First-in-human imaging and kinetic analysis of vesicular acetylcholine transporter density in the heart using [ 18 F]FEO

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Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada The Royal’s Institute of Mental Health Research, Ottawa, ON, Canada Brain Imaging Centre, The Royal’s Institute of Mental Health Research, Ottawa, ON, Canada Montreal Neurological Institute, McGill University, Montreal, QC, Canada Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada University of Ottawa Heart Institute, Ottawa, ON, Canada Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada ´ du Que ´ bec en Outaouais, Department of Psychoeducation and Psychology, Universite Gatineau, QC, Canada Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada

Received Jul 28, 2020; accepted Jul 28, 2020 doi:10.1007/s12350-020-02323-w

In contrast to cardiac sympathetic activity which can be assessed with established PET tracers, there are currently no suitable radioligands to measure cardiac parasympathetic (cholinergic) activity. A radioligand able to measure cardiac cholinergic activity would be an invaluable clinical and research tool since cholinergic dysfunction has been associated with a wide array of pathologies (e.g., chronic heart failure, myocardial infarction, arrythmias). [18F]Fluoroethoxybenzovesamicol (FEOBV) is a cholinergic radiotracer that has been extensively validated in the brain. Whether FEOBV PET can be used to assess cholinergic activity in the heart is not known. Hence, this study aimed to evaluate the properties of FEOBV for cardiac PET imaging and cholinergic activity mapping. PET data were collected for 40 minutes after injection of 230 ± 50 MBq of FEOBV in four healthy participants (1 female; Age: 37 ± 10; BMI: 25 ± 2). Dynamic LV time activity curves were fitted with Logan graphical, 1-tissue compartment, and 2-tissue compartment models, yielding similar distribution volume estimates for each participant. Our initial data show that FEOBV PET has favorable tracer kinetics for quantification of cholinergic activity and is a promising new method for assessing parasympathetic function in the heart. Key Words: Tracer development Æ molecular imaging agents Æ PET Æ molecular imaging Æ innervation tracers

Reprint requests: Zacharie Saint-Georges, BSc, BA, Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada; [email protected] J Nucl Cardiol 1071-3581/$34.00 Copyright Ó 2020 The Author(s)

Sympathetic and parasympathetic systems in the heart are critical for adequate cardiac function. While sympathetic innervation of the heart is assessed routinely with positron emission tomography (PET) radiopharmaceuticals mimicking norepinephrine,1 there are currently no suitable radioligands to measure cardiac

Saint-Georges et al First-in-human cardiac imaging using [18F]FEOBV

cholinergic (parasympathetic) activity. The human heart has both neuronal and non-neuronal cholinergic systems that account for cardiac parasympathetic activity.2,3 Failure of these cholinergic systems underli