In Vivo Evaluation of Angiogenic Activity and Its Correlation with Efficacy of Indirect Revascularization Surgery in Pediatric Moyamoya Disease

Journal of Nuclear Medicine

Ji Hoon Phi¹  Seung-Ki Kim¹  Yong-il Kim¹  Dong Soo Lee¹  Hongyoon Choi¹  Yun-Sang Lee¹  Kyu-Chang Wang¹  June-Key Chung¹  Ji Yeoun Lee¹  Jae Min Jeong¹  Keon Wook Kang¹  Jin Chul Paeng¹ 

关键词: moyamoya disease;    indirect revascularization;    angiogenesis;    positron emission tomography;   

DOI  :  10.2967/jnumed.114.142430

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Indirect revascularization is the most widely used treatment to induce angiogenesis in pediatric moyamoya disease (MMD). Molecular imaging methods targeted for angiogenesis have recently been developed. We performed angiogenesis imaging in indirect revascularization surgery for MMD to evaluate angiogenic activity and its correlation with treatment efficacy. Methods: Twelve patients with pediatric MMD were prospectively enrolled. Encephaloduroarteriosynangiosis surgery was conducted, and 68Ga-Arg-Gly-Asp (RGD) PET was performed 3.7 ± 1.0 mo after surgery. Basal perfusion and stress perfusion (PStr) in the middle cerebral artery territory were evaluated by acetazolamide-stress brain perfusion SPECT using statistical probabilistic anatomic mapping, at preoperative, early postoperative, and long-term follow-up states. Angiogenic activity was assessed on the images in terms of maximal uptake ratio, volume of increased uptake, and uptake-volume product. Results: Basal perfusion and PStr were significantly improved after surgery. Increased angiogenic activity was observed in the revascularized area, mainly around the bony flap. Angiogenic activity gradually decreased with time and significantly correlated with the postoperative time interval (P = 0.0015 for maximal uptake ratio and 0.0069 for volume of increased uptake). It was estimated to normalize at 6.3 mo after surgery. Uptake-volume product was inversely correlated with PStr improvement at the early postoperative state (r = −0.5960, P = 0.0409) and also weakly correlated with PStr improvement at long-term follow-up (r = −0.5010, P = 0.1165). Conclusion: Angiogenesis PET imaging with 68Ga-RGD was successfully used for the assessment of angiogenic activity in indirect revascularization surgery for MMD, and angiogenic activation measured at approximately 3.7 mo after surgery was inversely correlated with perfusion improvement. The assessment of angiogenic activity using 68Ga-RGD PET is expected to be effective for evaluating the mechanism or efficacy of revascularization treatment.

【 授权许可】

Unknown