Molecular Imaging of the Transplanted Heart: A Mechanistic Approach to Graft Survival

Abstract

In this review, we will discuss recent developments in noninvasive molecular imaging of immune-mediated changes seen in cardiac allograft rejection. The significant developments of molecular imaging agents across various modalities, including MRI, PET/SPECT, optical imaging, and echocardiography, provide us with opportunities to image specific immunological pathways of cardiac allograft rejection that were previously not possible. Recent studies using novel molecular imaging modalities have shown us new understanding of immune-mediated mechanisms involved in allograft rejection. Though these studies largely have been performed in animal models, use of molecular imaging is ripe for clinical translation to provide more personalized detection and monitoring of immune processes in heart-transplant patients. This review evaluates the recent application of molecular imaging to target distinct pathways of acute cellular rejection and cardiac allograft vasculopathy that have the potential to be translated into routine clinical use.