Positron Emission Tomography Reporter Gene Research Articles

Imaging CAR-NK cells targeted to HER2 ovarian cancer with human sodium-iodide symporter-based positron emission tomography.

Chimeric antigen receptor (CAR) cell therapies utilize CARs to redirect immune cells towards cancer cells expressing specific antigens like human epidermal growth factor receptor 2 (HER2). Despite their potential, CAR T cell therapies exhibit variable response rates and adverse effects in some patients. Non-invasive molecular imaging can aid in predicting patient outcomes by tracking infused cells post-administration. CAR-T cells are typically autologous, increasing manufacturing complexity and costs. An alternative approach involves developing CAR natural killer (CAR-NK) cells as an off-the-shelf allogeneic product. In this study, we engineered HER2-targeted CAR-NK cells co-expressing the positron emission tomography (PET) reporter gene human sodium-iodide symporter (NIS) and assessed their therapeutic efficacy and PET imaging capability in a HER2 ovarian cancer mouse model.NK-92 cells were genetically modified to express a HER2-targeted CAR, the bioluminescence imaging reporter Antares, and NIS. HER2-expressing ovarian cancer cells were engineered to express the bioluminescence reporter Firefly luciferase (Fluc). Co-culture experiments demonstrated significantly enhanced cytotoxicity of CAR-NK cells compared to naive NK cells. In vivo studies involving mice with Fluc-expressing tumors revealed that those treated with CAR-NK cells exhibited reduced tumor burden and prolonged survival compared to controls. Longitudinal bioluminescence imaging demonstrated stable signals from CAR-NK cells over time. PET imaging using the NIS-targeted tracer 18F-tetrafluoroborate ([18F]TFB) showed significantly higher PET signals in mice treated with NIS-expressing CAR-NK cells.Overall, our study showcases the therapeutic potential of HER2-targeted CAR-NK cells in an aggressive ovarian cancer model and underscores the feasibility of using human-derived PET reporter gene imaging to monitor these cells non-invasively in patients.

Abstract 4151: Development of a cancer-activated biologic imaging platform for early lung cancer diagnosis

Abstract Current modalities, such as LDCT and fluorodeoxyglucose positron emission tomography (FDG PET), for early lung cancer imaging, rely upon proxies resulting in poor specificity and/or sensitivity. They are also unreliable for discriminating benign versus malignant lesions resulting in the requirement of longitudinal analyses euphemistically called “watchful waiting”. Lung biopsies are marred by significant false negative rates and pose complications of collapsed lungs or bleeding in up to 22% of procedures and death rates up to 1%. To overcome these obstacles, Earli is developing a non-invasive, highly specific cancer-activated imaging platform that usurps dysregulated gene expression within malignancies to force only cancer cells to produce a synthetic biomarker that can be localized using PET imaging. EARLI-204 is a lipid nanoparticle that contains a DNA nanoplasmid comprised of a cancer-activated promoter driving selective expression of a functionally inactivated somatostatin receptor 2 (SSTR2fi) gene. Abrogation of internalization and signal transduction allows the safe use of SSTR2fi as an ectopically expressed PET reporter gene (PRG). Following administration, EARLI-204 transfects tumor and normal cells but transcriptional activation only within cancer cells results in selective cell-surface expression of SSTR2fi that can be imaged with FDA-approved SSTR2 PET tracers. H1299 human lung cancer cells engineered to express SSTR2 (H1299-SSTR2) revealed a discernable PET signal with as little as 31,000 engineered cells. Mixed cell titration studies using subcutaneous (SQ) tumors with H1299-SSTR2 and non-expressing H1299-wt cells suggest tumors with between 0.1% and 1% H1299-SSTR2 cells had a significant PET signal, compared to tumors with 100% H1299-wt. This result sets a benchmark transfection of ~1% to achieve a PET signal. Intratumoral (IT) dose titration of EARLI-204 revealed that 5 ug of EARLI-204 generates a significant PET signal. Consistent with the H1299-SSTR2 studies, IHC shows ~1% of tumor cells express the PRG at a 5 ug IT dose level. Furthermore, we measured 70 copies of EARLI-204 DNA per cell resulting in 22,629 SSTR2 mRNA copies/25 ng at a 5 ug IT dose level. IV dosing of EARLI-204 in SQ and intralung tumor models results in cancer-activated expression of SSTR2fi in both SQ and small (<4 mm) lung tumors with significantly increased (p < 0.05) PET signal. For lung tumors, analyses showed 1 copy of EARLI-204 DNA/cell resulting in 780 SSTR2 mRNA copies/25 ng. The results demonstrate an effective molecular imaging platform for drug discovery ranging from in vivo screening to building PK-PD-efficacy relationships and enabling human dose projection for the Earli PET localization drug. The benchmarks and findings established with this preclinical imaging pipeline are currently being evaluated in large animals such as dogs and pigs, and will be translated to humans in planned clinical trials. Citation Format: Mohammed Goryawala, Hung-Yu Henry Lee, Ling Tong, Trupti Patil, Alex Harwig, Chloe Xia, Suthara Ramachandran, Dariusz Wodziak, Dean Felsher, Tim Sproul, David Suhy. Development of a cancer-activated biologic imaging platform for early lung cancer diagnosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4151.

Abstract 3529: Leveraging deep learning for fully automated analysis of pre-clinical mouse positron emission tomography

Abstract Turning early-cancer diagnosis into actionable treatment often relies on highly accurate and sensitive imaging techniques to guide surgical intervention or to monitor therapeutic efficacy. Earli is developing a highly sensitive, orthogonal approach that uses genetic constructs to usurp dysregulated cancer pathways to force the tumor to produce a PET reporter gene, enabling the use of radiotracers amenable to positron emission tomography/computed tomography (PET/CT) to guide precision imaging. However, analysis of PET/CT images using standard manual and semi-automated methods is challenging resulting in reduced experimental throughput and user variability, highlighting the need for a fully automated PET/CT analysis pipeline using Deep Learning (DL). To increase pre-clinical throughput and reduce inter-user variability, we developed an automated DL processing pipeline in Python to perform three major tasks: separation of multi-mouse bed data for PET uptake quantification by mouse, segmentation of tumors and background organs, and quantification of PET signal for PK/PD analysis. Preclinical PET/CT data was acquired using a 4 animal, multi-mouse bed and separated into individual mice by co-registering the reconstructed CT image against a multi-mouse bed reference mask using a rigid 3D Euler transformation algorithm and cropping at fixed indices. Following mouse separation, a 3D nnUNet architecture is used to perform semantic segmentation of regions of interest (ROI) on CT for bi-hemispheric subcutaneous tumors, lungs, liver, kidneys, spleen, and the bladder. nnUNet was trained on PET/CT of 311 mice consisting of a mixture of naïve and tumor-bearing animals subcutaneously implanted with H1299 cells using a five-fold cross-validation strategy with 1000 epochs per fold. Model performance was evaluated by comparing the network prediction to the reference manually annotated masks using the Dice coefficient. PET uptake is reported as percent injected dose per milliliter (%ID/mL) or standardized uptake value (SUV). Segmentation performance results for the hold-out set identified mean Dice scores greater than 0.80 for all ROIs, reflecting the similarity between model predictions and human annotations. The automated pipeline reduced the analysis time from 5.5-6 hours per mouse when using traditional manual/semi-automatic approaches to approximately 15 minutes. In summary, we developed a fully automated DL-based PET/CT quantification pipeline for pre-clinical mouse studies that provides accurate ROI segmentation and PET uptake quantification, significantly increasing experimental throughput and reducing inter-user variability. Further improvements to model inference include loss functions weighted for poor performing ROIs and addition of lung nodule segmentation for eventual translation to humans as an accompaniment to Earli’s theranostic programs. Citation Format: Hung-Yu Henry Lee, Mohammed Goryawala, Tim Sproul, Maggie Louie, David Suhy. Leveraging deep learning for fully automated analysis of pre-clinical mouse positron emission tomography [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3529.

P-108 - PAM and FUS-assisted local AAV gene delivery into the brain of Alzheimer’s disease murine models assessed by quantitative PET reporter gene

P-108 - PAM and FUS-assisted local AAV gene delivery into the brain of Alzheimer’s disease murine models assessed by quantitative PET reporter gene

Construction of truncated PSMA as a PET reporter gene for CAR T cell trafficking.

In solid tumors, there are multiple barriers for a chimeric antigen receptor (CAR) T cell to surmount in order to reach the tumor site. For better understanding whether CAR T cells effectively infiltrate into tumor site, and simultaneously, whether there are off-target effects, real-time monitoring technologies need to be established. Cell-based positron emission tomography reporter genes have been developed to monitor engineered cells in living subjects. In this study, we reported the construction of a novel reporter gene truncated prostate-specific membrane antigen (ΔPSMA) pending for monitoring CAR T cells using 68Ga-PSMA-617 and a method for tracking the distribution of CAR T cells in vivo was developed. Data were provided to demonstrate that ΔPSMA was predominantly localized on the plasma membrane and could take up 68Ga-PSMA-617 in vitro in a time-dependent manner. And the expression of ΔPSMA did not affect CAR expression and cytolytic capacity of CAR T cells. CAR-ΔPSMA T cell xenografts in nude mice were clearly imaged by positron emission tomography 60 min after injection of 68Ga-PSMA-617. PSMA paired with 68Ga-PSMA-617 was capable of identifying approximately 1 × 104 engineered CAR T cells. The ability to image small numbers of CAR T cells in vivo would be helpful to accelerate the translation of cell-based therapies into the clinic, and it may reinforce our understanding of treatment success, failure, and toxicity.

Multimodal imaging of capsid and cargo reveals differential brain targeting and liver detargeting of systemically-administered AAVs

The development of gene delivery vehicles with high organ specificity when administered systemically is a critical goal for gene therapy. We combine optical and positron emission tomography (PET) imaging of 1) reporter genes and 2) capsid tags to assess the temporal and spatial distribution and transduction of adeno-associated viruses (AAVs). AAV9 and two engineered AAV vectors (PHP.eB and CAP-B10) that are noteworthy for maximizing blood-brain barrier transport were compared. CAP-B10 shares a modification in the 588 loop with PHP.eB, but also has a modification in the 455 loop, added with the goal of reducing off-target transduction. PET and optical imaging revealed that the additional modifications retained brain receptor affinity. In the liver, the accumulation of AAV9 and the engineered AAV capsids was similar (∼15% of the injected dose per cc and not significantly different between capsids at 21 h). However, the engineered capsids were primarily internalized by Kupffer cells rather than hepatocytes, and liver transduction was greatly reduced. PET reporter gene imaging after engineered AAV systemic injection provided a non-invasive method to monitor AAV-mediated protein expression over time. Through comparison with capsid tagging, differences between brain localization and transduction were revealed. In summary, AAV capsids bearing imaging tags and reporter gene payloads create a unique and powerful platform to assay the pharmacokinetics, cellular specificity and protein expression kinetics of AAV vectors in vivo, a key enabler for the field of gene therapy.

Abstract 2480: A more sensitive approach to cancer imaging using cancer-activated PET reporters

Abstract Early detection and localization of primary cancers has been shown to improve clinical outcomes and overall survival. While liquid biopsy may indicate the presence of cancer and possibly provide the tissue of origin, it cannot pinpoint the exact location of cancer and its metastases. Furthermore, current imaging techniques lack the sensitivity to locate early-stage tumors, diminishing the ability for early clinical intervention. Current imaging approaches using 18F-FDG rely on increased metabolic rates of tumors vs. surrounding non-tumor tissue, often resulting in high background and inability to detect low-metabolic tumors. Earli is developing a highly sensitive, orthogonal approach that uses genetic constructs to usurp dysregulated cancer pathways to force the tumor to produce a synthetic biomarker used to detect and localize the malignancy. We previously demonstrated the utility of cancer-activated expression of blood-based biomarkers in preclinical cancer models, which are currently in an ongoing clinical study. EARLI-201 is novel genetic imaging probe comprised of a DNA construct containing a cancer-activated promoter to drive the expression of a PET Reporter Gene (PRG). The HSV-sr39TK PRG product specifically sequesters the 18F-FHBG tracer inside the cell, enabling detection by PET imaging. Initial studies for sensitivity combined H1299 lung cancer cells engineered with only two copies of the PRG were implanted subcutaneously into immunocompromised mice followed by the administration of the 18F-FHBG tracer. Results demonstrate a robust signal from as few as 62,000 injected cells. Given that a 1 mm3 tumor contains ~1,000,000 cells, suggests that we can localize tumors as small as 6.25mm3 with only a 1% transfection efficiency. EARLI-201 was tested in a variety of murine models including the metastatic “Lung Trap” and spontaneous HCC-MYC/Twist1, which produce discrete tumor nodules in the lungs or liver, respectively. A single intravenous injection of EARLI-201 given at Day 1 results in cancer-activated expression and accumulation of the PRG in tumors. 18F-FHBG PET imaging three days post dosing revealed distinct tumor foci that co-register with tumors detected by CT. Additional ex vivo techniques confirmed PRG expression only in tumor-containing tissues and not in healthy tissue. Imaging the same animals with 18F-FDG failed to produce any appreciable signal in the same tumors, likely because they are of low metabolic nature. These pre-clinical results clearly demonstrate the potential of Earli’s approach to detect and localize very small tumors currently outside the sensitivity of existing imaging modalities. Additional experiments to evaluate EARLI-201 in companion dogs diagnosed with cancer are currently in progress and provides the ability to validate the platform in larger body masses with spontaneously formed tumors. Citation Format: Alex Harwig, Morgan Wang, Ling Tong, Regina Nieu, Vy Nguyen, Dean Felsher, David Suhy. A more sensitive approach to cancer imaging using cancer-activated PET reporters [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2480.

P-102 - Imaging of AAV-mediated gene transfer in the brain using a novel PET reporter gene tracer

P-102 - Imaging of AAV-mediated gene transfer in the brain using a novel PET reporter gene tracer

Minicircles for a two-step blood biomarker and PET imaging early cancer detection strategy

Early cancer detection can dramatically increase treatment options and survival rates for patients, yet detection of early-stage tumors remains difficult. Here, we demonstrate a two-step strategy to detect and locate cancerous lesions by delivering tumor-activatable minicircle (MC) plasmids encoding a combination of blood-based and imaging reporter genes to tumor cells. We genetically engineered the MCs, under the control of the pan-tumor-specific Survivin promoter, to encode: 1) Gaussia Luciferase (GLuc), a secreted biomarker that can be easily assayed in blood samples; and 2) Herpes Simplex Virus Type 1 Thymidine Kinase mutant (HSV-1 sr39TK), a PET reporter gene that can be used for highly sensitive and quantitative imaging of the tumor location. We evaluated two methods of MC delivery, complexing the MCs with the chemical transfection reagent jetPEI or encapsulating the MCs in extracellular vesicles (EVs) derived from a human cervical cancer HeLa cell line. MCs delivered by EVs or jetPEI yielded significant expression of the reporter genes in cell culture versus MCs delivered without a transfection reagent. Secreted GLuc correlated with HSV-1 sr39TK expression with R2 = 0.9676. MC complexation with jetPEI delivered a larger mass of MC for enhanced transfection, which was crucial for in vivo animal studies, where delivery of MCs via jetPEI resulted in GLuc and HSV-1 sr39TK expression at significantly higher levels than controls. To the best of our knowledge, this is the first report of the PET reporter gene HSV-1 sr39TK delivered via a tumor-activatable MC to tumor cells for an early cancer detection strategy. This work explores solutions to endogenous blood-based biomarker and molecular imaging limitations of early cancer detection strategies and elucidates the delivery capabilities and limitations of EVs.

PET Reporter Gene Imaging and Ganciclovir-Mediated Ablation of Chimeric Antigen Receptor T Cells in Solid Tumors.

Imaging strategies to monitor chimeric antigen receptor (CAR) T-cell biodistribution and proliferation harbor the potential to facilitate clinical translation for the treatment of both liquid and solid tumors. In addition, the potential adverse effects of CAR T cells highlight the need for mechanisms to modulate CAR T-cell activity. The herpes simplex virus type 1 thymidine kinase (HSV1-tk) gene has previously been translated as a PET reporter gene for imaging of T-cell trafficking in patients with brain tumor. The HSV1-TK enzyme can act as a suicide gene of transduced cells through treatment with the prodrug ganciclovir. Here we report the molecular engineering, imaging, and ganciclovir-mediated destruction of B7H3 CAR T cells incorporating a mutated version of the HSV1-tk gene (sr39tk) with improved enzymatic activity for ganciclovir. The sr39tk gene did not affect B7H3 CAR T-cell functionality and in vitro and in vivo studies in osteosarcoma models showed no significant effect on B7H3 CAR T-cell antitumor activity. PET/CT imaging with 9-(4-[18F]-fluoro-3-[hydroxymethyl]butyl)guanine ([18F]FHBG) of B7H3-sr39tk CAR T cells in an orthotopic model of osteosarcoma revealed tumor homing and systemic immune expansion. Bioluminescence and PET imaging of B7H3-sr39tk CAR T cells confirmed complete tumor ablation with intraperitoneal ganciclovir administration. This imaging and suicide ablation system can provide insight into CAR T-cell migration and proliferation during clinical trials while serving as a suicide switch to limit potential toxicities. SIGNIFICANCE: This study showcases the only genetically engineered system capable of serving the dual role both as an effective PET imaging reporter and as a suicide switch for CAR T cells.

Imaging CAR T Cell Trafficking with eDHFR as a PET Reporter Gene.

Cell-based therapeutics have considerable promise across diverse medical specialties; however, reliable human imaging of the distribution and trafficking of genetically engineered cells remains a challenge. We developed positron emission tomography (PET) probes based on the small-molecule antibiotic trimethoprim (TMP) that can be used to image the expression of the Escherichia coli dihydrofolate reductase enzyme (eDHFR) and tested the ability of [18F]-TMP, a fluorine-18 probe, to image primary human chimeric antigen receptor (CAR) Tcells expressing the PET reporter gene eDHFR, yellow fluorescent protein (YFP), and Renilla luciferase (rLuc). Engineered Tcells showed an approximately 50-fold increased bioluminescent imaging signal and 10-fold increased [18F]-TMP uptake compared to controls invitro. eDHFR-expressing anti-GD2 CAR Tcells were then injected into mice bearing control GD2- and GD2+ tumors. PET/computed tomography (CT) images acquired on days 7 and 13 demonstrated early residency of CAR Tcells in the spleen followed by on-target redistribution to the GD2+ tumors. This was corroborated by autoradiography and anti-human CD8 immunohistochemistry. We found a high sensitivity of detection for identifying tumor-infiltrating CD8 CAR Tcells, ∼11,000 cells per mm3. These data suggest that the [18F]-TMP/eDHFR PET pair offers important advantages that could better allow investigators to monitor immune cell trafficking to tumors in patients.

P5990In vivo tracking of long-term survival of xenogeneic porcine mesenchymal stem cells seeded on tissue-engineered heart valve implanted in sheep

Abstract Background Long-term survival of xenogeneic transplanted cells in adults requires strong immunosuppression and/or encapsulation of the cells to achieve peripheral transplant tolerance. Purpose The aim of our project was to seed decellularized tissue engineered heart valves (TEHV) with xenogeneic (porcine) mesenchymal stem cells (pMSCs) transfected transiently (Lipofectamine) with a positron emission tomography (PET)-reporter gene (pMSC-PETr), followed by implantation as pulmonary valve replacement into sheep without immunosuppression. The fate of the seeded pMSC-PETr was tracked via serial in-vivo non-invasive PET-computed tomography (PET-CT). Methods Static cultivation of TEHV scaffold led to successful ingrowth of the pMSC-PETr. For enabling quantitative assessment of viable pMSC-PETr in the TEHV scaffold after in vivo implantation, vials containing 5x104, 2x105, and 4x105 pMSC-PETr were in vitro mixed with the [18F]-FHBG PET tracer for 1 hr, then the non-bound tracer was washed out and vials were in vitro PET-CT imaged, giving reference values. TEHV-pMSC-PETr were then implanted percutaneously into the pulmonary valve position of sheep (n=4) under general anesthesia, while an additional sheep with no valve implantation served as a control. Ten mCi of [18F]-FHBGPET radiotracer was produced for each procedure and serial PET-CT imaging of the sheep was performed at 3 hr, 24 hr, 2 or 3 weeks, and 5 and 6 months after valve implantation. The study followed the Principles of laboratory animal care. Results PET-CT of vials containing increasing number of pMSC-PETr showed dose-dependent tracer uptake in the transfected cells in vitro (Figure). PET-CT images of the sheep 3 hr after implantation of the TEHV-pMSC-PETr showed a clear signal of transfected cells, with a mean estimated number of viable pMSC-PETr of 5.18±1.19x106. No meaningful decrease of the amount of living cells occurred at 24 hr or 2 or 3 weeks. Interestingly, 5- and 6-month follow-up PET-CT images showed clear in vivo and in vitro (after explantation) PET signals of the pMSC-PETr on TEHV, indicating spontaneous stable transfection of the PET reporter plasmid (insertional mutagenesis). Histology confirmed the survival of the pMSC-PETr at 5 and 6-month after xenogeneic transplantation. Merged immunohistochemistry and fluorescence imaging of anti-pig SLA I and anti-sheep MHC I antibodies and PET-reporter gene (HSV1-tk) suggested in vivo inter-species lateral jump gene transfer between pig MSCs and host sheep cells. Figure 1 Conclusions This is the first report on serial non-invasive in vivo tracking of long-term survival of xenogeneic pMSCs-PETr seeded on TEHVs and percutaneously implanted into the pulmonary position of sheep. Long-term follow-up revealed spontaneous stable transfection of the plasmid PET-reporter gene, which suggests the risk of insertional mutagenesis induced by the plasmid (transposon), and PET-reporter gene shuttle from xenogeneic pig MSCs to sheep cells. Acknowledgement/Funding LifeValve EU project (grant number: 242008)

Positron emission tomography reporter gene strategy for use in the central nervous system

There is a growing need for monitoring or imaging gene therapy in the central nervous system (CNS). This can be achieved with a positron emission tomography (PET) reporter gene strategy. Here we report the development of a PET reporter gene system using the PKM2 gene with its associated radiotracer [18F]DASA-23. The PKM2 reporter gene was delivered to the brains of mice by adeno-associated virus (AAV9) via stereotactic injection. Serial PET imaging was carried out over 8 wk to assess PKM2 expression. After 8 wk, the brains were excised for further mRNA and protein analysis. PET imaging at 8 wk post-AAV delivery showed an increase in [18F]DASA-23 brain uptake in the transduced site of mice injected with the AAV mice over all controls. We believe PKM2 shows great promise as a PET reporter gene and to date is the only example that can be used in all areas of the CNS without breaking the blood-brain barrier, to monitor gene and cell therapy.

Imaging T Cell Dynamics and Function Using PET and Human Nuclear Reporter Genes.

Adoptive cell transfer immunotherapy has demonstrated significant promise in the treatment of cancer, with long-term, durable responses. T cells expressing T cell receptors (TCRs) that recognize tumor antigens, or engineered with chimeric antigen receptors (CARs) can recognize and eliminate tumor cells even in advanced disease. Positron emission tomography (PET) imaging with nuclear reporter genes, a noninvasive method to track and monitor function of engineered cells in vivo, allows quantitative, longitudinal monitoring of these cells, including their expansion/contraction, migration, retention at target and off-target sites, and biological state. As an additional advantage, some reporter genes also exhibit "suicide potential" permitting the safe elimination of adoptively transferred T cells in instances of adverse reaction to therapy. Here, we describe the production of human nuclear reporter gene-expressing T cells and noninvasive PET imaging to monitor their cell fate in vivo.

Thymidine Kinase PET Reporter Gene Imaging of Cancer Cells In Vivo.

Positron emission tomography (PET) is a three dimensional imaging modality that detects the accumulation of radiolabeled isotopes in vivo. Ectopic expression of a thymidine kinase reporter gene allows for the specific detection of reporter cells in vivo by imaging with the reporter specific probe. PET reporter imaging is sensitive, quantitative and can be scaled into larger tumors or animals with little to no tissue diffraction. Here, we describe how thymidine kinase PET reporter genes can be used to noninvasively image cancer cells in vivo.

Somatostatin receptor type 2 as a radiotheranostic PET reporter gene for oncologic interventions

Reporter gene systems can serve as therapy targets. However, the therapeutic use of reporters has been limited by the challenges of transgene delivery to a majority of cancer cells. This study specifically assesses the efficacy of targeting human somatostatin receptor subtype 2 (hSSTR2) with peptide receptor radionuclide therapy (PRRT) when a small subpopulation of cells bears the transgene.Methods: The hSSTR2 transgene was delivered to A549 and Panc-1tumors using the lentiviral vector, LV-hSSTR2-IRES-GFP or murine mesenchymal stem cells (mMSC)s using a retroviral vector. SSTR2 expression was assessed using Western blot and correlated to GFP fluorescence and 68Ga-DOTATOC uptake. Wild type (WT), transduced (TD), and mixed population A549 or Panc-1 xenografts were implanted in nude mice. Separate groups with A549WT and Panc-1WT tumors received intratumoral injection of SSTR2-expressing mMSCs. Tumor-bearing mice were treated with 90Y-DOTATOC or saline and evaluated with 68Ga-DOTATOC PET before and after treatment.Results: Cell studies showed a strong correlation between 68Ga-DOTATOC uptake and SSTR2 expression in A549 (p < 0.004) and Panc-1 cells (p < 0.01). 68Ga-DOTATOC PET SUVmean was 8- and 5-fold higher in TD compared to WT A549 and Panc-1 tumors, respectively (p < 0.001). After 90Y-DOTATOC treatment, 100% TD and mixed population TD xenografts showed growth cessation while the WT xenografts did not. A549WT and Panc-1WT tumors with SSTR2-expressing mMSCs treated with 90Y-DOTATOC showed significantly lower tumor volumes compared to controls (p < 0.05). 68Ga-DOTATOC PET SUVmean of treated TD tumors monotonically declined and was significantly lower than that of non-treated xenografts.Conclusions: We showed that SSTR2 delivery to a small population of cells in tumor in conjunction with PRRT is effective in tumor growth cessation. The availability of various transgene delivery methods for hSSTR2 and radiotherpaeutic somatostatin analogs highlights the direct translational potential of this paradigm in the treatment of various cancers.

Molecular Imaging of Stem Cells and Exosomes for Myocardial Regeneration

Stem cell therapy is studied for the treatment of ischemic heart disease. Despite high expectations, investigation has yielded mixed results. For further advancement of this field, it is essential to understand the fate of the transplanted stem cells in living subjects. A myriad of tools has been developed to allow for the immediate and longitudinal monitoring of stem cells in vivo. In this review, we outline the most reliable techniques and their implications for cardiac regenerative medicine. Direct (e.g., PET/SPECT, MRI) and indirect labeling (e.g., reporter gene) techniques have existed for decades prior to their use in stem cell imaging. In this review, we describe some of the key developments in the context of stem cell therapy for cardiac ischemia, including new contrast agents (MRI, SPECT) and novel reporter genes (e.g., near-infrared fluorescent protein). Furthermore, we discuss innovative techniques that integrate direct and indirect labeling, such as PET reporter gene systems. Finally, we examine the potential of exosomes, a component of the stem cell secretome, which has recently garnered much attention for its potential in myocardial regeneration, and how they may be imaged in vivo. This review outlines the most reliable techniques for stem cell imaging in cardiac injury animal models, new and notable advancements in the field, and possible directions for cardiac regenerative medicine.

Quantitative PET Reporter Gene Imaging with [11C]Trimethoprim

There is a need for improved methods to image genetically engineered cells, including immune cells used for cell-based therapy. Given the genetic manipulation inherent to gene therapy, the use of a reporter protein is a logical solution and positron emission tomography (PET) can provide the desired sensitivity and spatial localization. We developed a broadly applicable PET imaging strategy based on the small bacterial protein E.coli dihydrofolate reductase (Ec dhfr) and its highly specific small molecule inhibitor, trimethoprim (TMP). The difference in TMP affinity for bacterial compared to mammalian DHFR suggests that a TMP radioligand would have a low background in unmodified mammalian tissues and high retention in Ec dhfr engineered cells, providing high contrast imaging. Here, we describe the invitro properties of [11C]TMP and show over 10-fold increased signal in transgenic Ec dhfr cells compared to control. In a mouse xenograft model, [11C]TMP rapidly accumulated in Ec dhfr carrying cells within minutes of intravenous administration. Moreover, [11C]TMP can identify less than a million xenografted cells in a small volume in tissues other than the abdominal compartment. This limit of detection is a clinically relevant number and bodes well for clinical translation especially given that [11C]TMP is an isotopologue of clinically approved antibiotic.

Multimodality Molecular Imaging of Cardiac Cell Transplantation: Part II. In Vivo Imaging of Bone Marrow Stromal Cells in Swine with PET/CT and MR Imaging.

Purpose To quantitatively determine the limit of detection of marrow stromal cells (MSC) after cardiac cell therapy (CCT) in swine by using clinical positron emission tomography (PET) reporter gene imaging and magnetic resonance (MR) imaging with cell prelabeling. Materials and Methods Animal studies were approved by the institutional administrative panel on laboratory animal care. Seven swine received 23 intracardiac cell injections that contained control MSC and cell mixtures of MSC expressing a multimodality triple fusion (TF) reporter gene (MSC-TF) and bearing superparamagnetic iron oxide nanoparticles (NP) (MSC-TF-NP) or NP alone. Clinical MR imaging and PET reporter gene molecular imaging were performed after intravenous injection of the radiotracer fluorine 18-radiolabeled 9-[4-fluoro-3-(hydroxyl methyl) butyl] guanine ((18)F-FHBG). Linear regression analysis of both MR imaging and PET data and nonlinear regression analysis of PET data were performed, accounting for multiple injections per animal. Results MR imaging showed a positive correlation between MSC-TF-NP cell number and dephasing (dark) signal (R(2) = 0.72, P = .0001) and a lower detection limit of at least approximately 1.5 × 10(7) cells. PET reporter gene imaging demonstrated a significant positive correlation between MSC-TF and target-to-background ratio with the linear model (R(2) = 0.88, P = .0001, root mean square error = 0.523) and the nonlinear model (R(2) = 0.99, P = .0001, root mean square error = 0.273) and a lower detection limit of 2.5 × 10(8) cells. Conclusion The authors quantitatively determined the limit of detection of MSC after CCT in swine by using clinical PET reporter gene imaging and clinical MR imaging with cell prelabeling. (©) RSNA, 2016 Online supplemental material is available for this article.

Multimodality Molecular Imaging of Cardiac Cell Transplantation: Part I. Reporter Gene Design, Characterization, and Optical in Vivo Imaging of Bone Marrow Stromal Cells after Myocardial Infarction.

Purpose To use multimodality reporter-gene imaging to assess the serial survival of marrow stromal cells (MSC) after therapy for myocardial infarction (MI) and to determine if the requisite preclinical imaging end point was met prior to a follow-up large-animal MSC imaging study. Materials and Methods Animal studies were approved by the Institutional Administrative Panel on Laboratory Animal Care. Mice (n = 19) that had experienced MI were injected with bone marrow-derived MSC that expressed a multimodality triple fusion (TF) reporter gene. The TF reporter gene (fluc2-egfp-sr39ttk) consisted of a human promoter, ubiquitin, driving firefly luciferase 2 (fluc2), enhanced green fluorescent protein (egfp), and the sr39tk positron emission tomography reporter gene. Serial bioluminescence imaging of MSC-TF and ex vivo luciferase assays were performed. Correlations were analyzed with the Pearson product-moment correlation, and serial imaging results were analyzed with a mixed-effects regression model. Results Analysis of the MSC-TF after cardiac cell therapy showed significantly lower signal on days 8 and 14 than on day 2 (P = .011 and P = .001, respectively). MSC-TF with MI demonstrated significantly higher signal than MSC-TF without MI at days 4, 8, and 14 (P = .016). Ex vivo luciferase activity assay confirmed the presence of MSC-TF on days 8 and 14 after MI. Conclusion Multimodality reporter-gene imaging was successfully used to assess serial MSC survival after therapy for MI, and it was determined that the requisite preclinical imaging end point, 14 days of MSC survival, was met prior to a follow-up large-animal MSC study. (©) RSNA, 2016 Online supplemental material is available for this article.