risk factors including age (P, 0.0001), arterial hypertension (P, 0.0001), hypercholesterolemia (P 5 0.0005), history of smoking (P 5 0.01), and prior cardiovascular events (P 5 0.0004). Both the prevalence (P, 0.0001) and the signal intensity (P 5 0.009) of 68 Ga-pentixafor uptake increased as the number of risk factors increased. Conclusion: 68 Ga-pentixafor PET/CT is suitable for noninvasive, highly specific PET imaging of CXCR4 expression in the atherosclerotic arterial wall. Arterial wall 68 Ga-pentixafor uptake is significantly associated with surrogate markers of atherosclerosis and is linked to the presence of cardiovascular risk factors. 68 Ga-pentixafor signal is higher in patients with a high-risk profile and may hold promise for identification of vulnerable plaque.

Original languageEnglish
Pages (from-to)266-272
Number of pages7
JournalJournal of Nuclear Medicine
Volume59
Issue number2
DOIs
StatePublished - 1 Feb 2018

Keywords

  • 68Ga-pentixafor
  • Atherosclerosis
  • CXCR4
  • PET/CT
  • Plaque

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