As cardiovascular medicine evolves to more molecular targeted therapeutic intervention, the role of these molecular imaging approaches will continue to grow in the future
As regards healing of damage tissue after myocardial infarction, there is the risk of too much or persistent inflammation. Here, he said, intervention that targets or attenuates inflammation may be beneficial for patients to prevent heart failure. This “complex inflammatory response” can be examined with molecular targeted tracers, but while FDG is not the “perfect tracer” to do this because of lack of specificity, there are other tracers that target subgroups of inflammatory cells more specifically. He pointed to the example from his lab of one targeting chemokine receptor CXCR4, that is expressed on almost all leukocytes.
“What we learn from using this tracer is that early after acute myocardial infarction you get a specific signal from the infarct area and the higher the signal, the higher the likelihood that patients will subsequently go into heart failure and suffer cardiovascular events,” he explained. “So, we may have a measure here that may give us information about how further healing of the infarct will develop over time and if something shows us that signal is indicating a high risk, we may be able to modify this signal at early time point. We are going to see more about those inflammation targeted tracers in the future and learn more about their value in the guidance of heart failure therapy.” Another novel set of tracers, he said, are those targeting tissue fibrosis, or precursors of tissue fibrosis.
In conclusion, Prof Bengel said: “Molecular imaging, especially imaging of 3i – infiltration infection and inflammation – emerges as an important diagnostic and therapeutic tool in cardiovascular medicine. While cardiovascular medicine is still mostly mechanical medicine, there is already growth in these areas of imaging, for example, for guidance of implant infection. As cardiovascular medicine evolves to more molecular targeted therapeutic intervention, the role of these molecular imaging approaches will continue to grow in the future.”
ICNC-CT was co-organised by the American Society of Nuclear Cardiology (ASNC), the European Association of Cardiovascular Imaging (EACVI), and the European Association of Nuclear Medicine (EANM).
The session on novel molecular-targeted tracers also heard Professor Jamshid Maddahi, Professor of Molecular and Medical Pharmacology at the David Geffen School of Medicine at UCLA, discuss promising perfusion tracers in cardiovascular imaging and Professor Ahmed Tawakol, Director of Nuclear Cardiology and Associate Professor of Medicine at Massachusetts General Hospital and Harvard Medical School, outline promising MR tracers.
Professor Frank Bengel is Director of the Department of Nuclear Medicine at the Hannover Medical School. His research focus is on the application of non-invasive imaging techniques for the assessment of functional mechanisms in the cardiovascular system and advancing nuclear imaging techniques targeting blood flow, metabolism and autonomic nervous system of the heart.
Source: Healthcare in Europe