A phase 1, first-in-human study of 18 F-GP1 positron emission tomography for imaging acute arterial thrombosis

Sun Young Chae, Tae Won Kwon, Soyoung Jin, Sun U. Kwon, Changhwan Sung, Seung Jun Oh, Sang Ju Lee, Jungsu S. Oh, Youngjin Han, Yong Pil Cho, Narae Lee, Ji Young Kim, Norman Koglin, Mathias Berndt, Andrew W. Stephens, Dae Hyuk Moon

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Abstract

Background: 18 F-GP1 is a novel positron emission tomography (PET) tracer that targets glycoprotein IIb/IIIa receptors on activated platelets. The study objective was to explore the feasibility of directly imaging acute arterial thrombosis (AAT) with 18 F-GP1 PET/computed tomography (PET/CT) and to quantitatively assess 18 F-GP1 uptake. Safety, biodistribution, pharmacokinetics and metabolism were also evaluated. Methods: Adult patients who had signs or symptoms of AAT or had recently undergone arterial intervention or surgery within 14 days prior to 18 F-GP1 PET/CT were eligible for inclusion. The AAT focus was demonstrated by conventional imaging within the 5 days prior to 18 F-GP1 administration. Whole-body dynamic 18 F-GP1 PET/CT images were acquired for up to 140 min after injection of 250 MBq of 18 F-GP1. Venous plasma samples were analysed to determine 18 F-GP1 clearance and metabolite formation. Results: Among the ten eligible patients assessed, underlying diseases were abdominal aortic aneurysm with endovascular repair (n = 6), bypass surgery and stent placement (n = 1), endarterectomy (n = 1), arterial dissection (n = 1) and acute cerebral infarction (n = 1). 18 F-GP1 administration and PET/CT procedures were well tolerated, with no drug-related adverse events. All patients showed high initial 18 F-GP1 uptake in the spleen, kidney and blood pool, followed by rapid clearance. Unmetabolised plasma 18 F-GP1 levels peaked at 4 min post-injection and decreased over time until 120 min. The overall image quality was sufficient for diagnosis in all patients and AAT foci were detected in all participants. The 18 F-GP1 uptake in AAT foci remained constant from 7 min after injection and began to separate from the blood pool after 20 min. The median standardised uptake value of AAT was 5.0 (range 2.4–7.9) at 120 min post-injection. The median ratio of standardised uptake value of AAT foci to the mean blood pool activity was 3.4 (range 2.0–6.3) at 120 min. Conclusions: 18 F-GP1 is a safe and promising novel PET tracer for imaging AAT with a favourable biodistribution and pharmacokinetic profile. Trial registration: ClinicalTrials.gov identifier: NCT02864810, Registered August 3, 2016.

Original languageEnglish
Article number3
JournalEJNMMI Research
Volume9
DOIs
StatePublished - 2019 Jan 1

Keywords

  • Arterial thrombosis
  • F-GP1
  • Glycoprotein IIb/IIIa receptor
  • Platelet activation
  • Positron emission tomography

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    Chae, S. Y., Kwon, T. W., Jin, S., Kwon, S. U., Sung, C., Oh, S. J., Lee, S. J., Oh, J. S., Han, Y., Cho, Y. P., Lee, N., Kim, J. Y., Koglin, N., Berndt, M., Stephens, A. W., & Moon, D. H. (2019). A phase 1, first-in-human study of 18 F-GP1 positron emission tomography for imaging acute arterial thrombosis EJNMMI Research, 9, [3]. https://doi.org/10.1186/s13550-018-0471-8