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Review ArticleContinuing Education

Radiotracer Imaging of Peripheral Vascular Disease

Mitchel R. Stacy, Wunan Zhou and Albert J. Sinusas
Journal of Nuclear Medicine Technology September 2015, 43 (3) 185-192; DOI: https://doi.org/10.2967/jnumed.112.115105
Mitchel R. Stacy
1Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; and
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Wunan Zhou
1Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; and
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Albert J. Sinusas
1Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; and
2Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
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  • FIGURE 1.
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    FIGURE 1.

    Arteriography (A) demonstrates unilateral PVD, which is confirmed by abnormal 201Tl SPECT stress perfusion profile curves of anterior and posterior tibial muscle components of the left leg (B) as well as visual inspection of 201Tl SPECT transverse images (C; perfusion defect noted by arrow). (Reprinted from (24).)

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    FIGURE 2.

    Multimodality evaluation with ankle–brachial indices (A), CT angiography (B), and hybrid 99mTc-tetrofosmin SPECT/CT (C) reveals impaired lower-extremity pressures and tissue perfusion in PVD patient with previously implanted aortoiliac stents (B). Segmentation of muscle groups into 3-dimensional regions of interest by CT attenuation images (D) confirmed differences in regional tissue perfusion between legs (E). Red = gastrocnemius; yellow = soleus; green = tibialis; purple = fibularis; ABI = ankle–brachial index; PPG = photoplethysmograph; PVR = pulse volume recording; TBI = toe–brachial index.

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    FIGURE 3.

    Lower-extremity PET H215O imaging of healthy subject and PVD patient during selective adenosine infusion into left leg (A). Baseline and adenosine stress blood flow was assessed, and flow reserve was expressed as ratio of adenosine flow to baseline flow (B). Flow reserve was significantly lower in PVD patients than in healthy subjects. (Reprinted from (32).).

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    FIGURE 4.

    PET/CT imaging with 64Cu-DOTA–C-type atrial natriuretic factor–comb (A) and 64Cu-DOTA–comb (B) in mouse model of hind limb ischemia, 7 d after femoral artery occlusion. 64Cu-DOTA–C-type atrial natriuretic factor–comb uptake was significantly higher than uptake of 64Cu-DOTA–comb in ischemic limb when percentage injected tracer dose per gram of tissue (C) or ischemic-to-nonischemic leg ratios (D) were examined. (Reprinted from (52).) CANF = C-type atrial natriuretic factor.

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    FIGURE 5.

    Analysis of mean (A) and maximum (B) 18F-FDG tumor-to-background ratios within multiple arterial regions on day 1 (solid bars) and 14 d later (hatched bars). No significant differences were observed within arterial regions across time. Carotid artery uptake was significantly higher than 18F-FDG uptake within lower-extremity arteries on days 1 and 14. 18F-FDG PET (C, middle) fused with CT imaging (C, right) revealed similar uptake in femoral arteries on days 1 and 14 (noted by arrows). CFA = common femoral artery; SFA = superficial femoral artery; TBR = tumor-to-background ratio. *P < 0.001. (Reprinted from (58).)

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    TABLE 1

    Radiotracers for Perfusion and Molecular Imaging of PVD

    ModalityPerfusion/blood flowAngiogenesisAtherosclerosis
    SPECT201Tl (7,21,24–26)99mTc-NC100692 (47,48)
    99mTc-sestamibi (27,29,31)111In-VEGF121 (45)
    99mTc-pyrophosphate (76)125I-c(RGD(I)yV) (77)
    99mTc-tetrofosmin
    PET15O-water (32,33,36,40)76Br-nanoprobe (50)18F-FDG (58–62)
    C15O2 (35)68Ga-NOTA-RGD (49)18F-sodium fluoride (66)
    15O2 (35,36)64Cu-DOTA-CANF-comb (52)11C-acetate (67)
    13N-ammonia (34)64Cu-DOTA-VEGF121 (46)64Cu-DOTA-CANF (65)
    • CANF = C-type atrial natriuretic factor.

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Journal of Nuclear Medicine Technology: 43 (3)
Journal of Nuclear Medicine Technology
Vol. 43, Issue 3
September 1, 2015
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Radiotracer Imaging of Peripheral Vascular Disease
Mitchel R. Stacy, Wunan Zhou, Albert J. Sinusas
Journal of Nuclear Medicine Technology Sep 2015, 43 (3) 185-192; DOI: 10.2967/jnumed.112.115105

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Radiotracer Imaging of Peripheral Vascular Disease
Mitchel R. Stacy, Wunan Zhou, Albert J. Sinusas
Journal of Nuclear Medicine Technology Sep 2015, 43 (3) 185-192; DOI: 10.2967/jnumed.112.115105
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Keywords

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