Novel PET imaging method could track and guide therapy for type 1 diabetes

TOP: Representative axial slices of PET/CT overlay of pancreas uptake (white arrows) for each dopaminergic radioligand A) 11C-(+)-PHNO B) 11C-FLB457 and C) 11C-raclopride. All SUV images summed from 20-30 minutes. BOTTOM: Representative coronal PET/CT images of 11C-(+)-PHNO in pancreas (white arrows) for A) healthy control B) C-peptide deficient T1DM subject C) T1DM subject with detectable C-peptide All SUV images are summed from 20-30 minutes. Credit: J Bini et al., Yale University, New Haven, CT.

According to the American Diabetes Association, approximately 1.25 million American children and adults have type 1 diabetes. Jason Bini, PhD, at the Yale University PET Center in New Haven, Connecticut, explains the significance to patients of being able to track their beta-cell mass:

“Beta-cell mass includes both functional and non-functional beta cells. Many indirect methods to measure beta-cell function are influenced by factors such as glucose and insulin levels and are not able to measure non-functional (dormant) beta cells that may be responsive to treatments. This work is important for patients because uptake of a radiotracer measured on a PET scan could guide treatment options. For example, if a patient has low beta-cell function with high signal in the PET scan, this could represent a patient with dormant beta cells that could respond to a treatment targeting existing cells. If a patient has low beta-cell function and low signal in the PET scan (very few viable or dormant beta cells present), that individual may be a candidate for beta-cell transplantation.”

Beta cells and neurological tissues have common cellular receptors and transporters, so, the Yale researchers screened brain radioligands for their ability to identify beta cells. Then, 12 healthy control subjects and two subjects with type 1 diabetes mellitus underwent dynamic PET/CT scans with six tracers.

The dopamine type 2/type 3 (D2/D3)-receptor agonist radioligand carbon-11 (11C)-(+)-4-propyl-9-hydroxynaphthoxazine (PHNO) was the only radioligand to demonstrate sustained uptake in the pancreas with high contrast versus abdominal organs such as the kidneys, liver, and spleen.

The results provide preliminary evidence that 11C-(+)-PHNO is a potential marker of beta-cell mass with 2:1 binding of D3 receptors over D2 receptors. While further research is needed before clinical application, 11C-(+)-PHNO is a promising way to differentiate the beta-cell mass of healthy individuals from those with type 1 diabetes mellitus, as well as track and guide therapies for diabetes patients.

Bini also points out, “These findings could facilitate development and wider dissemination of novel imaging methods in molecular imaging and nuclear medicine to assess receptor/enzyme pharmacology in diabetes and other endocrine disorders.”

###

Authors of “Evaluation of PET Brain Radioligands for Imaging Pancreatic β-Cell Mass: Potential Utility of 11C-(+)-PHNO” include Jason Bini, Mika Naganawa, Nabeel Nabulsi, Yiyun Huang, Jim Ropchan, Keunpoong Lim, Soheila Najafzadeh, Kevan C. Herold, Gary W. Cline, and Richard E. Carson, Yale University, New Haven, Connecticut.

This study was supported by National Institutes of Health (NIH) grant 1DP3DK104092-01 and was also made possible by NIH grant 1S10OD010322-01 and by Clinical and Translational Science Awards (CTSA) grant UL1 TR000142 from the National Center for Advancing Translational Sciences (NCATS) at NIH.

Please visit the SNMMI Media Center to view the PDF of the study, including images, and more information about molecular imaging and personalized medicine. To schedule an interview with the researchers, please contact Laurie Callahan at (703) 652-6773 or lcallahan@snmmi.org. Current and past issues of The Journal of Nuclear Medicine can be found online at http://jnm.snmjournals.org.

ABOUT THE SOCIETY OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and medical organization dedicated to advancing nuclear medicine and molecular imaging, vital elements of precision medicine that allow diagnosis and treatment to be tailored to individual patients in order to achieve the best possible outcomes.

SNMMI's more than 17,000 members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit http://www.snmmi.org.

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