Emerging PET radiotracers for vascular imaging

Area of Science:

• Nuclear Medicine
• Immunology
• Cardiovascular Imaging

Background:

• Positron Emission Tomography (PET) imaging is crucial for diagnosing and monitoring large-vessel vasculitis (LVV).
• Current PET imaging with 18F-fluorodeoxyglucose (FDG) shows good accuracy but can have non-specific uptake in the vessel wall, unrelated to active inflammation.
• There is a clinical need for novel PET tracers that specifically target inflammatory cells and pathways in LVV.

Purpose of the Study:

• To review emerging PET radionuclide tracers for imaging vascular inflammation in LVV.
• To discuss the potential of new tracers in assessing disease activity and guiding individualized LVV treatments.
• To highlight tracers targeting monocytes/macrophages, lymphocytes, and other inflammatory cells.

Main Methods:

• Review of current literature on PET imaging in large-vessel vasculitis.
• Discussion of emerging PET tracers initially developed for oncology and atherosclerosis.
• Focus on tracers targeting specific cellular pathways and inflammatory markers.

Main Results:

• 18F-FDG PET has limitations due to non-specific uptake, despite its diagnostic utility for LVV.
• Advances in PET technology, like delayed imaging, may enhance 18F-FDG accuracy.
• Emerging tracers targeting immune cells show promise for more specific assessment of LVV inflammation.

Conclusions:

• Novel PET tracers targeting specific inflammatory cells and pathways are needed for accurate LVV diagnosis and management.
• Tracers initially developed for other conditions may be repurposed for imaging vascular inflammation in LVV.
• Future research should focus on validating these emerging tracers for clinical application in LVV.