Preliminary Evaluation of 18 F-Labeled Benzylguanidine Analogs as NET Tracers for Myocardial Infarction Diagnosis.

Purpose: Heart failure (HF) remains a major cause of late morbidity and mortality after myocardial infarction (MI). To date, no clinically established ¹⁸ F-labeled sympathetic nerve PET tracers for monitoring myocardial infarction are available. Therefore, in this study, we synthesized a series of ¹⁸ F-labeled benzyl guanidine analogs and evaluated their efficacy as cardiac neuronal norepinephrine transporter (NET) tracers for myocardial imaging. We also investigated the preliminary diagnostic capabilities of these tracers in myocardial infarction animal models, as well as the structure-activity relationship of these tracers.
Procedures: Three benzyl guanidine-NET tracers, including [ ¹⁸ F]1, [ ¹⁸ F]2, and [ ¹⁸ F]3, were synthesized and evaluated in vivo as PET tracers in a myocardial infarction mouse model. [ ¹⁸ F]LMI1195 was used as a positive control for the tracers. H&E staining of the isolated myocardial infarction heart tissue sections was performed to verify the efficacy of the selected PET tracer.
Results: Our data show that [ ¹⁸ F]3 had a moderate decay corrected labeling yield (~10%) and high radiochemical purity (>95%) compared to other tracers. The uptake of [ ¹⁸ F]3 in normal mouse hearts was 1.7±0.1%ID/cc at 1 h post-injection (p. i.), while it was 2.4±0.1, 2.6±0.9, and 2.1±0.4%ID/cc in the MI mouse hearts at 1, 2, and 3 days after surgery, respectively. Compared with [ ¹⁸ F]LMI1195, [ ¹⁸ F]3 had a better myocardial imaging effect in terms of the contrast between normal and MI hearts. The area of myocardial infarction shown by PET imaging corresponded well with the infarcted tissue demonstrated by H&E staining.
Conclusions: With an obvious cardiac uptake contrast between normal mice and the myocardial infarction mouse model, [ ¹⁸ F]3 appears to be a potential tool in the diagnosis of myocardial infarction. Therefore, it is necessary to conduct further structural modification studies on the chemical structure of [ ¹⁸ F]3 to improve its in vivo stability and diagnostic detection ability to achieve reliable and practical imaging effects.
(© 2023. The Author(s), under exclusive licence to World Molecular Imaging Society.)