Overview of the RGD-Based PET Agents Use in Patients With Cardiovascular Diseases: A Systematic Review

Matthieu Dietz; Christel H Kamani; Vincent Dunet; Stephane Fournier; Vladimir Rubimbura; Nathalie Testart Dardel; Ana Schaefer; Mario Jreige; Sarah Boughdad; Marie Nicod Lalonde; Niklaus Schaefer; Nathan Mewton; John O Prior; Giorgio Treglia

doi:10.3389/fmed.2022.887508

Overview of the RGD-Based PET Agents Use in Patients With Cardiovascular Diseases: A Systematic Review

Front Med (Lausanne). 2022 May 6:9:887508. doi: 10.3389/fmed.2022.887508. eCollection 2022.

Authors

Matthieu Dietz^{1

2}, Christel H Kamani^{1

3}, Vincent Dunet^{4

5}, Stephane Fournier^{3

5}, Vladimir Rubimbura³, Nathalie Testart Dardel¹, Ana Schaefer¹, Mario Jreige⁴, Sarah Boughdad¹, Marie Nicod Lalonde^{1

5}, Niklaus Schaefer^{1

5}, Nathan Mewton^{2

6

7}, John O Prior^{1

5}, Giorgio Treglia^{1

5

8

9}

Affiliations

¹ Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland.
² INSERM U1060, CarMeN Laboratory, University of Lyon, Lyon, France.
³ Cardiology Department, Lausanne University Hospital, Lausanne, Switzerland.
⁴ Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.
⁵ University of Lausanne, Lausanne, Switzerland.
⁶ Cardiovascular Hospital Louis Pradel, Department of Heart Failure, Hospices Civils de Lyon, Lyon, France.
⁷ Clinical Investigation Center Inserm 1407, Lyon, France.
⁸ Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
⁹ Università della Svizzera Italiana, Lugano, Switzerland.

Abstract

Studies using arginine-glycine-aspartate (RGD)-PET agents in cardiovascular diseases have been recently published. The aim of this systematic review was to perform an updated, evidence-based summary about the role of RGD-based PET agents in patients with cardiovascular diseases to better address future research in this setting. Original articles within the field of interest reporting the role of RGD-based PET agents in patients with cardiovascular diseases were eligible for inclusion in this systematic review. A systematic literature search of PubMed/MEDLINE and Cochrane library databases was performed until October 26, 2021. Literature shows an increasing role of RGD-based PET agents in patients with cardiovascular diseases. Overall, two main topics emerged: the infarcted myocardium and atherosclerosis. The existing studies support that α_vβ₃ integrin expression in the infarcted myocardium is well evident in RGD PET/CT scans. RGD-based PET radiotracers accumulate at the site of infarction as early as 3 days and seem to be peaking at 1-3 weeks post myocardial infarction before decreasing, but only 1 study assessed serial changes of myocardial RGD-based PET uptake after ischemic events. RGD-based PET uptake in large vessels showed correlation with CT plaque burden, and increased signal was found in patients with prior cardiovascular events. In human atherosclerotic carotid plaques, increased PET signal was observed in stenotic compared with non-stenotic areas based on MR or CT angiography data. Histopathological analysis found a co-localization between tracer accumulation and areas of α_vβ₃ expression. Promising applications using RGD-based PET agents are emerging, such as prediction of remodeling processes in the infarcted myocardium or detection of active atherosclerosis, with potentially significant clinical impact.

Keywords: RGD; angiogenesis; atherosclerosis; cardiovascular diseases; myocardial infarction; positron emission tomography; αvβ3 integrin.

Publication types

Systematic Review